News Release

Mortality of older people in Latin America, India and China: Causes and prevention

Stroke is the leading cause of death in people over 65 in low- and middle-income countries, finds new research

Peer-Reviewed Publication

King's College London

King's College London press release

Stroke is the leading cause of death in people over 65 in low- and middle-income countries, according to new research published this week. Deaths of people over 65 represent more than a third of all deaths in developing countries yet, until now, little research has focused on this group. The study was led by researchers King's College London and is published in PLoS Medicine. The study also finds that education and social protection are as important in prolonging people's lives as economic development.

Professor Martin Prince, who led the study from the 10/66 Dementia Research Group at the Institute of Psychiatry at King's says: 'Chronic diseases are rapidly replacing communicable diseases as the leading cause of mortality and disability in developing countries. Since stroke is the leading cause of death in older people, and education is a strong protective factor, prevention may be possible, adding years to life and life to years.

Professor Prince, who is also co-director of London's Centre for Global Mental Health (CGMH), adds: 'The current global health chronic disease agenda is largely focused on reducing mortality among working age adults. The concept of 'premature mortality' applied in such cases, is essentially ageist. I hope our findings will help highlight the lack of information about end of life among older people in developing countries, both regarding potential for prevention, and support and care of the dying, who, in the poorest settings, may not receive timely or effective medical intervention.'

In 2005, deaths of people aged 60 and over accounted 61 percent of all deaths in middle-income countries, and 33 percent in low-income countries, compared to 84 percent in high-income countries, yet there has been little research into the causes and determinants of these deaths.

Researchers surveyed 12,373 people aged 65 and over between 2003 and 2005 in a total of 10 urban and rural sites in Cuba, the Dominican Republic, Venezuela, Peru, Mexico, China and India, documenting over 2,000 deaths over a three to five year follow-up period.

Chronic diseases – particularly stroke, heart disease and diabetes – were the leading causes of death in all sites other than rural Peru. Overall, stroke was the most common cause of death (21.4 percent), ranking first in all sites other than rural Peru and rural Mexico. The authors found that education, more than occupational status and wealth in late-life, had a strong effect in reducing mortality risk in later life.

Most deaths occurred at home, with a particularly high proportion in rural China (91 percent), India (86 percent), and rural Mexico (65 percent). Other than in India, most received medical care for their final illness, but this was usually at home rather than in the hospital or clinic.

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The 10/66 Dementia Research Group's research has been funded by the Wellcome Trust Health Consequences of Population Change Programme, the World Health Organisation, the US Alzheimer's Association with support from the Rockefeller Foundation and Alzheimer's Disease International.

CONTACT
Katherine Barnes
International Press Officer
King's College London
Tel: +44 207 848 3076
Email: katherine.barnes@kcl.ac.uk

NOTES TO EDITORS

Ferri, C. et al. 'Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study', PLoS Medicine

About King's College London (www.kcl.ac.uk)

King's College London is one of the top 30 universities in the world (2011/12 QS international world rankings), and was The Sunday Times 'University of the Year 2010/11', and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,500 students (of whom more than 9,000 are graduate students) from nearly 140 countries, and some 6,000 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £525 million (year ending 31 July 2011).

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.

The College is in the midst of a five-year, £500 million fundraising campaign – World questions|King's answers – created to address some of the most pressing challenges facing humanity as quickly as feasible. The campaign's three priority areas are neuroscience and mental health, leadership and society, and cancer. More information about the campaign is available at www.kcl.ac.uk/kingsanswers.


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