Prognosis of risk factors and trends in mortality from external causes among middle-aged men in Lithuania

Aims: The aims of this study were to investigate the risk of death and time trends from external causes, and to evaluate the significance of the effects of age, period and birth cohort on suicide mortality among middle-aged men during the period 1971 - 2000 in Lithuania. Methods: Random samples of men aged 45 - 59 years from the Kaunas Rotterdam Intervention Study ( conducted in 1972 - 74) and Study of Multifactorial Prevention of CHD ( conducted in 1977 - 80) were examined ( n = 6,480). The participants of the two surveys were observed until 1 January 2001. Over this time 2,841 men had died, 230 of these from external causes. The Cox proportional hazards model was used to evaluate the risk of death from external causes. Trends in mortality from external causes and average annual changes were based on logarithmic regression analysis. For assessment of the effects of age, period, and birth cohort the Poisson regression model was applied. Results: The risk of mortality from external causes among men was positively related to smoking habits and arterial hypertension and negatively related to education level and total serum cholesterol concentration but there was no association with consumption of alcohol. The risk of suicide mortality was associated with family status and occupation only. Trends in mortality from all external causes showed no significant changes during the period 1971 - 2000. After adjusting for age and cohort effects, the period effect was statistically significant. Conclusion: Prognosis of risk factors for mortality from external causes and period effect on suicide mortality rates will form important parts of future research agendas.