scholarly journals Inequalities in Life Expectancy With Frailty Among Brazilian Older Adults: A Multistate Approach

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Luciana Correia Alves ◽  
Flávia Cristina Drumond Andrade ◽  
Ligiana Pires Corona ◽  
Jair Licio Ferreira Santos ◽  
Yeda Aparecida De Oliveira Duarte
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Educational Achievement ◽  
Well Being ◽  
Healthy Life ◽  
Public Health Policies ◽  
Frailty Status ◽  
Total Life Expectancy ◽  
Aging Societies ◽  
Total Life

Abstract Background and Objectives Frailty is considered one of the major conditions faced by aging societies. Little has been reported about the effect of becoming frail on life expectancy among older adults in developing countries. The aim was to estimate total life expectancy and life expectancy with or without frailty by age, sex, and education among older adults in Brazil. Data and Methods:  The study was developed based on information provided by the Health, Well-being, and Aging (SABE) Study. The sample included 1,399 older adults (≥60 years old) followed up from 2006 to 2010. Frailty status was classified according to the Fried criteria. Additional variables include age (in years), gender, and years of education. Estimates of total life expectancy, frailty-free life expectancy, and frailty life expectancy were obtained using the multistate life table method. Results At the baseline, the proportion of individuals with frailty was 13.7% and participants had, on average, 4.0 years of education. Men had more years of education than women (4.6 vs. 3.7, p < .001). Older adults with higher education live fewer years with frailty. Compared with older adults with no education, those with 6 years of education have higher frailty-free life expectancy. At age 70, men with no education expect to live 9.1 years (95% confidence interval [CI] = 7.8, 10.4) without frailty compared with 10.6 years (95% CI = 9.4, 11.8) among those with 6 years of education. Among women age 70, frailty-free life expectancy reaches 11.7 years (95% CI = 10.6, 12.8) among those with no education, but 13.9 years (95% CI = 12.5, 15.3) among those with 6 years. Implications Given the recent changes in educational achievement in Brazil, we believe that educational policies are powerful ways in addressing inequalities in healthy life expectancy. Public health policies aimed at avoiding the development of frailty among elderly at risk should be encouraged.

scholarly journals Ageing and COVID-19: What Is the Role for Elderly People?

Geriatrics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 25 ◽  
Author(s):  
Donatella Rita Petretto ◽  
Roberto Pili
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Elderly People ◽  
Well Being ◽  
Good Health ◽  
Complex Situation ◽  
Risk Of Death ◽  
Age Related ◽  
Total Life Expectancy ◽  
Very High

Italy is one of the oldest countries in Europe and in the world and now it is also one of the first countries that are fighting against COVID-19. In our country, the increasing life expectancy (80.5 for males and 84.9 for females, with a total life expectancy of 82.9) has led to very positive consequences for health and the well-being of elderly people: a very high number of older adults lives and acts independently in their daily life, even if they have one or more than one chronic disease. In the time of COVID-19′s outbreak in Italy, the focus of the media was on elderly people for two main reasons. First, many older people demonstrated a very high civic sense and they were helping society to fight against the pandemic. Second, also in Italy, like in China, the older adults are at higher risk in being infected with COVID-19 and if they get ill, they have a higher risk of death. The balance previously achieved between age-related disorders and a good quality of life and good health is now under high pressure. It is very important to protect elderly people from infection, but also it is important to respect them and to support them in this complex situation. There is a great risk of “ageism”. In agreement with Lloyd-Sherlock and colleagues (2020), in this editorial we propose some hints of analysis, starting from the ongoing experience in Italy.

US State Disparities in Life Expectancy, Disability-Free Life Expectancy, and Disabled Life Expectancy Among Adults Aged 25 to 89 Years

2021 ◽  
Vol 111 (4) ◽  
pp. 708-717
Author(s):  
Mateo P. Farina ◽  
Anna Zajacova ◽  
Jennifer Karas Montez ◽  
Mark D. Hayward
Keyword(s):  
Life Expectancy ◽  
Well Being ◽  
The United States ◽  
Community Survey ◽  
Us States ◽  
Southern States ◽  
Total Life Expectancy ◽  
Similar Range ◽  
Disability Free Life Expectancy ◽  
Total Life

Objectives. To estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and disabled life expectancy (DLE) by US state for women and men aged 25 to 89 years and examine the cross-state patterns. Methods. We used data from the 2013–2017 American Community Survey and the 2017 US Mortality Database to calculate state-specific TLE, DFLE, and DLE by gender for US adults and hypothetical worst- and best-case scenarios. Results. For men and women, DFLEs and DLEs varied widely by state. Among women, DFLE ranged from 45.8 years in West Virginia to 52.5 years in Hawaii, a 6.7-year gap. Men had a similar range. The gap in DLEs across states was 2.4 years for women and 1.6 years for men. The correlation among DFLE, DLE, and TLE was particularly strong in southern states. The South is doubly disadvantaged: residents have shorter lives and spend a greater proportion of those lives with disability. Conclusions. The stark variation in DFLE and DLE across states highlights the large health inequalities present today across the United States, which have significant implications for individuals’ well-being and US states’ financial costs and medical care burden.

Decennial trends and inequalities in healthy life expectancy: The HUNT Study, Norway

2017 ◽  
Vol 46 (1) ◽  
pp. 124-131 ◽  
Author(s):  
Siri H. Storeng ◽  
Steinar Krokstad ◽  
Steinar Westin ◽  
Erik R. Sund
Keyword(s):  
Life Expectancy ◽  
Good Health ◽  
Healthy Life Expectancy ◽  
Healthy Life ◽  
Self Rated Health ◽  
Total Life Expectancy ◽  
Life Years ◽  
Educational Groups ◽  
Hunt Study ◽  
Total Life

Aims: Norway is experiencing a rising life expectancy combined with an increasing dependency ratio – the ratio of those outside over those within the working force. To provide data relevant for future health policy we wanted to study trends in total and healthy life expectancy in a Norwegian population over three decades (1980s, 1990s and 2000s), both overall and across gender and educational groups. Methods: Data were obtained from the HUNT Study, and the Norwegian Educational Database. We calculated total life expectancy and used the Sullivan method to calculate healthy life expectancies based on self-rated health and self-reported longstanding limiting illness. The change in health expectancies was decomposed into mortality and disability effects. Results: During three consecutive decades we found an increase in life expectancy for 30-year-olds (~7 years) and expected lifetime in self-rated good health (~6 years), but time without longstanding limiting illness increased less (1.5 years). Women could expect to live longer than men, but the extra life years for females were spent in poor self-rated health and with longstanding limiting illness. Differences in total life expectancy between educational groups decreased, whereas differences in expected lifetime in self-rated good health and lifetime without longstanding limiting illness increased. Conclusions: The increase in total life expectancy was accompanied by an increasing number of years spent in good self-rated health but more years with longstanding limiting illness. This suggests increasing health care needs for people with chronic diseases, given an increasing number of elderly. Socioeconomic health inequalities remain a challenge for increasing pensioning age.

Impact of Diabetes on Life and Healthy Life Expectancy Among Older Women

2020 ◽  
Author(s):  
Befikadu L Wubishet ◽  
Julie E Byles ◽  
Melissa L Harris ◽  
Carol Jagger
Keyword(s):  
Life Expectancy ◽  
Older Women ◽  
Healthy Life Expectancy ◽  
Diabetes Diagnosis ◽  
Healthy Weight ◽  
Healthy Life ◽  
Total Life Expectancy ◽  
Increased Risk ◽  
The Impact ◽  
Total Life

Abstract Background Diabetes is a major chronic condition with ever-increasing health and economic burden. This study aimed to measure the impact of diabetes on total life expectancy (TLE) and healthy life expectancy (HLE) at ages 70 and 80 and to assess how educational level, obesity, and comorbidity affected the expectancies. Methods The study involved 9849 population-representative women born between 1921 and 1926 from the Australian Longitudinal Study on Women’s Health (ALSWH). Self-rated health was obtained from the ALSWH surveys. Diabetes diagnosis was ascertained using survey and health care administrative data. Total life expectancy and HLE were estimated for women with and without diabetes using multistate modeling. Results Diabetes was associated with an increased risk of poor health (adjusted risk ratio: 1.63, 95% confidence interval: 1.49–1.79). Diabetes was also associated with a reduction of 0.9 years in HLE and 2.6 years in TLE at age 70 and 0.4 years in HLE and 1.3 years in TLE at age 80. If a woman had low education, obesity, and more than 2 comorbidities in addition to diabetes, these reductions increased to 3.0 years in TLE and 7.9 years in HLE at age 70 and 1.5 years in TLE and 3.8 years in HLE at age 80. Conclusions Diabetes substantially reduced older women’s quantity and quality of life, with further reductions for those with lower education, obesity, and comorbidities. These findings underscore the importance of optimally managing diabetes by maintaining a healthy weight and delaying the onset of comorbidities, to promote healthy aging for older women with diabetes.

scholarly journals Life expectancy with negative physical oral health impact on quality of life in older adults

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Eduardo José Pereira Oliveira ◽  
Luciana Correia Alves ◽  
Yeda Aparecida de Oliveira Duarte ◽  
Fabíola Bof de Andrade
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Oral Health ◽  
Life Expectancy ◽  
Well Being ◽  
Health Impact ◽  
Education Level ◽  
Mortality Data ◽  
Total Life Expectancy

Abstract: Oral impairments can affect overall health and life expectancy in older adults. Our study evaluates the life expectancy with negative physical oral health impact on quality of life (POHIQoL) among older adults. Life expectancy with negative POHIQoL was estimated by the Sullivan method, using the prevalence of POHIQoL - obtained in the Health, Well-being and Ageing (SABE Study); and official mortality data for adults aged 60 years or older living in São Paulo, Brazil. Between 2000 and 2010, negative POHIQoL increased from 23.4% (95%CI: 20.2-26.9) to 30.4% (95%CI: 27.0-34.3) among older adults; total life expectancy increased from 22 and 17.5 to 23.7 and 19.4 years among 60-year-old women and men, respectively; and the proportion of remaining years to be lived with negative POHIQoL increased from 25.1% to 32.1% for the same age group. In both years, individuals aged 60 years with lower education level were expected to live more years with negative POHIQoL when compared with the most schooled ones (2000: 15.9 [95%CI: 15.0-16.8] vs. 14.3 [95%CI: 13.7-14.8]; 2010: 16.3 [95%CI: 15.1-17.4] vs. 14.1 [95%CI: 13.2-15.1]). Similarly, women were expected to live more years with negative POHIQoL than men. Within ten years, life expectancy with negative POHIQoL increased, as well as the existence of inequalities in sex and education level among Brazilian older adults. Expansion in coverage and focus on equity in dental care are still necessary to overcome persistent dental-related problems and inequalities and, therefore, contribute to healthy ageing.

scholarly journals Changing Educational Gradients in Life Expectancy With and Without Disease Among U.S. Older Adults From 2000 to 2010

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 505-505
Author(s):  
Matthew Farina ◽  
Phillip Cantu ◽  
Mark Hayward
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Chronic Diseases ◽  
Population Aging ◽  
Good Health ◽  
Vital Statistics ◽  
Healthy Life Expectancy ◽  
Healthy Life ◽  
Education Group ◽  
Education Groups

Abstract Recent research has documented increasing education inequality in life expectancy among U.S. adults; however, much is unknown about other health status changes. The objective of study is to assess how healthy and unhealthy life expectancies, as classified by common chronic diseases, has changed for older adults across education groups. Data come from the Health and Retirement Study and National Vital Statistics. We created prevalence-based life tables using the Sullivan method to assess sex-specific life expectancies for stroke, heart disease, cancer, and arthritis by education group. In general, unhealthy life expectancy increased with each condition across education groups. However, the increases in unhealthy life expectancy varied greatly. While stroke increased by half a year across education groups, life expectancy with diabetes increased by 3 to 4 years. In contrast, the evidence for healthy life expectancy provides mixed results. Across chronic diseases, healthy life expectancy decreased by 1 to 3 years for respondents without a 4-year degree. Conversely, healthy life expectancy increased for the college educated by .5 to 3 years. While previous research shows increases in life expectancy for the most educated, trends in life expectancy with chronic conditions is less positive: not all additional years are in lived in good health. In addition to documenting life expectancy changes across education groups, research assessing health of older adults should consider the changing inequality across a variety of health conditions, which will have broad implications for population aging and policy intervention.

scholarly journals Neighborhood Disadvantage and Active, Disabled and Total Life Expectancy Among Community-living Older Persons

2021 ◽  
Author(s):  
Thomas M. Gill ◽  
Emma X. Zang ◽  
Terrence E. Murphy ◽  
Linda Leo-Summers ◽  
Evelyne A. Gahbauer ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Life Expectancy ◽  
Older Persons ◽  
Neighborhood Disadvantage ◽  
Community Living ◽  
Remaining Life ◽  
Disadvantaged Group ◽  
Individual Level ◽  
Total Life Expectancy ◽  
Total Life

AbstractBackgroundNeighborhood disadvantage is a novel social determinant of health that could adversely affect the functional well-being and longevity of older persons. We evaluated whether estimates of active, disabled and total life expectancy differ on the basis of neighborhood disadvantage after accounting for individual-level socioeconomic characteristics and other prognostic factors.MethodsWe used data on 754 community-living older persons from South Central Connecticut, who completed monthly assessments of disability from 1998 to 2020. Scores on the area deprivation index were dichotomized at the 80th state percentile to distinguish neighborhoods that were disadvantaged (81-100) from those that were not (1-80).ResultsWithin 5-year age increments from 70 to 90, active and total life expectancy were consistently lower in participants from neighborhoods that were disadvantaged versus not disadvantaged, and these differences persisted and remained statistically significant after adjustment for individual-level race/ethnicity, education, income, and other prognostic factors. At age 70, adjusted estimates (95% CI) for active and total life expectancy (in years) were 12.3 (11.5-13.1) and 15.0 (13.8-16.1) in the disadvantaged group and 14.2 (13.5-14.7) and 16.7 (15.9-17.5) in the non-disadvantaged group. At each age, participants from disadvantaged neighborhoods spent a greater percentage of their projected remaining life disabled, relative to those from non-disadvantaged neighborhoods, with adjusted values (SE) ranging from 17.7 (0.8) vs. 15.3 (0.5) at age 70 to 55.0 (1.7) vs. 48.1 (1.3) at age 90.ConclusionsLiving in a disadvantaged neighborhood is associated with lower active and total life expectancy and a greater percentage of projected remaining life disabled.

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