Læknablaðið : fylgirit - 01.03.1983, Page 95
For each of these persons a younger control person was selected
according to the following guidelines:
1) Autopsy performed in the same year.
2) Same sex.
3) Same place of death.
4) A control person should be 70 years old or younger. The age was
matched such that the control person was as many year younger than
80 as the older person's age exceeded 80. This was estimated to be
a large enough separation in years for adequate comparison.
The diagnoses were analysed according to the standard international
rules for classification of medical certification with regard to
intervening cause of death, underlying cause of death and other
significant conditions contributing to the death but not related to
the disease or condition causing it (5).
From each of these 200 autopsy reports, information about four
diseases was also extracted:
1) Coronary heart disease.
2) Gallstones.
3) Diverticulosis of the colon.
4) Dementia.
Coronary atherosclerosis was classified as follows: No disease,
mild (stenosis <50%), moderate (stenosis<50%>75%), and severe
(stenosis > 75%) .
Pathological changes in the myocardium indicating recent or old
infarcts or interstitial fibrosis were recorded.
Dementia was assessed from the clinical summaries included in the
autopsy reports.
Results
Most deaths in Iceland take place in hospitals. As shown in table 1,
30% of the nonagenerian group died in residential homes. Fewer
deaths in the control group happened in residential homes.
Table 2 shows a comparison of the underlying causes of death. In
the nonagenerian group fewer deaths occured from ischemic heart
disease and neoplasm but more deaths from respiratory diseases,
strokes, urogenital diseases and accidents. When compared with the
national mortality statistics only neoplasm rank higher in the two
groups (6).
Table 3 shows the distribution of neoplasms in the two groups. As
an underlying cause of death, colorectal cancer occured more
frequently in the nonagenerian group and breast cancer in the
control group, but these figures are small.
Intervening diseases are shown on table 4. Nonagenerians died more
frequently from complications to the underlying cause of death.
Far the commonest were pneumonias which occured in 52 and 36 per
cent of cases respectively.
Table 5 shows that other significant disorders are found more often
among nonagenerians at autopsy. Aortic stenosis, malignant neo-
plasms and organic brain diseases have the highest prevalence.
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