Changes in health status among participants of the Framingham Heart Study from the 1960s to the 1990s: application of an index of cumulative deficits.

Journal Article (Journal Article)


Health of the general population is improving along a number of major health dimensions. Using a cumulative deficits approach, we investigated whether such improvements were evident at the level of minor health traits.


We selected 37 small-effect traits consistently measured in the 9th (performed in 1964) and 14th (1974) Framingham Heart and 5th (1991-1995) Offspring Study exams to construct indices of cumulative deficits (DIs).


We identified deficits-specific DIs characterizing health dimensions associated with no health changes (DI(NHC)), health worsening (DI(WRS)), and health improving (DI(IMP)) between the 1960s and 1990s. The risks of death attributable to the DI(NHC) dominate within shorter time horizons. For longer time horizons, both the DI(NHC) and DI(IMP) provide the same contribution to the risks of death. The mortality risks associated with the DI(WRS) are the weakest and least significant.


The analyses show that the cumulative deficits approach might be an efficient tool for analyzing the effects of a large number of health characteristics for which the individual effects are small, inconsistent, or non-significant. They show favorable trends such that health of the Framingham studies participants either did not change or improved over time for the most serious small-effect traits.

Full Text

Duke Authors

Cited Authors

  • Kulminski, AM; Arbeev, KG; Ukraintseva, SV; Culminskaya, IV; Land, K; Yashin, AI

Published Date

  • September 2008

Published In

Volume / Issue

  • 18 / 9

Start / End Page

  • 696 - 701

PubMed ID

  • 18794010

Pubmed Central ID

  • PMC2556901

Electronic International Standard Serial Number (EISSN)

  • 1873-2585

International Standard Serial Number (ISSN)

  • 1047-2797

Digital Object Identifier (DOI)

  • 10.1016/j.annepidem.2008.06.005


  • eng