scholarly journals Area-Level Disadvantage and Changes in Disability-Free Life Expectancy for Older Australians

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-641
Author(s):  
Richard Tawiah ◽  
Kaarin Anstey ◽  
Carol Jagger ◽  
Kim Kiely
Keyword(s):  
Life Expectancy ◽  
Socioeconomic Position ◽  
Household Income ◽  
Activity Limitation ◽  
Disability Free Life Expectancy ◽  
Nationally Representative ◽  
Global Activity

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).

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 ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Socioeconomic Position ◽  
Daily Living ◽  
Late Life ◽  
Risk Of Death ◽  
Disability Free Life Expectancy

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.

scholarly journals Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Conditions ◽  
Disadvantaged Groups ◽  
Disability Free Life Expectancy ◽  
Reported Health

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.

Disability-free life expectancy at old ages in Egypt

2020 ◽  
pp. 1-15
Author(s):  
Soha Metwally
Keyword(s):  
Life Expectancy ◽  
Decision Makers ◽  
Sample Population ◽  
Functional Difficulties ◽  
Disability Prevalence ◽  
Disability Free Life Expectancy ◽  
The Common ◽  
Nationally Representative ◽  
Type Data ◽  
Sullivan Method

Abstract This study aimed to estimate among the older population in Egypt (aged 60 years and over): 1) disability prevalence rates, their levels of severity and the common types and 2) disability-free life expectancy (DFLE) by sex, age and disability type. Data were from the nationally representative 2016 Household Observatory Survey (HOS-2016), with 4658 persons aged 60+ constituting the study sample population. To identify individuals with disabilities, the HOS asked respondents a short set of questions on functional difficulties, as suggested by the United Nations Washington Group on Disability Statistics. The DFLE was estimated using the Sullivan method. Older (60+) women reported a higher prevalence of disability than older men. Women had longer DFLEs and longer disabled life expectancies (DLEs) than men but had lower proportions of DFLE to their total lifetime. The findings suggest that, at age 60, around 30% of life expectancy in Egypt can be expected to be with limitations in mobility and vision. Men, although they live for fewer years than women, can expect to have a greater proportion of their life expectancy free of disability. The findings of the study suggest that the contextual differences in how the process of ageing is experienced need to be considered by decision-makers when designing gender-responsive health policies.

scholarly journals Income inequality in disability-free life expectancy in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Brønnum-Hansen ◽  
E Foverskov ◽  
I Andersen
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Social Inequality ◽  
Socioeconomic Position ◽  
Life Tables ◽  
Register Data ◽  
Disposable Income ◽  
Inequality In Health ◽  
Disability Free Life Expectancy ◽  
The Difference

Abstract Background The state old-age pension in Denmark is adjusted in line with the projected increasing life expectancy without taking social inequality in health and life expectancy into account. The purpose of the study was to estimate income disparities in life expectancy and disability-free life expectancy (DFLE) at age 50. Methods By linking nationwide register data on income and mortality each individual at any age was divided into equivalised disposable income quartiles and life tables were constructed for each quartile. Data from the Danish Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data providing access to information on respondents equivalised disposable income. Finally, data from the life tables were combined with prevalence on activity limitations by income quartiles from SHARE to estimate DFLE by Sullivan’s method. Differences in DFLE were investigated and decomposed into contributions from mortality and disability effects. Results A clear social gradient was seen for life expectancy as well as DFLE. Thus, life expectancy at age 50 differed between the highest and lowest income quartile by 8.0 years for men and 5.0 years for women. The difference in DFLE was 11.8 and 10.3 years for men and women, respectively. For men the mortality effect from the decomposition contributed by 4.1 years to the difference of 11.8 years in DFLE and 3.9 years to the difference in expected years with disability of 3.8 years while the disability effect contributed by 7.7 years. Conclusions The study quantifies social inequality in health in Denmark. Although income inequality in life expectancy and DFLE can partly be explained by loss of income due to chronic diseases, one would expect a welfare state to provide better financial security for citizens with health problems. Furthermore, the marked social disparity when approaching retirement age is questioning the fairness of implementing a pension scheme independently of socioeconomic position. Key messages Disability-free life expectancy differs between income quartiles by more than 10 years. Pension age follows the projected increasing life expectancy independently of socioeconomic position. This seems unfair.

Recent Trends in Disability-Free Life Expectancy in the French Elderly Twenty Years Follow-Up of the Paquid Cohort

2013 ◽  
Vol 33 (1) ◽  
pp. 293-311 ◽  
Author(s):  
Karine Pérès ◽  
Arlette Edjolo ◽  
Jean-François Dartigues ◽  
Pascale Barberger-Gateau
Keyword(s):  
Life Expectancy ◽  
Recent Trends ◽  
Disability Free Life Expectancy

Trends in disability-free life expectancy at age 50 years in Australia between 2001 and 2011 by social disadvantage

2021 ◽  
pp. jech-2020-214906
Author(s):  
Richard Tawiah ◽  
Carol Jagger ◽  
Kaarin J Anstey ◽  
Kim M Kiely
Keyword(s):  
Life Expectancy ◽  
Dynamic Equilibrium ◽  
Short Form ◽  
Social Disadvantage ◽  
Multistate Models ◽  
Disability Free Life Expectancy ◽  
Economic Indexes ◽  
Nationally Representative ◽  
Adl Disability ◽  
Disability Severity

BackgroundThe aims of this study were (1) to estimate 10-year trends in disability-free life expectancy (DFLE) by area-level social disadvantage and (2) to examine how incidence, recovery and mortality transitions contributed to these trends.MethodsData were drawn from the nationally representative Household Income and Labour Dynamics in Australia survey. Two cohorts (baseline age 50+ years) were followed up for 7 years, from 2001 to 2007 and from 2011 to 2017, respectively. Social disadvantage was indicated by the Socio-Economic Indexes for Areas (SEIFA). Two DFLEs based on a Global Activity Limitation Indicator (GALI) and difficulties with activities of daily living (ADLs) measured by the 36-Item Short Form Survey physical function subscale were estimated by cohort, sex and SEIFA tertile using multistate models.ResultsPersons residing in the low-advantage tertile had more years lived with GALI and ADL disability than those in high-advantage tertiles. Across the two cohorts, dynamic equilibrium for GALI disability was observed among men in mid-advantage and high-advantage tertiles, but expansion of GALI disability occurred in the low-advantage tertile. There was expansion of GALI disability for all women irrespective of their SEIFA tertile. Compression of ADL disability was observed for all men and for women in the high-advantage tertile. Compared to the 2001 cohort, disability incidence was lower for the 2011 cohort of men within mid-advantage and high-advantage tertiles, whereas recovery and disability-related mortality were lower for the 2011 cohort of women within the mid-advantage tertile.ConclusionOverall, compression of morbidity was more common in high-advantage areas, whereas expansion of morbidity was characteristic of low-advantage areas. Trends also varied by sex and disability severity.

scholarly journals Trends in Education-specific Differences in Disability-Free Life Expectancy in Spain, 2008-2017

2020 ◽  
Author(s):  
Mathias Voigt ◽  
Sebastian Daza ◽  
Dariya Ordanovich ◽  
Alberto Palloni
Keyword(s):  
Chronic Disease ◽  
Life Expectancy ◽  
Functional Limitations ◽  
Social Disparities ◽  
Men And Women ◽  
Disability Free Life Expectancy ◽  
Nationally Representative ◽  
Education Differentials ◽  
Education Groups ◽  
Expansion Of Morbidity

Background: There is mounting evidence for a recent increase of social disparities in chronicdisease prevalence and mortality. However, little is known about how these trends are reflected incombined measures of morbidity, disability and mortality.Method: We use two nationally representative surveys of the Spanish population for the years2008 to 2017 and standard measures of expected duration of disability and illness to assess timetrends and social disparities in mortality, morbidity and expected years lived in disability (DFLE)and with chronic illness (chrDFLE). We provide empirical evidence of shifting trends for thesemeasures. We then decompose these changes into contributions associated with disability, chronicillness and mortality. Finally, we estimate the size of education differentials in DFLE and chrDFLEand evaluate the magnitude and direction of changes of these differentials over time.Results: While the disability based indicator suggests a decrease of expected years withoutdisability for both men and women (expansion of morbidity), the morbidity based indicator showsan increase in time spend free of chronic disease for women but a slight decrease for men. Thedecrease in time spent without disability was observed for all education groups but is particularlymarked for those with low education.Conclusion: We find evidence of an expansion of morbidity in Spain between 2008 and 2017.The bulk of this development is related to increases in time spent with functional limitations overthis period. These patterns occur in conjuncture with growing social disparities in time spend withchronic illness or disability.

scholarly journals Why Are Inequalities in Disability-Free Life Expectancy by Socioeconomic Position Widening?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-640
Author(s):  
Carol Jagger
Keyword(s):  
Life Expectancy ◽  
Life Course ◽  
Socioeconomic Position ◽  
Occupational Status ◽  
Late Life ◽  
Healthy Life ◽  
Disability Free Life Expectancy ◽  
Life Education ◽  
The Uk ◽  
The Life Course

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.

scholarly journals Az élettartammal és az időskori betegségteherrel kapcsolatos szubjektív várakozások

2021 ◽  
Vol 162 (23) ◽  
pp. 911-923
Author(s):  
Zsombor Zrubka ◽  
Áron Kincses ◽  
László Gulácsi ◽  
Levente Kovács ◽  
Márta Péntek
Keyword(s):  
Gender Differences ◽  
Life Expectancy ◽  
Informal Caregiver ◽  
Perceived Health ◽  
Activity Limitation ◽  
Healthy Life Expectancy ◽  
Care Needs ◽  
Healthy Life ◽  
Subjective Expectations ◽  
Global Activity

Összefoglaló. Bevezetés: A lakosság idősödésével növekvő betegségteher egyéni és társadalmi szinten is fokozódó nyomást jelent. Célkitűzés: Felmérni a hazai általános felnőtt lakosságnak a korlátozottsággal, a gondozási igényekkel és a munkavégzéssel kapcsolatos időskori szubjektív várakozásait. Módszer: Online keresztmetszeti felmérést végeztünk. A korlátozottsággal kapcsolatos várakozásokat a hivatalos szakstatisztikákban alkalmazott globális tevékenységkorlátozottsági mutató (Global Activity Limitation Indicator, GALI) segítségével elsőként vizsgáltuk. A jelen és szubjektíve várt munkavégzést, gondozási igényt, gondozói tevékenységet, valamint a jelen egészségi állapotot és szociodemográfiai helyzetet vizsgáló kérdéseket is feltettünk. Statisztikai analízis: A mintában mért adatokat lokális polinom segítségével simítottuk, és a 60/70/80/90 éves korra adott szubjektív várakozásokkal hasonlítottuk össze. A szubjektív várakozásokat meghatározó tényezőket intervallumregresszióval becsültük. Eredmények: 1000 kitöltőtől 914 érvényes választ kaptunk. Az átlagéletkor (± szórás) 51,2 (± 15,2) év, a minta 55,8%-a nő volt. A férfiak között a fizetett munkát végzők (p<0,001), a nők között az informális gondozók aránya volt magasabb (p = 0,010). Az átlagos (± szórás) szubjektíve várható élettartam (81,0 ± 11,1 év) a minta statisztikailag várható élettartamánál (79,6 ± 3,7 év) 1,3 évvel volt hosszabb (p<0,001), azonban az átlagos, szubjektíve várható egészséges élettartam (64,6 ± 15,2 év) 5,3 évvel volt rövidebb a statisztikailag várható értéknél (70,0 ± 4,2 év; p<0,001). A szubjektíve várható egészséges élettartamot és gondozási igényt elsősorban a válaszadók jelenlegi egészségi állapota befolyásolta. Az életmód és a szubjektíve várható egészséges élettartam között nőknél nem találtunk összefüggés, míg a túlzott gyakorisággal alkoholt fogyasztó vagy elhízott férfiak hosszabb egészséges élettartamra számítottak. A szubjektív várakozások meghatározó tényezői jelentős nemi különbségeket mutattak. Következtetés: Az egészséggel, munkával és gondozással kapcsolatos szubjektív várakozások eltérőek a populációban mért valós adatoktól, és különböznek a nemek között. Orv Hetil. 2021; 162(23): 911–923. Summary. Introduction: The growing disease burden due to ageing populations poses a challenge on both individuals and societies. Objective: To explore the general population’s subjective expectations concerning disability, care needs and employment at older ages. Method: We conducted an online cross-sectional survey. We were the first to measure subjective health expectations using the Global Activity Limitation Indicator (GALI) of official health statistics. Respondents’ actual status and subjective expectations concerning employment, care needs and informal caregiver status, self-perceived health and sociodemographic factors were queried. Statistical analysis: We estimated sample characteristics by local polynomial smoothing and compared with subjective expectations at ages of 60/70/80/90 years. Determinants of subjective expectations were analyzed via interval regression. Results: From 1000 subjects, 914 provided valid responses. Mean (± SD) age was 51.2 (± 15.2) years, and 55.8% of respondents were women. Paid employment was more frequent among men (p<0.001), while informal caregiver status among women (p = 0.010). Mean (± SD) subjective life expectancy (81.0 ± 11.1 years) was 1.3 years longer (p<0.001) than actuarial life-expectancy (79.6 ± 3.7 years), while mean subjective healthy life expectancy (sHLE) (64.6 ± 15.2 years) was 5.3 years shorter than actuarial healthy life expectancy (70.0 ± 4.2 years; p<0.001). sHLE and care needs were mainly determined by respondents’ self-perceived health. Lifestyle risks were not associated with sHLE in women, while pervasive drinker or obese men expected longer healthy life span. Determinants of sHLE showed considerable gender differences. Conclusion: Subjective expectations concerning health, employment and care needs differ from actual values of the general population, with considerable gender differences. Orv Hetil. 2021; 162(23): 911–923.

scholarly journals Investigating the effect of e-cigarette use on quitting smoking in adults aged 25 years or more using the PATH study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1099 ◽  
Author(s):  
Peter N. Lee ◽  
John S. Fry
Keyword(s):  
Household Income ◽  
Epidemiological Data ◽  
Study Data ◽  
Sensitivity Analyses ◽  
Cigarette Use ◽  
The Us ◽  
Quitting Smoking ◽  
Recorded Data ◽  
Nationally Representative

Background: Part of the evidence on harms and benefits of e-cigarettes concerns whether using e-cigarettes encourages smokers to quit.  With limited results from controlled trials, and weaknesses in much epidemiological data, we addressed this using nationally representative prospective study data, with detailed accounting for factors associated with quitting. Methods: Analyses used data for adults aged 25+ years from Waves 1 to 3 of the US PATH study. Separate analyses concerned follow-up from Waves 1 to 2, 2 to 3 and 1 to 3.  The main analyses related baseline ever e-cigarette use (or e-product use at Wave 2) to having quit at follow-up, adjusting for predictors of quitting derived from 55 candidates.  Sensitivity analyses omitted adults who had never used other products, linked quitting to current rather than ever e-cigarette use, used modified values of some predictors using later recorded data, or (in Wave 1 to 3 analysis only) also adjusted for quitting by Wave 2. Results: In the main analyses, unadjusted odds ratios (ORs) of quitting for ever e-cigarette use were 1.29 (95% CI 1.01-1.66), 1.52 (1.26-1.83) and 1.47 (1.19-1.82) for the Wave 1 to 2, 2 to 3, and 1 to 3 analyses.  These estimates reduced after adjustment, to 1.23 (0.94-1.61), 1.51 (1.24-1.85) and 1.39 (1.11-1.74).  The final models, including between six and nine predictors, always included household income, everyday/someday smoking, wanting to smoke after waking and having tried quitting, with other variables included in specific analyses.  Quitting rates remained elevated in e-cigarette users in all sensitivity analyses. ORs were increased where other product users were omitted.  Adjusted ORs of quitting for current e-cigarette use were 1.41 (1.06-1.89), 1.30 (1.01-1.67) and 1.56 (1.21-2.00). Conclusions: The results suggest e-cigarettes may assist adult smokers to quit, particularly in individuals not using other nicotine products, and who are current e-cigarette users.

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