Predictors of death and vascular events in the elderly - The Perth Community Stroke Study

Background and Purpose-The goal of the present study was to identify risk f actors for vascular disease in the elderly. Methods-We conducted a prospective study of control subjects from a populat ion-based study of stroke in Perth, Western Australia, that was completed i n 1989 to 1990 and used record linkage and a survey of survivors to identif y deaths and nonfatal vascular events. Data validated through reference to medical records were analyzed with the use of Cox proportional hazards mode ls. Results-Follow-up for the 931 subjects was 88% complete. By June 24, 1994, 198 (24%) of the subjects had died (96 from vascular disease), and there ha d been 45 nonfatal strokes or myocardial infarctions. The hazard ratio for diabetes exceeded 2.0 for all end points, whereas the consumption of meat > 4 times weekly was associated with a reduction in risk of less than or equa l to 30%. In most models, female sex and consumption of alcohol were associ ated with reduced risks, whereas previous myocardial infarction was linked to an increase in risk. Conclusions-There are only limited associations between lifestyle and major vascular illness in old age. Effective health promotion activities in earl y and middle life may be the key to a longer and healthier old age.