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Population-Based Analysis of Incidence Rates of Cancer and Noncancer Chronic Diseases in the US Elderly Using NLTCS/Medicare-Linked Database

DOI: 10.1155/2013/943418

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Abstract:

The age, disability, and comorbidity patterns of incidence rates of cancer and chronic noncancer diseases such as heart failure, diabetes mellitus, asthma, Parkinson's disease, Alzheimer's disease, skin melanoma, and cancers of breast, prostate, lung, and colon were studied for the US elderly population (aged 65+) using the National Long-Term Care Survey (NLTCS) data linked to Medicare records for 1991–2005. Opposite to breast cancer and asthma, incidence rates of heart failure and Alzheimer's diseases were increasing with age. Higher incidence rates of heart failure, diabetes, asthma, and Parkinson's and Alzheimer's diseases were observed among individuals with severe disabilities or/and comorbidities, while rates of breast and prostate cancers were higher among those with minor disabilities or fewer comorbidities. Our results were in agreement with those obtained from other epidemiological datasets, thus suggesting that Medicare administrative records can provide nationally representative incidence rates. Detailed sensitivity analysis that focused on the effects of alternative onset definitions, latent censoring, study design, and other procedural uncertainties showed the stability of reconstructed incidence rates. This Medicare-linked dataset can be used for studying highly debated effects of new medical technologies on aging-related diseases burden and future Medicare costs. 1. Introduction The proportion of the elderly population in USA is constantly growing. That prioritizes the task of determining the national trends in health and vital status of older adults making it a major public health concern. To better address these health demands and to reduce economic burdens on society, it is important to understand the key factors driving the onset and progression of aging-related chronic diseases in humans. Unfortunately, the identification of disease age patterns with sufficient precision requires large population-based databases that are costly to collect. This is a reason why the studies on disease age patterns, along with investigations of factors affecting them, are not common in the US elderly population. Among aging-associated diseases, cancer incidences are better studied at a national level, predominantly due to the existence of the Surveillance Epidemiology and End Results (SEER) Registry data [1]. Age patterns of incidence of cardiovascular, cerebrovascular, and neurodegenerative diseases in general population and in oldest adults were recently studied using the Cardiovascular Health Study (CHS) data [2, 3]. However, this database is not

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