Impact of smoking, diabetes and hypertension on survival time in the elderly: the Dubbo Study

Leon A Simons, Judith Simons, John McCallum and Yechiel Friedlander
Med J Aust 2005; 182 (5): 219-222.


Objective: To study the impact of various risk factors on survival time in a cohort of elderly Australians.

Design, setting and participants: A longitudinal, prospective cohort study conducted in Dubbo, NSW. Participants were men and women aged 60 years or over living in the community, first assessed in 1988–1989 and followed for 15 years.

Main outcome measures: Mortality rates; risk factors; survival times.

Results: There were 668 deaths in 1233 men (54%) and 625 deaths in 1572 women (40%). Coronary heart disease was the major cause of death, rates being higher in men than women until age group 80+ years; stroke death rates were similar in both sexes; cancer and respiratory death rates were higher in men than women across all ages. In a proportional hazards model, the independent predictors of mortality were cigarette smoking, diabetes, very high blood pressure (BP), impaired peak expiratory flow (PEF), physical disability, and zero intake of alcohol. Over 15 years, the average reductions in survival time associated with various risk factors, in men and women respectively, were smoking, 22 and 15 months; diabetes, 18 and 18 months; very high BP, 16 and 9 months; impaired PEF, 14 and 17 months; physical disability, 16 and 12 months; zero alcohol intake, 9 and 5 months. Combinations of selected risk factors were associated with a multiplier effect.

Conclusion: The reduction in survival time in elderly citizens demonstrated in the presence of smoking, diabetes and hypertension highlights a potential benefit to healthy ageing to be gained from prevention and intervention.

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  • Leon A Simons1
  • Judith Simons2
  • John McCallum3
  • Yechiel Friedlander4

  • 1 Lipid Research Department, University of New South Wales at St Vincent’s Hospital, Darlinghurst, NSW.
  • 2 Victoria University, Footscray, VIC.
  • 3 Department of Social Medicine, Hebrew University-Hadassah Hospital, Jerusalem, Israel.



We acknowledge the work of our Dubbo nurse manager, Mrs Lyn Dallinger, and her predecessors in collecting the data used here. The Dubbo Study is currently funded by the Australian Research Council and has received past support from the National Health and Medical Research Council and the pharmaceutical industry. The funding bodies have made no input into the design and conduct of the study, nor to the reporting of the findings.

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