Search

Growing life expectancy poses important societal challenges, placing an increasing burden on ever more strained health systems. Digital technologies offer tremendous potential for shifting from traditional medical routines to remote medicine and transforming our ability to manage health and independence in aging populations. In this Perspective, we summarize the current progress toward, and challenges and future opportunities of, harnessing digital technologies for effective geriatric care. Special attention is given to the role of wearables in assisting older adults to monitor their health and maintain independence at home. Challenges to the widespread future use of digital technologies in this population will be discussed, along with a vision for how such technologies will shape the future of healthy aging., (© 2023. Springer Nature America, Inc.)

The purpose of this article is to analyze the possibilities that the hegemonic medical model will continue to prevail in the future or if significant changes will take place. The discussion will take as a starting point the characteristics and current functions of the hegemonic medical model, and reexamine them through a look at advancements in artificial intelligence, genetic research, and robotics in health-illness-care-prevention processes. The analysis takes on issues such as possible increases in life expectancy, what is needed to "cure old age," as well as processes that are modifying the doctor-patient relationship. It is concluded that although significant changes are taking place, the characteristics and functions of the hegemonic medical model remain unmoved.

The article considers the role of interdepartmental cooperation in modernization of health sector at the regional level exemplified by Mari El Republic. Based on data of study monitoring, the dynamics of medical and demographic indicators are determined. Over the past five years, life expectancy increased, patient satisfaction with medical care increased. Its accessibility increased in rural areas. The primary health care is provided in 49 outpatient clinics and in 207 paramedic and midwifery centers, that meets the established standards. Against this background, the birth continues decreasing of birth rate and increasing of mortality because of diseases of blood circulation system and neoplasms. In order to more thoroughly study the state of health care and and taking into account requirements of the National Health Care Project, the sociological survey of two categories of respondents (patients and medical staff of the district hospital) was carried out. The indicators of demographic development are restrained by negative alterations in demographic structure of population, its aging and regressivity, decreasing of percentage of women of most active reproductive age and high mortality of men of able-bodied age. The social partnership of interested bodies and organizations involved in the reform and improvement of health care system can reduce severity of the above-mentioned problems. Statistical monitoring of implementation of requirements to accessibility and quality of medical care was carried out. The article presents original scheme of interaction between twelve ministries and departments of the Republic. The proposals of to improve quality and accessibility of medical care, the prestige of medical profession and implementation of healthy lifestyles are proposed.

Background: Stress and mortality are negatively correlated and it is generally accepted that certain professions are more stressful than others. Medical graduates begin as a relatively homogenous population who then choose vastly different career options making doctors an ideal population in which to try to assess whether job stress is likely to be causal to increased mortality., Aims: To establish the influence of various modifiable risk factors on the life expectancy of UK doctors., Methods: We analysed a decade of obituaries from the British Medical Journal published between January 2003 and December 2012. Data included age at death (AAD), specialty, region (deanery), marriage status and children., Results: A total of 3068 obituaries were eligible for inclusion. Mean AAD was 78.5 years. Male sex was associated with a significantly increased AAD by an additional 3.8 years (95% CI 2.4-5.2 years, P < 0.001). Public health, obstetrics and gynaecology and laboratory medicine specialties were all associated with significantly increased AAD (P < 0.05). London and Northern Ireland deaneries were both associated with significantly increased AAD (P < 0.05). Each additional child was associated with a relative increase in AAD of +1.1 years (95% CI 0.7-1.4 years, P < 0.001)., Conclusions: Our results show that location and career choices may affect life expectancy. While this does not necessarily reflect quality of life, the additional years of life gained from having extra children have a positive effect on your quantity of life., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Discussions about the goals of medicine and health care have significantly increased through the last decade of the past century. This was determined by the highly increased extent of health care, scarce health care resources, fundamental changes of health care technologies and well-established market relationships in health care. For a long time medicine attempted to achieve three main goals: to save and prolong life, fight and prevent diseases, reduce pain and sufferings. In the result of development of medicine the previous goals became rather problematic. Technological progress of medicine of the second half of the 20th century has implemented the believing, that medicine is able to prolong the life of human without restrictions. Ageing population has started expecting from medicine not only the saving of life and health enhancement, but also prolonging of life, since the mentioned is tended to be more socioeconomic, not medical, problem. Nowadays discussion about the goals of health care comes from the doubts, if the questions for medicine really have medical background. Often the society tries to escape from number of social problems medicalizing them. Spiritual and social problems of human are often supposed to be as medical ones, thus it is crucial to separate the main goals of medicine, which represent its values and targets, from the secondary ones, related to social or individual welfare, crime, dilemmas of poverty or morality. The aim of the article is to reveal the key values of medicine and health care, which determine the goals of medicine and health care.

Objective: To determine physicians' opinions about the role of cost considerations in treatment decisions., Design: Oral inquiry., Setting: Hospitals in the area of Leiden and Amsterdam, the Netherlands., Methods: 82 medical specialists (41 surgeons and 41 internists) were interviewed and answered questions regarding cost considerations in medical care. They were also asked to determine the probability of success below which they considered an expensive medical treatment useless., Results: The respondents agreed that the government can set limits to care and incorporate cost considerations, but they also indicated that the role of physicians is to treat individual patients. About half the physicians would agree to discontinue treatment when it became too expensive. Decisions regarding the limitation of care should be made by politicians with or without the advice of physicians. The respondents would discontinue (an expensive) treatment (in a presented case) if the probability of success was on average below 12%, but half the physicians said they would accept a lower probability of success for individual patients than they would recommend as a policy., Conclusion: Although physicians agreed about the necessity to set limits to medical care, their behaviour in clinical practice appeared to be not always in agreement with this.

Health systems that have a strong orientation toward primary care achieve lower overall costs, better satisfaction of their populations, and better health. The role of specialists in such systems is to provide consultative services on a short-term basis (secondary care) or long-term services for rare or complicated problems (tertiary care). Among both primary-care and specialist physicians, opinions vary considerably as to the specific tasks that are appropriate in primary and specialist care. Medical education has not proved an adequate basis for judging either the relative appropriateness of care by primary-care physicians and specialists or criteria for referral. Recent studies indicate that conventional wisdom concerning the nature and treatment of disease that is derived from research in tertiary medical centers is contradicted by collaborative practice-based studies in primary care. Better collaboration between primary-care physicians and specialists both in research and in the design of services will be the key to more informed decisions about improvement in the care of patients with diabetes and other important and common health-care problems.

The relationship between the availability of primary care and specialty care and certain life chance indicators such as mortality rates and life expectancy is analyzed using the multiple regression procedure. Dependent variables are life chance indicators; independent variables were selected based on Starfield's and Blum's health determinant models and include socioeconomic environment, lifestyles, demographics, and medical care. The author also examines the rankings of states in terms of these indicators, using Spearman's rho coefficient. Among the medical care variables, primary care is by far the most significant variable related to better health status, correlating with lower overall mortality, lower death rates due to diseases of the heart and cancer, longer life expectancy, lower neonatal death rate, and lower low birth weight. In contrast, the number of specialty physicians is positively and significantly related to total mortality, deaths due to heart diseases and cancer, shorter life expectancy, higher neonatal mortality, and higher low birth weight. From a policy perspective, a likely implication is to reorient the medical profession from its current expensive, clinically based, treatment-focused practice to a more cost-effective, prevention-oriented primary care system.

Official government data published in 1974 are used to examine mortality among children over one year of age and adults in France during the years 1950-1969. "On the synchronic level, the analysis shows which causes affect subjects according to age and sex, and indicates in particular the causes of greater than average masculine mortality. As far as the diachronic level is concerned, the period is dominated by the lengthening of life due to the almost total elimination of death due to infectious diseases, and to the improvement of medical treatment. It must be pointed out that the raw data were such as to rule out, as far as possible, irregularities due to the age pyramid." (summary in ENG), (excerpt)

Abstract Despite long-term survival reports in early gastric cancer, comparative life expectancy data with the general population is scarce. This study aimed to estimate patients’ life expectancy and analyze disparities between early gastric cancer patients and the general population. Patients with stage 1 gastric cancer who underwent curative gastrectomy at Asan Medical Center were enrolled. Survival status was tracked via national health insurance records. Life expectancy was compared with general population data from the Korean Statistical Information Service database. The cohort comprised 8,637 patients (64.7% men, 17.3% aged 70+). Approximately 20% of patients underwent total gastrectomy. Life expectancy was favorable among women. Across all age groups, women’s life expectancy generally exceeded 80 years. Male patients showed a reduced life expectancy, typically 4–10 years shorter than their female counterparts. The average life expectancy of male patients aged over 80 years who underwent total gastrectomy was about 5 years, whereas that of their female counterparts was approximately 7 years. Female patients undergoing distal gastrectomy did not demonstrate a statistically significant variance in life expectancy compared to the general population. This study provided comprehensive life expectancy data, organized by age, sex, and type of gastrectomy in a large stage 1 gastric cancer cohort. Our findings are expected to alleviate uncertainties and anxieties for individuals diagnosed with early gastric cancer.

Abstract Prolonged evacuation after disasters increases the risks of diseases and challenges in healthcare access. This study aimed to analyze changes in life expectancy (LE) and years of life lost (YLL) in Fukushima Prefecture after the Great East Japan Earthquake. LE and YLL were calculated based on a dataset of 276,314 deaths in Fukushima Prefecture from January 2006 to December 2018 and were aggregated and compared in three time periods: 2006–2010, 2012–2015, and 2016–2018. LE and YLL were obtained using a life table method, focusing on four major causes of death: heart diseases, cerebrovascular diseases, pneumonia, and cancers. The overall LE for both males and females in Fukushima prefecture showed an increasing trend in all three periods. Notably, in 2012–2015, the increase in LE and YLL due to cancer was greater in areas with evacuation zones compared to those without evacuation zones. In contrast, in 2016–2018, a notable decrease in YLL due to cerebrovascular diseases for both males and females and due to heart diseases for males was observed in areas with evacuation zones compared to areas without. LE continued to rise in Fukushima Prefecture despite the significant long-term impact of the disaster on the population. Post-disaster changes in LE and YLL differed between areas with and without evacuation zones, suggesting that implementation of effective measures and policies in the region contributed to a successful recovery. This study may be crucial for evaluating future health measures and conditions in Fukushima Prefecture.

Abstract Background The extent to which type 2 diabetes (T2D) reduces life expectancy depends on the risk of complications. We aimed to characterise the relationship between risk factors for diabetes complications and life expectancy, in individuals with T2D, free from major chronic disease, in a regional database linked with national New Zealand health databases. Methods A prospective cohort study design was employed, analysing data from individuals with T2D drawn from the comprehensive Diabetes Care Support Service database (1994–2018). Participants with known values for all five within-target risk factors (WTRF +) including blood pressure, glycaemia, and LDL cholesterol, alongside being non-smoking with normal renal function at baseline, were included. Life expectancy free from cardiovascular disease (CVD), cancer, and dementia at age 50 years was estimated using multistate life tables, adjusting for demographics and clinical metrics. Results Women and men with no WTRF + at enrolment had a life expectancy free from CVD, cancer, or dementia of 13.1 (95% confidence interval: 9.1–19.0) and 11.2 (6.7–18.6) years, respectively. For the most socioeconomically deprived groups or Māori with no WTRF + at baseline, life expectancies were markedly lower. Life expectancies were 23.7 (18.9–29.7) years for women and 23.2 years (17.2–31.4) years for men with four or five WTRF + at baseline, respectively. While an increasing number of WTRF + at baseline was significantly associated with improved outcomes in men and certain subgroups (e.g. Other ethnicity group), this trend was not statistically significant for women overall or in most subgroups. Conclusions Having multiple WTRF + at baseline is associated with a considerable increase in life expectancy free from major chronic disease among individuals with T2D. This highlights the importance of lifestyle and clinical interventions in the management of T2D and in the prevention and management of associated chronic conditions.

Abstract Oral frailty (OF) is a form of frailty. Laughter and social communication such as talking and participating in community activities, contribute to extending healthy life expectancy by reducing stress and increasing physical activity. However, limited research exists on the association between laughter and social communication and OF. This cross-sectional study aimed to explore the association of laughter and social communication with the risk of developing OF using the eight-item OF Index among Fukushima residents. In 2020–2021, 916 residents aged 60–79 were surveyed regarding OF and psychosocial factors. Binomial logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for psychosocial factors associated with the OF prevalence. The OF prevalence was 41.5%. The sex- and age-adjusted ORs (95% CIs) for psychosocial factors associated with OF prevalence were 0.38 (0.26–0.57) for daily laughter, 0.51 (0.35–0.76) for laughter 1–5 times/week, 0.42 (0.20–0.89) for daily talking, 0.40 (0.22–0.72) for participating in community activities more than once/week, and 0.29 (0.20–0.43) for no depressive symptoms. After multivariate adjustment, only daily laughter and no depressive symptoms were associated with OF. As a public health strategy, increasing laughter and social communication frequencies, along with reducing depressive symptoms, may enhance healthy life expectancy through improved frailty.

Sri Lanka presents higher life expectancy (LE) of 76 years among its citizens which also marks a substantial male-female gap. Considering the country’s deaths, deaths due to non-communicable diseases are on the rise also indicating differences among males and females. The main objective of this study is to explore the gender differentials of non-communicable diseases in Sri Lanka. The study uses secondary data collected from 2010-2015 by the Registrar General’s Department and the Department of Census and Statistics (2015). Arriaga’s decomposition techniques of life expectancy and the calculation of causespecific death rates have been utilised in the main analysis. Decomposition of LE indicates that major contribution is through the indirect effect, which is 3.5 years considering the LE change during 2011-2013. Results reveal that males have a higher number of deaths due to NCDs compared to women. Considering the main three diseases of cancer, cardiovascular and diabetes, prevalence and mortality is relatively higher among males than females in most districts. It is important to identify the gender differentials in the mortality of the most common NCDs in order to support policy planning related to the management of the health and wellbeing of the population.

Abstract Background Current cardiovascular prevention strategies are based on studies that seldom include valvular heart disease (VHD). The role of modifiable lifestyle factors on VHD progression and life expectancy among the elderly with different socioeconomic statuses (SES) remains unknown. Methods This cohort study included 164,775 UK Biobank participants aged 60 years and older. Lifestyle was determined using a five-factor scoring system covering smoking status, obesity, physical activity, diet, and sleep patterns. Based on this score, participants were then classified into “poor,” “moderate,” or “ideal” lifestyle groups. SES was classified as high or low based on the Townsend Deprivation Index. The association of lifestyle with major VHD progression was evaluated using a multistate mode. The life table method was employed to determine life expectancy with VHD and without VHD. Results The UK Biobank documented 5132 incident VHD cases with a mean follow-up of 12.3 years and 1418 deaths following VHD with a mean follow-up of 6.0 years. Compared to those with a poor lifestyle, women and men followed an ideal lifestyle had lower hazard ratios for incident VHD (0.66 with 95% CI, 0.59–0.73 for women and 0.77 with 95% CI, 0.71–0.83 for men) and for post-VHD mortality (0.58 for women, 95% CI 0.46–0.74 and 0.62 for men, 95% CI 0.54–0.73). When lifestyle and SES were combined, the lower risk of incident VHD and mortality were observed among participants with an ideal lifestyle and high SES compared to participants with an unhealthy lifestyle and low SES. There was no significant interaction between lifestyle and SES in their correlation with the incidence and subsequent mortality of VHD. Among low SES populations, 60-year-old women and men with VHD who followed ideal lifestyles lived 4.2 years (95% CI, 3.8–4.7) and 5.1 years (95% CI, 4.5–5.6) longer, respectively, compared to those with poor lifestyles. In contrast, the life expectancy gain for those without VHD was 4.4 years (95% CI, 4.0–4.8) for women and 5.3 years (95% CI, 4.8–5.7) for men when adhering to an ideal lifestyle versus a poor one. Conclusions Adopting a healthier lifestyle can significantly slow down the progression from free of VHD to incident VHD and further to death and increase life expectancy for both individuals with and without VHD within diverse socioeconomic elderly populations.

ObjectiveTo analyze the trends in life expectancy and cause-eliminated life expectancy of the registered residents in Qingpu District, Shanghai from 2002 to 2021, and to identify the major diseases causing life expectancy loss in the area, so as to provide a theoretical basis for strengthening disease prevention and interventions and optimizing health resources allocation.MethodsUsing the International Classification of Diseases (ICD)-10 classification of death causes, average life expectancy and cause-eliminated life expectancy were calculated with the abbreviated life table and the cause-eliminated life expectancy table. A trend forecast of life expectancy from 2022 to 2029 was made.ResultsFrom 2002 to 2021, the life expectancy of Qingpu District residents showed an increasing trend, with an average annual growth of 0.32 years (AAPC=0.39%, P

Health economics is an area of study that has critical tools for evidence-based healthcare decision making, among which are economic evaluations. These tools allow us to weigh the costs incurred for a given intervention in relation to its health outcomes. The main utility of these studies lies in accomplishing decision-making in healthcare and the formulation of public policies. This article is the first of two reviews on whose main purpose is to address fundamental theoretical concepts of health economic evaluations to facilitate their understanding and critical analysis. The text is part of a methodological series on clinical epidemiology, biostatistics and research methodology conducted by the Evidence-based Medicine team at the School of Medicine of the University of Valparaíso, Chile.

Background: In the last two decades, tyrosine kinase inhibitors (TKIs) and advances in molecular diagnostics have revolutionized management and long-term clinical outcomes in chronic myeloid leukemia (CML). Real-world data from different countries allow for the identification of country-specific issues in the clinical management and development of specific plans for improvement. Here, we aimed to analyze the trend in overall survival in Bulgarian CML patients since 2000. Methods: We retrieved publicly available Bulgarian CML data from several sources such as the Bulgarian National Cancer Registry, Bulgarian National Statistical Institute, and National Health Insurance Fund since 2000. We used the retrieved data of a total of 1513 Bulgarian CML patients to describe the trends in overall survival (OS), conditional overall survival, life expectancy, and life years lost over five time periods. We also described the trends in healthcare expenditures for TKIs and CML patients’ coverage with TKIs since 2014. Results: In both uni- and multivariate models, we found a constant increase in OS over the three 5-year periods until 2014. The period 2015–2019 was not associated with an additional increase in OS. Identical dynamics in the improvement in life expectancy (LE) and in life years lost (LYLs) was observed. Additionally, conditional 5-year survival did not improve during 2015–2019 in comparison to 2010–2014. Population-level data did not show consistent changes in the documented number of deaths due to CML since 2013. The period after 2013 is marked by a constant increase in the annual expenditures for TKIs, reaching to about 2.0 EUR/capita. The number of patients who received at least one TKI also increased during that period. Conclusions: After the initial significant improvement in the clinical outcomes for Bulgarian CML patients until 2014, subsequent periods did not bring further benefit in spite of the improved coverage with second- and third-line TKIs. Multiple factors may contribute to these suboptimal outcomes. Therefore, one can propose several additional measures at the country level, which could lead to additional improvement in the OS of Bulgarian CML patients.

Abstract Purpose An increasing number of patients with Duchenne muscular dystrophy (DMD) now have access to improved standard of care and disease modifying treatments, which improve the clinical course of DMD and extend life expectancy beyond 30 years of age. A key issue for adolescent DMD patients is the transition from paediatric- to adult-oriented healthcare. Adolescents and adults with DMD have unique but highly complex healthcare needs associated with long-term steroid use, orthopaedic, respiratory, cardiac, psychological, and gastrointestinal problems meaning that a comprehensive transition process is required. A sub-optimal transition into adult care can have disruptive and deleterious consequences for a patient’s long-term care. This paper details the results of a consensus amongst clinicians on transitioning adolescent DMD patients from paediatric to adult neurologists that can act as a guide to best practice to ensure patients have continuous comprehensive care at every stage of their journey. Methods The consensus was derived using the Delphi methodology. Fifty-three statements were developed by a Steering Group (the authors of this paper) covering seven topics: Define the goals of transition, Preparing the patient, carers/parents and the adult centre, The transition process at the paediatric centre, The multidisciplinary transition summary – Principles, The multidisciplinary transition summary – Content, First visit in the adult centre, Evaluation of transition. The statements were shared with paediatric and adult neurologists across Central Eastern Europe (CEE) as a survey requesting their level of agreement with each statement. Results Data from 60 responders (54 full responses and six partial responses) were included in the data set analysis. A consensus was agreed across 100% of the statements. Conclusions It is hoped that the findings of this survey which sets out agreed best practice statements, and the transfer template documents developed, will be widely used and so facilitate an effective transition from paediatric to adult care for adolescents with DMD.

The article announces that David R. Williams has received the William B. Graham Prize for Health Services Research, recognizing his contributions to addressing health inequities and emphasizing the profound impact of socioeconomic status and systemic biases on health outcomes.

Abstract Diabetes and hypertension are among the leading causes of death in Bangladesh. This study examined hypertension, diabetes, and either or both, free life expectancy, to measure the effect of the diseases on the overall health of individuals in Bangladesh with regional variations. We utilized data from Bangladesh Sample Vital Statistics 2018 for mortality and Bangladesh Demographic and Health Survey 2017–2018 for diabetes and hypertension. The Sullivan method was employed to estimate age-specific hypertension and diabetes-free life expectancy. Altogether, 10.3% of the people aged 18–19 years lived with either diabetes or hypertension. The hypertension-free life expectancy was 40.4 years, and the diabetes-free life expectancy was 53.2 years for those aged 15–19. Overall, individuals would expect to spend 38.7% of their lives with either of the diseases. Females suffered more from hypertension and males from diabetes. Still, females suffered more from the aggregate of both. Rural people had more diabetes and hypertension-free life expectancy than those of urban. Individuals of Mymensingh had the highest life expectancy free of both diseases compared to other divisions of Bangladesh. Diabetes and hypertension affect a considerable proportion of the life of the population in Bangladesh. Policy actions are needed to guide the prevention, diagnosis, and treatment of both diseases, specifically focusing on women and urban populations. Widespread health-enhancing actions need to be taken to diminish the effect of these two diseases in Bangladesh.

Abstract Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Abstract Background Type 2 diabetes (T2D) is associated with an increased risk of premature death. Whether multifactorial risk factor modification could attenuate T2D-related excess risk of death is unclear. We aimed to examine the association of risk factor target achievement with mortality and life expectancy among patients with T2D, compared with individuals without diabetes. Methods In this longitudinal cohort study, we included 316 995 participants (14 162 with T2D and 302 833 without T2D) free from cardiovascular disease (CVD) or cancer at baseline between 2006 and 2010 from the UK Biobank. Participants with T2D were categorised according to the number of risk factors within target range (non-smoking, being physically active, healthy diet, guideline-recommended levels of glycated haemoglobin, body mass index, blood pressure, and total cholesterol). Survival models were applied to calculate hazard ratios (HRs) for mortality and predict life expectancy differences. Results Over a median follow-up of 13.8 (IQR 13.1–14.4) years, deaths occurred among 2105 (14.9%) participants with T2D and 18 505 (6.1%) participants without T2D. Compared with participants without T2D (death rate per 1000 person-years 4.51 [95% CI 4.44 to 4.57]), the risk of all-cause mortality among those with T2D decreased stepwise with an increasing number of risk factors within target range (0–1 risk factor target achieved: absolute rate difference per 1000 person-years 7.34 [4.91 to 9.78], HR 2.70 [2.25 to 3.25]; 6–7 risk factors target achieved: absolute rate difference per 1000 person-years 0.68 [-0.62 to 1.99], HR 1.16 [0.93 to 1.43]). A similar pattern was observed for CVD and cancer mortality. The association between risk factors target achievement and all-cause mortality was more prominent among participants younger than 60 years than those 60 years or older (P for interaction = 0.012). At age 50 years, participants with T2D who had 0–1 and 6–7 risk factors within target range had an average 7.67 (95% CI 6.15 to 9.19) and 0.99 (-0.59 to 2.56) reduced years of life expectancy, respectively, compared with those without T2D. Conclusions Individuals with T2D who achieved multiple risk factor targets had no significant excess mortality risk or reduction in life expectancy than those without diabetes. Early interventions aiming to promote risk factor modification could translate into improved long-term survival for patients with T2D.