[PMID]: | 26768386 |
[Au] Autor: | Washington DL; Bird CE; LaMonte MJ; Goldstein KM; Rillamas-Sun E; Stefanick ML; Woods NF; Bastian LA; Gass M; Weitlauf JC |
[Ad] Endereço: | VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, California. University of California Los Angeles, Geffen School of Medicine. donna.washington@va.gov. |
[Ti] Título: | Military Generation and Its Relationship to Mortality in Women Veterans in the Women's Health Initiative. |
[So] Source: | Gerontologist;56 Suppl 1:S126-37, 2016 Feb. |
[Is] ISSN: | 1758-5341 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | PURPOSE OF THE STUDY: Women's military roles, exposures, and associated health outcomes have changed over time. However, mortality risk-within military generations or compared with non-Veteran women-has not been assessed. Using data from the Women's Health Initiative (WHI), we examined all-cause and cause-specific mortality by Veteran status and military generation among older women. DESIGN AND METHODS: WHI participants (3,719 Veterans; 141,802 non-Veterans), followed for a mean of 15.2 years, were categorized into pre-Vietnam or Vietnam/after generations based on their birth cohort. We used cox proportional hazards models to examine the association between Veteran status and mortality by generation. RESULTS: After adjusting for sociodemographic characteristics and WHI study arm, all-cause mortality hazard rate ratios (HRs) for Veterans relative to non-Veterans were 1.16 (95% CI: 1.09-1.23) for pre-Vietnam and 1.16 (95% CI: 0.99-1.36) for Vietnam/after generations. With additional adjustment for health behaviors and risk factors, this excess mortality rate persisted for pre-Vietnam but attenuated for Vietnam/after generations. After further adjustment for medical morbidities, across both generations, Veterans and non-Veterans had similar all-cause mortality rates. Relative to non-Veterans, adjusting for sociodemographics and WHI study arm, pre-Vietnam generation Veterans had higher cancer, cardiovascular, and trauma-related morality rates; Vietnam/after generation Veterans had the highest trauma-related mortality rates (HR = 2.93, 1.64-5.23). IMPLICATIONS: Veterans' higher all-cause mortality rates were limited to the pre-Vietnam generation, consistent with diminution of the healthy soldier effect over the life course. Mechanisms underlying Vietnam/after generation Veteran trauma-related mortality should be elucidated. Efforts to modify salient health risk behaviors specific to each military generation are needed. |
[Mh] Termos MeSH primário: |
Doenças Cardiovasculares/mortalidade Neoplasias/mortalidade Veteranos/estatística & dados numéricos Ferimentos e Lesões/mortalidade
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[Mh] Termos MeSH secundário: |
Idoso Efeito de Coortes Feminino Seres Humanos Guerra da Coreia Estudos Longitudinais Meia-Idade Modelos de Riscos Proporcionais Estados Unidos Guerra do Vietnã II Guerra Mundial
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; OBSERVATIONAL STUDY |
[Em] Mês de entrada: | 1701 |
[Cu] Atualização por classe: | 170117 |
[Lr] Data última revisão:
| 170117 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 160116 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1093/geront/gnv669 |
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