Analysis of age-period-cohort effect on mortality due to cerebrovascular diseases in Maceió and Florianópolis, Brazil

Lima, Fernanda Cristina da Silva de; Martins, Wolney de Andrade; Rosa, Maria Luiza Garcia; Nunes, Samon Henrique

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Sumário

ARTIGO ORIGINAL • Cad. saúde colet. 30 (3) • Jul-Sep 2022 • https://doi.org/10.1590/1414-462X202230030233 copy

Analysis of age-period-cohort effect on mortality due to cerebrovascular diseases in Maceió and Florianópolis, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

Cerebrovascular disease (CBVD) is the second leading cause of death in the world and Brazil.

Objective

To evaluate trends in mortality from CBVD in two Brazilian cities (Maceió and Florianópolis) with extreme socioeconomic differences, between 1981 and 2016, estimating the age, cohort effect.

Method

Study of CBVD mortality time series in individuals aged ≥40 years, using the Age, Period, Cohort (APC) analysis and the Web tool.

Results

CBVD mortality decreased with time, increased with age and was lower for younger generations. The effect was the same for both sexes. There was a decrease in mortality in both cities, but the difference was large, and mortality remains high in Maceió. Based on the amplitude of the estimated effects, it was possible to verify that the cohort effect was the most significant term to explain the temporal variability of mortality rates due to CVD in the period.

Conclusion

The comparison of the time trend in the two cities showed the importance of improving living conditions, access to health services for the prevention and control of risk factors, as well as hospital care for cases to reduce mortality from CVD nationwide.

Keywords:
cerebrovascular diseases; mortality; time trends; epidemiology

Período	Maceió				Florianópolis
Período	Masculino	IC 95% ^*	Feminino	IC 95%*	Masculino	IC 95%*	Feminino	IC 95%*
1981-1985	1,42	(1,29;1,58)	1,72	(1,47;2,00)	2,12	(1,69;2,66)	2,22	(1,85;2,67)
1986-1990	1,22	(1,11;1,34)	1,31	(1,14;1,51)	1,63	(1,32;2,01)	1,39	(1,16;1,66)
1991-1995	1,34	(1,23;1,46)	1,45	(1,28;1,65)	1,35	(1,10;1,65)	1,33	(1,13;1,56)
1996-2000	1	-	1	-	1	-	1	-
2001-2005	0,87	(0,80;0,94)	0,88	(0,77;0,99)	0,73	(0,59;0,89)	0,71	(0,61;0,84)
2006-2010	0,66	(0,61;0,72)	0,61	(0,54;0,70)	0,55	(0,45;0,68)	0,49	(0,41;0,58)
2011-2015	0,57	(0,52;0,62)	0,51	(0,45;0,58)	0,41	(0,33;0,5)	0,39	(0,33;0,47)
Coorte	Maceió				Florianópolis
Coorte	Masculino	IC 95%*	Feminino	IC 95%*	Masculino	IC 95%*	Feminino	IC 95%*
1901	2,22	(1,82;2,71)	2,70	(2,09;3,49)	4,10	(2,70;6,22)	4,20	(3,20;5,51)
1906	2,23	(1,94;2,57)	3,45	(2,86;4,17)	3,69	(2,69;5,06)	4,81	(3,84;6,04)
1911	2,23	(1,99;2,50)	2,65	(2,24;3,15)	3,97	(3,06;5,15)	3,64	(2,94;4,51)
1916	1,66	(1,48;1,85)	2,11	(1,79;2,49)	2,92	(2,28;3,74)	3,03	(2,47;3,73)
1921	1,50	(1,35;1,65)	1,78	(1,52;2,08)	2,37	(1,86;3,00)	2,41	(1,97;2,96)
1926	1,27	(1,15;1,40)	1,54	(1,33;1,79)	1,67	(1,32;2,12)	1,80	(1,48;2,20)
1931	1,14	(1,03;1,25)	1,27	(1,10;1,47)	1,28	(1,02;1,60)	1,43	(1,18;1,74)
1936	1	-	1	-	1	-	1	-
1941	0,83	(0,75;0,92)	0,86	(0,73;1,01)	0,76	(0,59;0,98)	0,66	(0,52;0,85)
1946	0,78	(0,70;0,87)	0,67	(0,56;0,81)	0,57	(0,42;0,76)	0,50	(0,38;0,66)
1951	0,57	(0,51;0,65)	0,52	(0,43;0,65)	0,37	(0,27;0,52)	0,37	(0,27;0,50)
1956	0,41	(0,35;0,48)	0,39	(0,30;0,50)	0,31	(0,21;0,45)	0,28	(0,19;0,40)
1961	0,38	(0,31;0,46)	0,33	(0,24;0,46)	0,23	(0,14;0,36)	0,18	(0,11;0,29)
1966	0,36	(0,28;0,46)	0,29	(0,20;0,44)	0,18	(0,09;0,35)	0,19	(0,11;0,34)
1971	0,37	(0,25;0,53)	0,23	(0,13;0,43)	0,10	(0,03;0,34)	0,29	(0,13;0,64)

Instituto de Estudos em Saúde Coletiva da Universidade Federal do Rio de Janeiro Avenida Horácio Macedo, S/N, CEP: 21941-598, Tel.: (55 21) 3938 9494 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@iesc.ufrj.br

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[1] Correspondência: Fernanda Cristina da Silva de Lima. E-mail: fernandacri2005@hotmail.com