Do Australian women live 20 years longer than American women?

In the developed world, looking older than your chronological age is taken into account a handicap. Western societies value physical beauty and vitality while science is trying to seek out a technique to completely reverse the aging process.

A study published in the newest issue of Australian Journal of Dermatologywhich concluded that Australian women report more severe signs of facial aging than other women, Plenty of media coverage.

This raised alarm bells. Headlines like:

Why do Australian women age 20 years faster than American women?

Like a research paper, these articles focused on photoaging – the damage our skin can do from exposure to high UV levels. But there's more to the aging process than wrinkles and crow's feet. And the “20 years faster” claim also deserves scrutiny.

How was the study conducted?

This paper was published in a good, peer-reviewed outlet – the official journal of the Australasian College of Dermatologists and the New Zealand Dermatological Society.

The sample was 1,472 women (average late 40s) aged 18–75 years from Australia, the United Kingdom, Canada, and the United States. They were recruited from an Internet-based polling panel between December 2013 and February 2014.

The women were asked to check their facial expression to photographs showing increasing signs of aging (from none to severe) for eight different features.

These include static brow lines, crow's feet, glabellar (brown) lines, tear troughs (grooves between the lower eyelids and cheeks), decreased mid-face volume, nasolabial folds (the 2 folds of skin that run from the nose to the corner of the mouth). ), corners of the mouth and perioral lines (wrinkles across the lips).

They were asked to pick out certainly one of 4 to 6 images (depending on the feature)—mostly representing their current facial expression within the absence of facial expressions.

People were excluded in the event that they had severe facial trauma or burns, or in the event that they had undergone any form of cosmetic surgery, including Botox, fillers or laser treatments.

Skin color will be classified by its specific response to UV light: from type one, which could be very fair-colored skin that at all times burns and never tans, to type six, which is darker. Has brown skin that never burns and is at all times tanned. Only women with skin types one to a few were included within the study.

What were the outcomes?

Australian women reported severe facial lines and better rates of facial changes with age than women from other countries, particularly the United States. Interestingly, nonetheless, for girls of their 70s, the common severity of facial lines was generally similar from country to country.

The researchers then checked out 30 percent or more of the ladies who reported moderate or severe aging for all characteristics. They found that in Australia, it happened:

From the age of 30-59 […] But this proportion of American women didn't report this level of severity until ages 40-69.

That appears to be the crux of the paper, and the finding results in the conclusion that we're growing 20 years faster than our age.

The study has many strengths. It is beautifully written and a few procedural facets are strong. For example, Asian women are more susceptible to skin wrinkles than Caucasian women, and smoking is related to skin aging. So the researchers adjusted their analyzes for age, race and smoking status to ensure that these aspects weren't answerable for the outcomes.

The results are definitely plausible and consistent with other studies. People living in Australia are exposed to high levels of UV radiation, which is answerable for most age-related cosmetic skin problems in individuals with fair skin.

Oh the study 1,400 randomly chosen residents of a Queensland community used dorsum of the hand and dermatological assessment to exhibit that premature skin aging was related to increased sun exposure during recreation or work. It is from light.

What is the issue?

The study has two principal limitations. First, differences in self-reported facial lines could also be statistically significant across countries, but this doesn't mean they're clinically significant.

The research data presents the common intensity of every line against age, with different colours representing each of the 4 countries.

Participants had as much as six images to select from, so the intensity scale could range from 0 to six. Even the biggest differences between countries appear to represent a difference of 0.3 or 0.5. It is comparatively small and might not be something that anyone can observe.

Second, it will not be clear why the researchers decided to concentrate on the 30% or more of ladies who reported moderate or severe aging for all characteristics. No other study has used this cutoff.

The authors stated that:

This cutoff was chosen to supply the most effective sensitivity in detecting differences within the severity of facial aging across countries.

This suggests that fewer differences were found than if every other cut-off was considered. For example, would there be a big difference when 20% of ladies rated each feature as moderate or severe symptoms of aging? Or 50%? Or 90%? Choosing a cutoff that will not be based on a clinically meaningful or validated ratio raises questions on the true significance of the reported changes.

What else should we consider?

The title of the study accurately reflects its content, stating that it's a comparison of self-reported signs of facial aging. But the accompanying media coverage suggests that Australian women are aging prematurely.

There is not any evidence that that is true. A strong study of several tens of 1000's of ladies shows that Australians are very much like women in Europe and North America, from middle age to the extremes of old age. gave Australian Longitudinal Study on Women's Health Provides a wealth of information on this field.

More necessary markers of health status in older people – disability, self-rated health, depression and anxiety, dementia – are all comparable. Life expectancy at birth (84.4 years for girls) is barely higher. More in Australia Compared to the opposite countries studied on this paper.

What is the take home message?

Despite the methodological limitations of the study, in some ways it is nice to have it widely publicized.

Just as public health campaigns about premature aging were used to scale back smoking rates amongst women (and thereby reduce many smoking-related diseases), UV radiation Because the Aussies' message might encourage us to limit our sun exposure. Melanoma and other skin cancers will then decrease.

As a form of redhead living in Brisbane, I will certainly proceed to wear my hat. – Ruth Hubbard

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Peer review

This research check adequately outlines strengths (variety of participants, age and other aspects reminiscent of smoking) and limitations (limitations in self-reporting and adjusting for confounding variables).

It also addresses the problem that caused the alarmist headlines – the graph shows when greater than 30% of ladies rated a facial feature as reflecting moderate or severe signs of aging. The creator appropriately points out that there isn't a justification for selecting the 30% cutoff, that no other study uses it and that it's unlikely to have clinical significance.

More importantly, ResearchCheck analyzes data that presents data for girls in numerous age groups. This suggests that almost all of the curves overlap, and that it is definitely difficult to see differences between groups of ladies.

I'd go even further and say that while the 95% confidence interval—a critical estimate of variance—is presented within the tables, it doesn't apply to the graphs. If you graph the 95% confidence intervals reported within the tables, you will notice that almost all values ​​for girls in other countries is not going to be significantly different from women in Australia.

For example, within the graph showing nasolabial folds, mildly impaired UK women have similar (ages 18-29, 40-49) or barely worse (ages 70-79) nasolabial folds than Australian women.

This research check provides a transparent, detailed and simply comprehensible background to the paper seen through the somewhat obsessive media reports. – Ian Musgrave