Inter-cohort shifts in chronic disease, dementia, and mortality.

Previous work using U.S. data has identified generational shifts, reflected in inter-cohort changes, in the incidence and prevalence of diseases in older ages. This study extends previous findings to England by examining similar results in memory complaints, heart conditions, stroke, diabetes, lung disease, and cancer using data from the English Longitudinal Study of Ageing (ELSA). We fit Cox proportional hazard models to the first eight waves (2002-2016) of the ELSA sample (n = 18,528). In addition to exploring shifts in disease incidence we also examine shifts in disease mortality. Both general and sex-related differences are examined. Disease incidence has increased for later-born cohorts in England, replicating similar trends in the U.S. Not all diseases showed differences between men and women, but when differences were identified, women had lower risks for disease. In comparison to the U.S. sample, disease trends in England are more negative (i.e. accelerated failure times) for more recently born cohorts. These results showing increasing incidence of disease among the later-born cohorts suggest the possibility of increased disease burden in coming years.