Marek Bryła

Self-rated quality of life of city-dwelling elderly people benefitting from social help: results of a cross-sectional study

BackgroundThe percentage of people aged 65 or older living in Poland is 13.6%, but 17.2% in Łódź. The aim of the study was to identify factors correlating with the self-rated quality of life of elderly inhabitants of cities applying for social help, on the basis of a cross-sectional study.MethodsThe study was conducted in Łódź, a large Polish city, between September 2011 and February 2012 in a group of people applying for help in the Municipal Social Welfare Centre. Four hundred and sixty-six respondents aged 65 or older were included in the study. The tool used in the study was an interview questionnaire. The respondents answered questions on their demographic situation, living conditions, financial, health and social situation. The authors also applied the WHOQOL-BREF Questionnaire, the Activities of Daily Living Scale (ADL) and the Geriatric Depression Scale (GSOD). For statistical purposes, the authors used single- and multiple-factor regression and the Statistica 9.0 Program. The results were presented as an odds ratio (OR) with a 95% confidence interval (CI); the adopted significance level was p < 0.05. The authors applied the Pearson’s x2 test in order to evaluate the structure of the studied group and the subpopulation, who were aged 65 or older and using social help, throughout the city.ResultsLogistic regression confirmed that a high quality of life depends on the following variables: university education (OR = 2.31; p < 0.05), an income which is sufficient to live (OR = 1.63; p < 0.05), no heart palpitations (OR = 2.32; p < 0.05), stable blood pressure (OR = 2.32; p < 0.05), no headaches (OR = 1.55; p < 0.05), no pain in the chest (OR = 1.51; p < 0.01), no shortness of breath (OR = 1.51; p < 0.01), no tiredness (OR = 2.08; p < 0.05), a score on the Geriatric Depression Scale pointing to a lack of suspected depression (OR = 9.88; p < 0.001 if the person does not suffer from depression and OR = 6.33; p < 0.001 if there is uncertain depression) as well as not using nursing services, a score on the ADL Scale confirming the person’s fitness and participation in family gatherings.ConclusionsA subjective evaluation of the quality of life of the elderly depends on many factors. An identification of these factors might be helpful in implementing steps aimed at improving the quality of life of elderly people who, as a consequence, will need less social help: particularly nursing services.

Factors associated with self-rated health (SRH) of a University of the Third Age (U3A) class participants

INTRODUCTION A U3A is a way of making elderly people active. Our study aims to investigate the association between socioeconomic variables, selected symptoms, disorders and the SRH of participants of classes at the U3A. MATERIALS AND METHODS The study was conducted in 2011 in a group of participants of classes at the U3A in Plock, Poland. The authors examined 250 people aged 60 or older. A survey questionnaire was the study tool. Statistica 9.0. was used for statistical analysis, including ordinal regression models. RESULTS Being younger (65-69) increases the chance of returning a good SRH score to over five times compared to being 75 and over (odds ratio (OR)=5.30, confidence interval (CI)=1.76-15.97), p<0.01). The chance of a good SRH score is almost four times more likely in subjects with a disposable income which satisfies basic needs compared to that which does not (OR=3.97, CI=1.12-14.04, p<0.05). Furthermore, lack of symptoms and disorders have a strong influence on good SRH (no leg edema - OR=4.06, CI=1.63-10.12, p<0.01; no headache - OR=2.75, CI=1.34-5.62, p<0.01; no toothache - OR=4.32, CI=1.12-16.68, p<0.05; no hypertension - OR=1.78, CI=1.02-3.14, p<0.05; no degenerative disease - OR=1.88, CI=1.08-3.27, p<0.05). Feeling happy raised the chance of reporting good SRH by almost three times (OR=2.91, CI=1.35-6.27, p<0.01). CONCLUSIONS A subjective evaluation of health by the elderly constitutes an important indicator of their health and quality of life. It can become a basis for implementing activities of gerontological prophylaxis and leveling out health inequalities.

The burden of premature mortality in Poland analysed with the use of standard expected years of life lost.

BackgroundDespite positive changes in the health of the population of Poland, compared to the EU average, the average life expectancy in 2011 was 5 years shorter for males and 2.2 years shorter for females. The immediate cause is the great number of premature deaths, which results in years of life lost in the population. The aim of the study was to identify the major causes of years of life lost in Poland.MethodsThe analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 375,501 death certificates of inhabitants of Poland who died in 2011. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (SEYLL per death) measures were calculated to determine years of life lost.ResultsIn 2011, the total number of years of life lost by in Polish residents due to premature mortality was 2,249,213 (1,415,672 for males and 833,541 for females). The greatest number of years of life lost in males were due to ischemic heart disease (7.8 per 1,000), lung cancer (6.0), suicides (6.6), cerebrovascular disease (4.6) and road traffic accidents (5.4). In females, the factors contributing to the greatest number of deaths were cerebrovascular disease (3.8 per 1,000), ischemic heart disease (3.7), heart failure (2.7), lung cancer (2.5) and breast cancer (2.3). Regarding the individual scores per person in both males and females, the greatest death factors were road traffic accidents (20.2 years in males and 17.1 in females), suicides (17.4 years in males and 15.4 in females) and liver cirrhosis (12.1 years in males and 11.3 in females).ConclusionsIt would be most beneficial to further reduce the number of deaths due to cardiovascular diseases, because they contribute to the greatest number of years of life lost. Moreover, from the economic point of view, the most effective preventative activities are those which target causes which result in a large number of years of life lost at productive age for each death due to a particular reason, i.e. road traffic accidents, suicides and liver cirrhosis.

Years of life lost due to external causes of death in the lodz province, Poland

Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

Determinants of premature mortality in a city population: An eight-year observational study concerning subjects aged 18–64

BackgroundPremature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures.Material and MethodsIn 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health — HR = 3.096 (95% CI: 1.729–5.543), poor financial situation — HR = 2.811 (95% CI: 1.183–6.672), occurring in the year preceding the study: coronary pain — HR = 2.754 (95% CI: 1.167–6.494), depression — HR = 2.001 (95% CI: 1.222–3.277) and insomnia — HR = 1.660 (95% CI: 1.029–2.678). Our research study also found a negative influence of smoking on the health status — HR = 2.782 (95% CI: 1.581–4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves.ConclusionsThe risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases.

Standard expected years of life lost due to tuberculosis in Poland

SETTING Central European countries such as Poland have higher tuberculosis (TB) morbidity and mortality than Western European Union countries. OBJECTIVE To evaluate changes in mortality due to TB during the period 1999-2012 in Poland and years of life lost due to the disease. DESIGN Information obtained from 5 219 205 death certificates in Poland during the period 1999-2012 was used for the study. Crude (CDRs) and standardised (SDRs) death rates due to TB were analysed. Standard expected years of life lost per living person (SEYLLp) was also calculated. RESULTS In Poland, TB and related complications contributed 0.23% of total deaths from 1999 to 2012. The SEYLLp was 3.46 per 10 000 population in 1999 and 1.88 in 2012. It was respectively 5.75 and 3.12 for males, and 1.31 and 0.72 for females. The SEYLLp index decreased over the period (annual per cent change [APC] -4.27%, P < 0.05); the decrease was greater in females than in males (APC -4.75%, P < 0.05 vs. APC -4.15%, P < 0.05). CONCLUSION Despite an improvement in the epidemiological situation, TB remains the most common single cause of death due to an infectious agent in Poland.

Years of Life Lost Due to Premature Mortality in a Province with the Shortest Life Expectancy in Poland

AIM The aim of the study was to evaluate years of life lost for citizens of the Lodz Province, which is characterized by the lowest life expectancy in Poland, and to identify current trends in this area according to the most common causes of death. METHODS The study material included a database containing information gathered from 470,000 death certificates of Lodz Province inhabitants, who died between 1999 and 2011. In order to calculate years of life lost, the authors applied the SEYLLp (Standard Expected Years of Life Lost per living person) and SEYLLd (per death) indices. The analysis of time trends was carried out with the application of joinpoint models. RESULTS The SEYLLp measure was 2,300 years per 10,000 males and 1,500 years per 10,000 females in 2011. Cardiovascular diseases contributed to the highest number of years of life lost (SEYLLp=682 years per 10,000 males and 559 years per 10,000 females). Next were malignant neoplasms (SEYLLp=505 years per 10,000 males and 437 years per 10,000 females), external causes of death (SEYLLp=361 years per 10,000 males and 83 years per 10,000 females). The number of years of life lost due to acute myocardial infarction decreased most rapidly, the Annual Percent Change (APC) was -10.1% in males and -3.7% in females. However, heart failure contributed to the highest increase in the number of years of life lost (APC=10.8% in males and 10.9% in females). CONCLUSIONS A further decrease in the mortality rate due to cardiovascular diseases might contribute to the highest reduction of years of life lost. The most effective preventive activities are those aimed at reducing productive years of life lost due to a particular cause of death, i.e. road traffic accidents, suicides, cirrhosis of the liver, alcoholic liver disease, and malignant neoplasms of the trachea, bronchi and lungs.

Educational inequalities in premature mortality in Poland, 2002-2011: a population-based cross-sectional study.

Background The aim of the study is to evaluate the differences in premature mortality between educational groups of Polish inhabitants in 2002 and 2011. Methods The analysis included all deaths among inhabitants of Poland, aged 25–64 years, which occurred in 2002 (N=97 004) and 2011 (N=104 598). We calculated age-standardised death rates (SDRs) and summary measures on inequalities. The relative index of inequality (RII) was calculated with Poisson regression. Results The SDR for Poland decreased from 285.7 per 100 000 in 2002 to 246.0 in 2011 among males with higher education and increased from 1141.0 in 2002 to 1183.0 in 2011 among males with lower secondary or less education (the rate ratio increased from 4.0 to 4.8). With regard to females with higher education, the SDR decreased from 127.2 per 100 000 in 2002 to 115.6 in 2011. Among females with lower secondary or less education, the SDR increased from 375.8 per 100 000 in 2002 to 423.1 in 2011 (the rate ratio increased from 3.0 to 3.7). The RII increased from 5.8 to 9.7 in the male group and from 4.4 to 8.3 in the female group. The greatest educational inequalities in 2011 were observed in females who died of cardiovascular diseases (RII=14.9) and lung cancer (RII=6.6) and in males who died of suicides (RII=19.3) and lung cancer (RII=11.9). Conclusions Educational inequalities in premature mortality in Poland are growing. There is a need to implement health education programmes targeted at groups of the most poorly educated Polish inhabitants, especially for diseases resulting from smoking and excessive alcohol consumption.

Years of life lost due to infectious diseases in Poland

Purpose An evaluation of mortality due to infectious diseases in Poland in 1999–2012 and an analysis of standard expected years of life lost due to the above diseases. Methods The study material included a database created on the basis of 5,219,205 death certificates of Polish inhabitants, gathered between 1999 and 2012 and provided by the Central Statistical Office. Crude Death Rates (CDR), Standardized Death Rates (SDR) and Standard Expected Years of Life Lost (SEYLL) due to infectious and parasitic diseases were also evaluated in the study period as well as Standard Expected Years of Life Lost per living person (SEYLLp) and Standard Expected Years of Life Lost per dead person (SEYLLd). Time trends were evaluated with the application of joinpoint models and an annual percentage change in their values. Results Death certificates report that 38,261 people died due to infectious diseases in Poland in the period 1999–2012, which made up 0.73% of the total number of deaths. SDR caused by these diseases decreased, particularly in the male group: Annual Percentage Change (APC = -1.05; 95% CI:-2.0 to -0.2; p<0.05). The most positive trends were observed in mortality caused by tuberculosis (A15-A19) (APC = -5.40; 95% CI:-6.3 to -4.5; p<0.05) and also meningitis, encephalitis, myelitis and encephalomyelitis (G03-G04) (APC = -3.42; 95% CI:-4.7 to -2.1; p<0.05). The most negative mortality trends were observed for intestinal infectious diseases (A00-A09) Annual Average Percentage Change (AAPC = 7.3; 95% CI:3.1 to 11.7; p<0.05). SDR substantially decreased in the first half of the study period, but then significantly increased in the second half. Infectious and parasitic diseases contributed to a loss of around 37,000 standard expected years of life in 1999 and more than 28,000 in 2012. During the study period, the SEYLLp index decreased from 9.59 to 7.39 per 10,000 population and the SEYLLd index decreased from 14.26 to 10.34 years (AAPC = 2.3; 95% CI:-2,9 to -1.7; p<0.05). Conclusions Despite smaller numbers of deaths reported from infectious causes these diseases still represent a serious problem for Poland compared to countries in Western Europe.

Years of Life Lost Due to Bronchial Asthma in Poland Between 1999–2013

ABSTRACT Objective: The aim of this study was to analyze the years of life lost due to asthma in Poland between 1999 and 2013, with the use of the SEYLL measure (Standard Expected Years of Life Lost). Methods: The study was based on a dataset of 5,606,516 records gathered from death certificates of Polish residents from 1999 to 2013. The data on the deaths due to bronchial asthma and status asthmaticus (J45 and J46 according to ICD-10) were used for the analysis. The SEYLL, SEYLLp (SEYLL per person) and SEYLLd (SEYLL per death) were implemented to assess lost life years. The analysis of time trends was performed with the use of the join point model. Results: In 1999–2013, asthma and status asthmaticus were the cause of 11,380 deaths of Poles (0.20% of all deaths), resulting in 4.23 prematurely lost life years per 10,000 males and 3.22 years per 10,000 females. Over the analyzed years, the value of SEYLL decreased both for men and women. Every man who died due to bronchial asthma in Poland in the studied period, lost on average 19.12 years of life, and every woman 18.20 years. Conclusions: The analysis of SEYLL indicated that premature mortality due to asthma is still a meaningful problem in the Polish population and a constant challenge for public health activities.