Familial Aggregation of Elderly Cause-Specific Mortality: Analysis of Extended Pedigrees in Utah, 1904–2002

This study addresses the impact of family history of disease and family history of longevity on cause-specific mortality in a large population-based cohort. We identified a cohort of 464,494 people born between 1830 and 1984 from the Utah Population Database, a resource of linked genealogy, vital statistics, and disease data. To be eligible, a cohort member must have lived at least 65 years and died between 1904 and 2002. We measured familial disease risks using the familial standardized mortality ratio (FSMR), and familial longevity using familial excess longevity (FEL). For each of the leading causes of death in the U.S., we constructed a nested casecontrol study using cohort members dying of a specific cause (cases) and individually matched cohort members who remained at risk at the time of the cases’ deaths (controls). Our results indicate that family histories of cause-specific mortality greatly affect risk of death from the same cause, especially for heart disease, cancer, and diabetes. However, familial excess longevity is associated with decreased risks of almost all causes of death, suggesting that whatever factors link kin survival, an important component is the familiality of longevity within their extended family. The one major disease for which familial longevity confers no substantial protection is cancer, suggesting that there may be some antagonism between genetic mechanisms that protect against aging and those that protect against cancer.