Nadine Ouellette’s research while affiliated with Université de Montréal and other places

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Publications (32)


Life expectancy at birth by U.S. race and ethnic groups, 2019.
Life expectancy at birth for non-Indigenous and Indigenous groups in Australia, 2015-2017.
Race and ethnicity dynamics in survival to 100 years in the United States
  • Article
  • Full-text available

December 2024

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1 Read

Journal of Internal Medicine

Nadine Ouellette

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Thomas Perls

Background After age 85, the U.S. non‐Hispanic Black population mortality rate becomes less than that of the White population (called the Black–White mortality crossover). It is not known how this survival advantage compares to Asian and Hispanic groups, and whether differences persist to age 100+ years. Methods The U.S. period life table data were extracted to obtain life expectancy at birth and at ages 70, 85, and 100 years according to year, sex, and race and ethnicity. Age‐specific death rates and adult modal age at death were calculated. We computed period probabilities of survival to age 100, from ages 70, 80, and 90. Pseudo‐birth cohort calculations were undertaken to enable comparison with period‐based results. Results In 2019, the Black–White mortality crossover occurred at 86–88 years and persisted at ages 100 and 100+. Life expectancies at age 100 for non‐Hispanic Black, Hispanic, and Asian populations were similar and were significantly greater than the non‐Hispanic White population. From 2006 to 2019, the probability of survival from 70 and 80 years to age 100 was highest for the Hispanic population, followed by non‐Hispanic Black and then non‐Hispanic White populations. Probability of survival from age 90 to 100 years was similar for all but the non‐Hispanic White population, which had a comparatively lower probability of survival. When Asian population data became available in 2019, this population had the highest probability of survival to age 100, starting from ages 70, 80, and 90 years. Pseudo‐cohort results displayed patterns consistent with those observed over calendar years. Conclusions Race‐ and ethnicity‐based variation in mortality between ages 85 and 100+ years suggests differences in environmental and possibly genetic influences upon risk for exceptional longevity.

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Longevity in Modern Populations

November 2024

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7 Reads

Why and how we age are probably two of science's oldest questions, echoing personal beliefs and concerns about our own finitude. From the earliest musings of ancient philosophers to recent pharmacological trials aimed at slowing ageing and prolonging longevity, these questions have fascinated scientists across time and fields of research. Taking advantage of the natural diversity of ageing trajectories, within and across species, this interdisciplinary volume provides a comprehensive view of the recent advances in ageing and longevity through a biodemographic approach. It includes the key facts, theories, ongoing fields of investigation, big questions, and new avenues for research in ageing and longevity, as well as considerations on how extending longevity integrates into the social and environmental challenges that our society faces. This is a useful resource for students and researchers curious to unravel the mysteries of longevity and ageing, from their origins to their consequences, across species, space and time.


Mortality Modelling at the Oldest Ages in Human Populations: A Brief Overview

November 2024

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8 Reads

Why and how we age are probably two of science's oldest questions, echoing personal beliefs and concerns about our own finitude. From the earliest musings of ancient philosophers to recent pharmacological trials aimed at slowing ageing and prolonging longevity, these questions have fascinated scientists across time and fields of research. Taking advantage of the natural diversity of ageing trajectories, within and across species, this interdisciplinary volume provides a comprehensive view of the recent advances in ageing and longevity through a biodemographic approach. It includes the key facts, theories, ongoing fields of investigation, big questions, and new avenues for research in ageing and longevity, as well as considerations on how extending longevity integrates into the social and environmental challenges that our society faces. This is a useful resource for students and researchers curious to unravel the mysteries of longevity and ageing, from their origins to their consequences, across species, space and time.


The case for counting multiple causes of death in the COVID-19 era

October 2023

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42 Reads

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5 Citations

International Journal of Epidemiology

The COVID-19 pandemic caused significant changes in mortality patterns, which have implications for the measurement, interpretation, and comparison of cause-specific mortality trends. So far, the majority of studies have focused either on excess mortality, which disregards causes of death, or on cause-specific mortality based exclusively on the underlying cause of death. We argue there is an urgent need for analyses of cause-specific trends that include all causes listed on death certificates, regardless of whether they appear as the underlying or contributing cause. This is especially important due to the high prevalence of comorbidities involved in COVID-19 deaths, because of the many challenges in correctly identifying COVID-19 deaths, and also since coding rules tend to prioritize COVID-19 as the underlying cause. Multiple causes of death analysis is key for a thorough understanding of mortality shifts between underlying and contributing causes, while avoiding biases associated with the selection of the underlying cause.


The case for counting multiple causes of death in the COVID-19 era

May 2023

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59 Reads

The COVID-19 pandemic caused significant changes in mortality patterns, which have implications for the measurement, interpretation, and comparison of cause-specific mortality trends. So far, the majority of studies have focused either on excess mortality, which disregards causes of death, or on cause-specific mortality based exclusively on the underlying cause of death. We argue there is an urgent need for analyses of cause-specific trends that include all causes listed on death certificates, regardless of whether they appear as the underlying or contributing cause. This is especially important due to the high prevalence of comorbidities involved in COVID-19 deaths, because of the many challenges in correctly identifying COVID-19 deaths, and also since coding rules tend to prioritize COVID-19 as the underlying cause. Multiple causes of death analysis is key for a thorough understanding of mortality shifts between underlying and contributing causes, while avoiding biases associated with the selection of the underlying cause.


Figure 1: Estimated cumulative hazard using nonparametric and parametric approaches, French females born 1883-1901, ages 105 and above
Table 1 :
Figure 2: Observed and fitted hazards, French females (left) and males (right), born in 1891
p-values for two hypothesis tests on Gompertz slope parameter, b, across all model specifications, French birth cohorts 1883-1901, ages 105 and above
Parameter estimates in model specifications with different combinations of variables, French birth cohorts 1883-1901, ages 105 and above
The question of the human mortality plateau: Contrasting insights by longevity pioneers

February 2023

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53 Reads

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15 Citations

Demographic Research

Linh Hoang Khanh Dang

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Carlo Giovanni Camarda

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France Meslé

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[...]

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Background: The debate about limits to the human life span is often based on outcomes from mortality at the oldest ages among longevity pioneers. To this day, scholars disagree on the existence of a late-life plateau in human mortality. Amid various statistical analysis frameworks, the parametric proportional hazards model is a simple and valuable approach to test the presence of a plateau by assuming different baseline hazard functions on individual-level data. Objective: We replicate and propose some improvements to the methods of Barbi et al. (2018) to explore whether death rates reach a plateau at later ages in the French population as it does for Italians in the original study. Methods: We use a large set of exceptionally reliable data covering the most recently extinct birth cohorts, 1883-1901, where all 3,789 members who were born and died in France, were followed from age 105 onward. Individual life trajectories are modeled by a proportional hazards model with fixed covariates (gender, birth cohort) and a Gompertz baseline hazard function. Results: In contrast with Barbi et al. (2018)'s results, our Gompertz slope parameter estimate is statistically different from zero across all model specifications, suggesting death rates continue to increase beyond 105 years old in the French population. In addition, we find no significant birth cohort effect but a significant male disadvantage in mortality after age 105. Conclusions: Using the best data currently available, we did not find any evidence of a mortality plateau in French individuals aged 105 and older. Contribution: The evidence for the existence of an extreme-age mortality plateau in recent Italian cohorts does not extend to recent French cohorts. Caution in generalizations is advised, and we encourage further studies on long-lived populations with high-quality data.


Figure 1: Taux de mortalité observés selon l'âge et le sexe pour les générations françaises (1883-1901), belges (1891-1904) et canadiennes-françaises (1880-1896)
Trajectoire des taux de mortalité aux âges extrêmes de la vie: Une représentation paramétrique des données récentes de la France, de la Belgique et du Québec

November 2022

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33 Reads

Quetelet Journal

Au cours de la vie des adultes, les taux de mortalité par âge augmentent à un rythme assez proche du rythme exponentiel décrit par le modèle de Gompertz. Aux très grands âges, toutefois, l’évolution de ce risque de décès reste encore un sujet de débat, principalement du fait de données insuffisantes en quantité et en qualité. La disponibilité de données récentes exceptionnellement fiables pour les populations française, belge et canadienne-française au-delà de 90 ans nous donne une nouvelle opportunité de mettre à jour les connaissances sur la trajectoire de mortalité aux âges le plus élevés de la vie humaine et de tester différents modèles pour ajuster ces données. Une décélération du rythme d’accroissement des taux de mortalité est confirmée chez les femmes très âgées et les modèles de type logistique (Beard et Kannisto) donnent toujours les meilleurs ajustements. Chez les hommes, bien que les données n’écartent pas complètement ces modèles logistiques, elles sont le plus souvent ajustées de façon optimale par une croissance exponentielle de type Gompertz. Le nombre de survivants masculins trop faible aux très grands âges pourrait être à l’origine de ce résultat. Throughout adult lifespan, age-specific death rates increase at a pace which is very close to an exponential pace as depicted by the Gompertz model. At very old ages, however, changes in the risk of death remain a matter of debate, mainly because data are insufficient both in terms of quantity and quality. The availability of exceptionally reliable recent data for the French, Belgian and French-Canadian populations beyond the age of 90 gives us a new opportunity to refine our understanding of the human mortality trajectory at the highest ages and to test different models to adjust these data. A deceleration in the pace of increase of death rates is confirmed among females in very old age and logistic-type models (Beard and Kannisto) always provide the best adjustments. Among males, although the data do not completely rule out these logistic-type models, they are more often optimally described by Gompertz-type exponential growth. The low number of male survivors at very old ages could explain this result.



Supercentenarians and Semi-supercentenarians in France

January 2021

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129 Reads

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6 Citations

The purpose of this study is twofold. Firstly, it attempts to exhaustively identify cases of French supercentenarians and semi-supercentenarians and to validate their alleged age at death. Secondly, it seeks to uncover careful patterns and trends in probabilities of death and life expectancy at very old ages in France. We use three sets of data with varying degrees of accuracy and coverage: nominative transcripts from the RNIPP ( Répertoire national d’identification des personnes physiques ), death records from the vital statistics system, and “public” lists of individual supercentenarians. The RNIPP stands out as the most reliable source. Based on all deaths registered in the RNIPP at the alleged ages of 110+ for extinct cohorts born between 1883 and 1901, errors are only few, at least for individuals who were born and died in France. For alleged semi-supercentenarians, age validation on a very large sample shows that errors are extremely rare, suggesting the RNIPP data can be used without any verification until age 108 at the minimum. Moreover, a comparison with “public” lists of individual supercentenarians reveals a single missing occurrence only in the RNIPP transcripts since 1991. While the quality of vital statistics data remains quite deficient at very old ages compared to RNIPP, the analytical results show a significant improvement over time at younger old ages. Our RNIPP-based probabilities of death for females appear to level-off at 0.5 between ages 108 and 111, but data becomes too scarce afterwards to assess the trend. Also, we obtain a quite low life expectancy value of 1.2 years at age 108.


Estimated modal age at death, M^\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\hat{M}$$\end{document}, and standard deviation above the mode, SD^\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\widehat{SD}$$\end{document}(M +), for all causes of death combined in Canada and the U.S., 1974–2011.
Source: Authors’ calculations based on the Canadian Vital Statistics Death database, U.S. National Vital Statistics System data files, and Human Mortality Database
Estimated modal age at death, M^k\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\hat{M}_{k}$$\end{document}, for leading causes of death among the elderly in Canada (dark colors) and the U.S. (light colors) and corresponding country differences in M^k\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\hat{M}_{k}$$\end{document} values, 1974–2011. Note: For calendar years 1977 and 1978 (in Canada), and 1974–1976, 1978 (in the U.S.), the smooth density function for breast cancer is bimodal. That is, we can distinguish two modal ages at death. In Fig. 2, only the “dominant” mode is illustrated, i.e., the age with the highest proportion of deaths. Please refer to Fig. 4 in the "Appendix" and to Figure A-2 in Diaconu et al. (2016) for an illustration of a smooth bimodal density function obtained with U.S. and Canadian data respectively.
Source: Authors’ calculations based on the Canadian Vital Statistics Death database, U.S. National Vital Statistics System data files, and Human Mortality Database
Estimated standard deviation of ages at death above the mode, SD^Mk+\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\widehat{SD}\left( {M_{k} + } \right)$$\end{document}, for leading causes of death among the elderly in Canada (dark colours) and the U.S. (light colours) and corresponding country differences in SD^Mk+\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\widehat{SD}\left( {M_{k} + } \right)$$\end{document} values, 1974–2011.
Source: Authors’ calculations based on the Canadian Vital Statistics Death database, U.S. National Vital Statistics System data files, and Human Mortality Database
Smooth density functions describing the age-at-death distribution for leading causes of death among elderly U.S. males and females aged 10 and above, for calendar years 1974 (thin line), 1993 (medium line), and 2011 (thick line).
Source: Authors’ calculations based on the U.S. National Vital Statistics System data files, and Human Mortality Database
Modal lifespan and disparity at older ages by leading causes of death: a Canada-U.S. comparison

December 2020

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109 Reads

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2 Citations

Journal of Population Research

The U.S. elderly experience shorter lifespans and greater variability in age at death than their Canadian peers. In order to gain insight on the underlying factors responsible for the Canada-U.S. old-age mortality disparities, we propose a cause-of-death analysis. Accordingly, the objective of this paper is to compare levels and trends in cause-specific modal age at death (M) and standard deviation above the mode (SD(M +)) between Canada and the U.S. since the 1970s. We focus on six broad leading causes of death, namely cerebrovascular diseases, heart diseases, and four types of cancers. Country-specific M and SD(M +) estimates for each leading cause of death are calculated from P-spline smooth age-at-death distributions obtained from detailed population and cause-specific mortality data. Our results reveal similar levels and trends in M and SD(M +) for most causes in the two countries, except for breast cancer (females) and lung cancer (males), where differences are the most noticeable. In both of these instances, modal lifespans are shorter in the U.S. than in Canada and U.S. old-age mortality inequalities are greater. These differences are explained in part by the higher stratification along socioeconomic lines in the U.S. than in Canada regarding the adoption of health risk behaviours and access to medical services.


Citations (20)


... Statistical representations: The clustering of COVID-19 with other causes of death poses a problem for cause-of-death statistics. On average death certificates with COVID-19 contain 2.6 causes of death as shown in this and other studies [14], [24], [25]. This implies selection for representation of a case in a cause-of-death statistics based on (just) one cause per deceased [24]. ...

Reference:

The interpretation of COVID-19 in cause-of-death statistics: a matter of causality
The case for counting multiple causes of death in the COVID-19 era
  • Citing Article
  • October 2023

International Journal of Epidemiology

... The Gompertz model has also been widely applied in detecting plateau periods [2]. Multi-country comparison studies have proven useful for analyzing specific aspects of mortality, considering economic and societal differences [3]. Building on these pioneering works, this study seeks to assess several mortality models by comparing Denmark and the Netherlands as representative examples of developed European countries, aiming to improve health risk management. ...

The question of the human mortality plateau: Contrasting insights by longevity pioneers

Demographic Research

... Since data quality at the oldest ages depends heavily on the accuracy of reported ages at death, the data we use here were validated following a strict protocol for thoroughly verifying the coherence between the information recorded on the person's official birth and death certificates. The details and results of the age-validation procedure on the French dataset can be found in Ouellette et al. (2021). In summary, for deaths that occurred at ages 110 onward (so-called supercentenarians), exhaustive validation was performed. ...

Supercentenarians and Semi-supercentenarians in France

... Although the model suffers from unidentifiability problems due to covariance between variables, it can provide a unique perspective for understanding the long-term trend of TB and offers basic information for long-term public health surveillance as the model is gradually optimized (8,11). In the fields of other infectious diseases, such as influenza, HIV/AIDS, and measles (12)(13)(14)(15), the APC model has been widely applied to identify the risk factor in different age groups. However, the potential function of the APC model in tuberculosis has not yet been fully summarized. ...

Correction to: Determinants of Influenza Mortality Trends: Age-Period-Cohort Analysis of Influenza Mortality in the United States, 1959–2016

Demography

... 9 Temporal variations in acute cardiovascular events were reported as early as 1937 10 and several time-series analyzes showed correlations of seasonal peaks of influenzaassociated mortality with cardiovascular deaths. [11][12][13][14][15] Meta-analysis of multiple case-control studies revealed that AMI cases were associated with greater incidence rates of recent acute respiratory illness, influenza-like illness, and laboratory-confirmed influenza compared to control groups (pooled odds ratio: 2.01; 95% confidence interval [CI]: 1.47-2.76), 16 which suggests that recent ARI and influenza may significantly contribute to the occurrence of AMI events. ...

Determinants of Influenza Mortality Trends: Age-Period-Cohort Analysis of Influenza Mortality in the United States, 1959–2016

Demography

... Among several drug targets for influenza A, HA and NA are important antigenic glycoproteins necessary for viral proliferation [6]. Of all the NA inhibitors, oseltamivir and zanamivir [8] are the most widely used. The former is administered orally and the latter by inhalation [9]. ...

Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic

... For instance, several works published during the late 1990s based on aggregated period mortality data from the 1950s onward documented the deceleration in the age pattern of mortality at advanced ages in a large set of low-mortality countries (Horiuchi and Wilmoth 1998;Thatcher, Kannisto, and Vaupel 1998;Thatcher 1999). More recently, mortality deceleration was also observed in a thoroughly validated set of data on French-Canadian cen-tenarians born to (extinct) cohorts 1870-1896 (Ouellette 2016), as well as thanks to an extensive testing of mortality models after age 80 on 360 high-quality cohort data sets (Feehan 2018). Evidence of such a late-life mortality deceleration seems consistent with various theoretical explanations (Beard 1959;Vaupel et al. 1979;Wachter and Finch 1997;Wilmoth and Horiuchi 1999;Steinsaltz and Wachter 2006;Mueller at al. 2011). ...

La forme de la courbe de mortalité des centenaires canadiens-français
  • Citing Article
  • November 2016

Gérontologie et société: cahiers de la Fondation nationale de gérontologie

... In mortality studies, the adult modal age at death (M) appears to be a relevant indicator for studying longevity. Defined as the age at which the maximum number of adult deaths occurs in a synthetic cohort of individuals experiencing similar mortality conditions, this indicator is less sensitive to improvements in mortality conditions in children and young adults compared to life expectancy at birth, which is highly sensitive to premature mortality (Canudas-Romo, 2008Horiuchi et al., 2013;Ouellette et al., 2012). In low-mortality countries characterized by aging populations, many studies have been devoted to the analysis of this indicator and the dynamic of its evolution over time and space (Canudas-Romo, 2008Cheung et al., 2005;Kannisto, 2000Kannisto, , 2001bKannisto, , 2007Missov et al., 2015;Ouellette, 2011;Ouellette et al., 2013;Ouellette & Bourbeau, 2011;Thatcher et al., 2010). ...

The Most Frequent Adult Length of Life in the Eighteenth Century: The Experience of the French-Canadians
  • Citing Article
  • January 2012

Population (English Edition 2002-)

... Moreover, Canada's age-specific mortality rate for both sexes combined rose, from 7.0 per 1000 population in 1991 to 7.6 in 2019 (Statistics Canada, Table 13a [2]). Bourbeau and Quellette [3] gave an excellent historical summary of mortality trends and patterns in Canada from 1921 to 2011, demonstrating the country's remarkable achievement in mortality management and efforts to promote health. In addition, there is literature on the epidemiology of population change due to cause-of-death analysis (Bah and Rajulton [4]) and changes in life-expectancy (Bourbeau [5]; Lussier et al. [6]) for an overview see Mandich and Margolis [7]. ...

Trends, patterns, and differentials in Canadian mortality over nearly a century (1921-2011)

Canadian Studies in Population

... With Canada's population aged 85 and older projected to double by 2050, alongside a 25% increase in overall deaths, understanding the factors that influence peace with dying is crucial to improve the overall dying experience [6,7]. Religious beliefs, healthcare professionals' attitudes, and end-of-life care practices directly shape a person's experience of peace with dying [8][9][10]. ...

Insight on 'typical' longevity: An analysis of the modal lifespan by leading causes of death in Canada

Demographic Research