Is stroke mortality on the decline in England?

Area of Science:

• Epidemiology
• Public Health
• Gerontology

Background:

• Assumptions of constant or declining stroke mortality are challenged.
• Stroke mortality is influenced by period effects (time of death) and cohort effects (birth generation).

Purpose of the Study:

• To analyze age-specific stroke death rates in England and Wales (1931-1985).
• To estimate the influence of age, period, and cohort effects on stroke mortality.
• To predict future stroke incidence trends.

Main Methods:

• Analysis of age-specific stroke mortality data from England and Wales (1931-1985).
• Cohort analysis to identify trends in mortality rates across different birth cohorts.
• Sex-stratified analysis to compare effects between males and females.

Main Results:

• Significant age, period, and cohort effects were observed for stroke mortality.
• Age effects were linear, increasing with age in both sexes.
• Mortality rates for cohorts born after 1880 showed deceleration, followed by acceleration for those born after 1910.
• Period effects from 1951-1954 showed deceleration, partially offsetting cohort risks.

Conclusions:

• Cohort effects suggest a lifetime increase in stroke mortality risk for certain generations.
• Predicting long-term declines in stroke incidence is difficult due to competing period and cohort influences.
• Future stroke mortality trends require careful consideration of generational risk factors.