scholarly journals US REGIONAL DIFFERENCES IN HEALTHY AND TOTAL LIFE EXPECTANCY FOR PERSONS WITH AND WITHOUT DIABETES: AN ILLUSTRATION OF TWO MULTISTATE LIFE TABLE METHODS

2015 ◽  
Vol 55 (Suppl_2) ◽  
pp. 350-351
BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045261
Author(s):  
Jose Eduardo Cabrero Castro ◽  
Carmen García-Peña ◽  
Ricardo Ramírez Aldana

ObjectivesTo analyse the transitions of disability onset and recovery, estimate life expectancy (LE) with and without disability and explore the relation between insurance and disability patterns in the population aged 50+ in Mexico.DesignMultistate life table analysis of data from a longitudinal cohort survey.SettingData came from the Mexican Health and Aging Study, a longitudinal and representative survey of older adults in Mexico.Participants10 651 individuals aged 50+ interviewed in 2012 and 2015, including those who died between waves.Primary and secondary outcome measuresDisability is measured using the activities of daily living (ADL) scale. Transition rates between disability free, ADL disabled and death were employed to estimate total life expectancy (TLE) and disability-free life expectancy (DFLE).Results46% of the individuals who reported an ADL limitation in 2012 recover from disability by 2015. TLE at age 60 for people without ADL limitations is 30 years (95% CI 28.9 to 31), out of which 4.7 years (95% CI 4.1 to 5.4) are lived with ADL limitations, while TLE at age 60 in the initially disabled is 18.7 years (95% CI 17.3 to 20), with 9.4 years (95% CI 8.4 to 10.3) lived with disability. DFLE at age 60 in people with social security is 24.2 years (95% CI 23.3 to 25.2), in people with public insurance is 24.6 years (95% CI 23.7 to 25.4) and in uninsured people is 26.9 years (95% CI 25.9 to 27.9).ConclusionsIn Mexico, a substantial proportion of ADL disabled individuals recover from disability. Nevertheless, initially disabled individuals have a considerably lower DFLE regardless of age when compared with initially active individuals. There appeared to be no differences in terms of disability and LEs between the individuals with social security and public insurance.


2021 ◽  
Author(s):  
Thomas M. Gill ◽  
Emma X. Zang ◽  
Terrence E. Murphy ◽  
Linda Leo-Summers ◽  
Evelyne A. Gahbauer ◽  
...  

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.


Author(s):  
Khaled TAFRAN ◽  
Makmor TUMIN ◽  
Ahmad Farid OSMAN

Background: The primary indicator of public health, which all nations aim to prolong, is life expectancy at birth. Uncovering its socioeconomic determinants is key to extending life expectancy. This study examined the determinants of life expectancy in Malaysia. Methods: This observational study employs secondary data from various official sources of 12 states and one federal territory in Malaysia (2002-2014). Panel data of 78 observations (13 cross-sections at six points in time) were used in multivariate, fixed-effect, regressions to estimate the effects of socioeconomic variables on life expectancy at birth for male, female and both-gender. Results: Poverty and income significantly determine female, male, and total life expectancies. Unemployment significantly determines female and total life expectancies, but not male. Income inequality and public spending on health (as a percentage of total health spending) do not significantly determine life expectancy. The coefficients of the multivariate regressions suggest that a 1% reduction in poverty, 1% reduction in unemployment, and around USD 23.20 increase in household monthly income prolong total life expectancy at birth by 17.9, 72.0, and 16.3 d, respectively. The magnitudes of the effects of the socioeconomic variables on life expectancy vary somewhat by gender. Conclusion: Life expectancy in Malaysia is higher than the world average and higher than that in some developing countries in the region. However, it is far lower than the advanced world. Reducing poverty and unemployment and increasing income are three effective channels to enhance longevity.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rumi Tsukinoki ◽  
Takehito Hayakawa ◽  
Aya Kadota ◽  
Yoshitaka Murakami ◽  
Katsuyuki Miura ◽  
...  

Abstract Background Healthy life expectancy (HLE) is an important measure of an ageing society. We estimated HLE based on combinations of smoking, blood pressure (BP), and body mass index (BMI) in the Japanese population using a multistate life table. Methods A nationwide cohort study of Japan was performed using NIPPON DATA90 (N = 6,676) with the Katz Activities of Daily Living Index as the HLE endpoint. Combinations of smoking (non-smokers and smokers), BP (2018 ESC/ESH Guidelines classification), and BMI (underweight, normal, and overweight) were developed, and the group-specific HLEs were calculated using a multistate life table. Results At age 65, smokers had shorter HLE than non-smokers for all BMI and BP groups. The HLE of men who were overweight, hypertensive (Grade 2 or 3), and smokers was 14.05 years (95% confidence interval: 15.77-21.36); in contrast, the HLE of men who were normal weight, normotensive, and non-smokers was 19.04 years (16.46-21.61). Among all BMI and smoking status groups, HLE decreased linearly as BP increased regardless of sex. The HLE distribution showed a slight inverted U-shape as BMI increased in both sexes. Conclusions This study showed that HLE at age 65 was considerably shorter in smokers and individuals with higher BP. Furthermore, both underweight and overweight had modest effects on HLE at age 65. Key messages HLE was considerably shorter in smokers and individuals with higher BP. In addition, both underweight and overweight had modest effects on HLE.


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

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.


Epidemiology ◽  
2005 ◽  
Vol 16 (4) ◽  
pp. 556-562 ◽  
Author(s):  
Marlies E. Ossewaarde ◽  
Michiel L. Bots ◽  
Andr?? L. M. Verbeek ◽  
Petra H. M. Peeters ◽  
Yolanda van der Graaf ◽  
...  

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 54-56
Author(s):  
Peerzada Umar Farooq Baba ◽  
Adil Hafeez Wani

The average life expectancy in the world has increased substantially in the past few decades. Modifiable lifestyle factors including smoking, physical activity, alcohol intake, body weight, and diet quality affect both total life expectancy and incidence of chronic diseases. Few studies have comprehensively examined how a combination of multiple lifestyle factors may relate to life expectancy free from major diseases such as diabetes, cardiovascular disease, and cancer. A Harvard team examined the effect of healthy lifestyle factors on life expectancy free of chronic diseases, using data from up to 34 years of follow-up in the Nurses’ Health Study (NHS) (1980-2014; n=73 196) and 28 years of follow-up in the Health Professions Follow-up Study (HPFS)(1986-2014;n=38 366). A healthy lifestyle score based on information on five lifestyle factors—diet, smoking, physical activity, alcohol consumption, and body mass index (BMI) was derived. Five low-risk lifestyle factors included: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). Women who met all the healthful lifestyle measures had an additional 10.7 years of disease-free life compared with women who met no healthful lifestyle measures. For men, the number was 7.6 additional disease-free years. So it was concluded that a healthier lifestyle was associated with an increased total life expectancy and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes. Findings suggest that the promotion of a healthy lifestyle would help to reduce healthcare burdens. Public policies for improving food and the physical environment conducive to adopting a healthy diet and lifestyle are critical to improving life expectancy, especially life expectancy free of major chronic diseases. Source: BMJ 2020; 368:l6669 http://dx.doi.org/10.1136/bmj.l6669


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