Cause-specific mortality, life expectancy, and debilitation in aging polynesians.

Between 1950 and 1980 life expectancy among middle-aged American Samoan men increased 22%; among women it increased 36%. The largest proportional increase were observed after age 65% Men 29%, women 118%. This study examined whether increasing longevity health of older Samoans. Cause-specific mortality data were used to calculate multiple decrement life tables for American Samoa by decades for both sexes from 1950 to 1979. Changes in two life table parameters were examined: The probability of dying from, and the remaining life expectancy among persons who would eventually die from, pneumonia/influenza, infections, cancer, or cardiovascular disease (CVD) after birth and after age 45. Pneumonia and infections may indicate frailty or delibitration in older individuals. The probability of dying from a specific cause after a particular age reflects its relative importance for survivors to that age. Residual life expectancy indicates whether older individuals are succumbing at earlier ages or surviving longer the risks of death from specific causes. Trends in the probability of dying from, and life expectancy among those ultimately dying from, pneumonia and infections did not suggest improved survival of debilitated individuals. Rather, they indicated that older Samoans may have had greater average resistance to pneumonia and infections in later cohorts. How much this was related to improved medical care and availability was not clear from the available data. However, Samoans who died from CVD and cancer did not survive longer than their counterparts had in earlier decades. Thus, there was little opportunity for an increase in debilitation among aging Samoans due to the longer-term survival of the chronically ill.