Diarrheal deaths in the United States, 1979 through 1987. A special problem for the elderly
J. F. Lew, R. I. Glass, R. E. Gangarosa, I. P. Cohen, C. Bern and C. L. Moe
Viral Gastroenteritis Unit, Centers for Disease Control, Atlanta, GA 30333.
OBJECTIVE.--Diarrhea is an important cause of death among young children in
both developing and developed countries, but little is known about
diarrheal death among adults. In this study, we examined trends in
diarrheal deaths among all age groups in the United States.
DESIGN/SETTING/PARTICIPANTS.--We reviewed national mortality data complied
by the National Center for Health Statistics, Hyattsville, Md, which
consists of information from all death certificates filed in the United
States for the period 1979 through 1987. A death for which diarrhea was
listed as an immediate or underlying cause was considered a "diarrheal
death" and included in the analysis. RESULTS.--We found that 28,538 persons
died of diarrhea cited as either an immediate or the underlying cause of
death during the 9-year period. A majority of diarrheal deaths occurred
among the elderly (older than 74 years of age, 51%), followed by adults 55
to 74 years of age (27%), and young children (younger than 5 years of age,
11%). For the elderly, adjusted risk factors for dying of diarrhea included
being white, female, and residing in a long-term care facility. Only the
elderly and young children had clear, distinct winter peaks of diarrheal
deaths, suggesting that the diarrhea may, in part, be infectious in origin.
CONCLUSION.--For the elderly, more directed studies of those at risk, such
as nursing home residents, are needed to determine if oral rehydration
therapy, vaccines, or other preventive measures might benefit this
population.
