scholarly journals Trends in Health Expectancies by Late-Life Disadvantage: The Cognitive Function and Ageing Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-640
Author(s):  
Holly Bennett ◽  
Andrew Kingston ◽  
Gemma Spiers ◽  
Louise Robinson ◽  
Clare Bambra ◽  
...  

Abstract To understand how and why disability-free life expectancy (DFLE) trends differ by socioeconomic position (SEP) we use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Between 1991 and 2011, men aged 65 gained more in life expectancy (LE) than DFLE, with the greatest gain in DFLE for the most advantaged and in disability years for the most disadvantaged. The most advantaged men experienced a 60% reduction in the risk of death when disability-free, 30% reduction in incident disability, and 80% increase in recovery. The most disadvantaged experienced a 30% reduction of death but from disability. Women overall, and in the most advantaged groups, gained similar years of LE and DFLE to men but due to a 30% reduction in incident disability only.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. We use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040098
Author(s):  
Bingyan Gong ◽  
Shaomei Shang ◽  
Chao Wu

ObjectivesThis study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).DesignCross-sectional analyses combined with retrospective longitudinal analyses.SettingWe included 450 communities in China.ParticipantsIn this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measuresDisability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.ResultsOf 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.ConclusionsIn older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-640
Author(s):  
Carol Jagger

Abstract Life expectancy has increased over previous decades, but several countries are seeing widening inequalities in disability-free life expectancy (DFLE) by socioeconomic position (SEP). In this symposium we address three unanswered questions.1. Do DFLE trends differ for SEP groups, and which of the underlying transitions (incidence, recovery, death when disability-free, death when already disabled) explains the differences?2. Do DFLE trends by SEP depend on when in the life-course SEP is measured (early life - education, mid-life - occupational status or late-life - material disadvantage)?3. How much does multi-morbidity contribute to differing trends in DFLE by SEP, since multi-morbidity is more prevalent in low SEP groups? To answer these questions, we use unique longitudinal studies of older people across different generations in two countries: the UK (Cognitive Function and Ageing Studies – CFAS I and II) and Australia (Household, Income and Labour Dynamics in Australia – HILDA). The first presentation sets the scene with findings from a systematic review of worldwide trends in life and healthy life expectancy by SEP. Presentations two and three examine the first question using DFLE at age65 by SEP defined by late-life disadvantage in CFAS (1991-2011), followed by HILDA (2001-2017). The fourth presentation investigates the effect of different life-course measures of SEP using HILDA. The final presentation from CFAS examines the third question. This symposium increases our understanding of how and why inequalities in DFLE by SEP are changing with the goal of achieving healthy ageing for all.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-641
Author(s):  
Richard Tawiah ◽  
Kaarin Anstey ◽  
Carol Jagger ◽  
Kim Kiely

Abstract We report the first analysis of inequalities in Disability-Free Life Expectancy (DFLE) trends for Australia, based on two cohorts of the nationally representative Household Income and Labour Dynamics in Australia survey. Each cohort was aged 45+ at baseline with 7-years of annual follow-up (Older cohort: 2001-2007, n=6363; Younger cohort: 2011-2017, n=8197). Disability was defined by a Global Activity Limitation Indicator, and socioeconomic position (SEP) by an area-level index of disadvantage. Compared to men in high advantage areas, men residing in low advantage areas experienced smaller gains in life expectancy (3.0 vs 4.6 years at age 65), DFLE (0.6 vs 1.8 years) and years with disability (2.4 vs 2.8 years). In contrast, for women in low advantage areas all years gained in life expectancy (2.6 years) were years with disability, whereas women in high advantage areas experienced gains in DFLE (1.7 years) and even more years with disability (2.7 years).


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 664-664
Author(s):  
Cesar de Oliveira ◽  
Dorina Cadar ◽  
Jane Biddulph ◽  
Juliana Vaz de Melo Mambrini ◽  
Fabiola Bof de Andrad ◽  
...  

Abstract Functional loss among older adults is known to follow a hierarchical sequence, but little is known about this in low-middle income countries. We examined longitudinally the hierarchy of loss in physical functioning in 1,602 older Brazilian adults (aged 60+) from the Bambui Cohort Study of Aging. Functional loss was ascertained using self-reported difficulties in six basic activities of daily living (BADL). The incidence for each BADL limitation was assessed using survival analysis while controlling for the competing risk of death. Over the 15-year follow-up, the incidence in BADL disability rate was highest for dressing, followed by getting out of bed, bathing/showering, walking across a room, using the toilet or eating. The findings from this 15-year follow-up Brazilian aging cohort support a hierarchical pattern of disability in activities of daily living based on both prevalence and incidence of disabilities over time, and they suggest gender differences in the incidence of disability.


2019 ◽  
Vol 34 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Esra Ates Bulut ◽  
Pinar Soysal ◽  
Idil Yavuz ◽  
Suleyman Emre Kocyigit ◽  
Ahmet Turan Isik

The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups ( P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia ( P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.


2015 ◽  
Vol 50 (2) ◽  
pp. 237-246 ◽  
Author(s):  
Po-Wen Ku ◽  
Kenneth R. Fox ◽  
Paul A. Gardiner ◽  
Li-Jung Chen

2021 ◽  
pp. 140349482110117
Author(s):  
Siri H. Storeng ◽  
Simon Øverland ◽  
Vegard Skirbekk Erstatt ◽  
Laila Arnesdatter Hopstock ◽  
Erik R. Sund ◽  
...  

Aim: Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017. Method: National life table data were combined with cross-sectional data on functional ability for 70+ year-olds from the population-based Trøndelag Health Surveys 2-4 (1995–1997, 2006–2008 and 2017–2019) ( n=24,733). Self-reported functional ability was assessed on a graded scale by a combination of Instrumental Activities of Daily Living (IADL) such as paying bills, going out or shopping (mild disability) and Personal Activities of Daily Living (PADL) such as washing, dressing or eating (severe disability). LE, DFLE, Mild-Disability LE and Severe-Disability LE at age 70 were estimated by the Sullivan method. Results: From 1995 to 2017 DFLE at age 70 increased from 8.4 to 13.0 years in women, and from 8.0 to 12.1 years in men. DFLE increased in the basic and high educational groups, but more so in the high educational group among men. Educational inequalities in years spent with disability however, remained low. Conclusions: From the mid-1990s and over the past three decades both LE and DFLE at 70 years increased in the older Norwegian population, for both men and women, and across basic and high educational levels. Educational inequalities in DFLE increased, especially in men, but years spent with disability were similar across the three decades.


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