Can You be Biologically Younger than Your Chronological Age? An Overview of Biological Ageing

The ageing of the population is rapidly escalating worldwide irrespective of unpredictable health challenges like climate change, emerging infectious disease, a microbe that develops drug resistance. India is also experiencing rapid socioeconomic progress and urbanization and the result of this demographic transition is population ageing. Even though there is an increase in life expectancy, there is no increase in health span, and thus increased life expectancy leads to ‘expansion of morbidity'. Longer life expectancy with the expansion of morbidity could enforce a challenge to geroscience as well as a substantial health burden and a threat to the national economy. In normal ageing, chronological age equates to biological age but certain disease conditions accelerate biological age. Similarly, intervention with physical activity, anti-ageing nutraceuticals would slow down the rate ageing process and provide powerful benefits for longevity. The current review article is based on MeSH and free-text terms in databases such as PubMed, the Cochrane Library, and Science Direct. This article aims to provide an overview of the concept of biological ageing with emphasis on the pathophysiology of ageing, quantification of biological ageing and the anti-ageing strategies.

Distribution of the compression and expansion of morbidity in 194 countries and territories, 1990–2016: The role of income inequality

Background Compression and expansion of morbidity are two critical hypotheses to analyze the relationship among morbidity, disability, and mortality. This study aims to analyze the global distribution of the compression and expansion of morbidity and to investigate its relationship with income inequality. Methods Data was from the Global Burden of Disease Study 2016 and Standardized World Income Inequality Database, version 8.2. Seven types of health changes were defined. Income inequality was measured with Gini coefficient index. Binary logistic regression was used to analyze the association of income inequality with the compression and expansion of morbidity. Results All the seven types of the compression and expansion of morbidity exist in the world, despite their uneven distribution. The relative expansion of morbidity with increased or constant life expectancy (Type 6) was the most popular type occurring to more than half of populations in the last quarter of century, which was followed by the relative compression of morbidity with increased or constant LE (Type 3, 30.71%). The income inequality was significantly associated with the health changes, which still held after controlling a variety of confounders and in robustness tests. Those societies with lower income inequality were more likely to incur Type 3. Conclusions It is necessary to distinguish the positive and negative changes in life expectancy when examing the compression and expansion of morbidity. The increasing popularity of Type 6 implies higher needs for health and social care. Measures to reduce income inequality or mitigate its negative influence on health changes might promote the occurrence of Type 3.

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

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.

An evaluation of the prevalence of malignant neoplasms in Russia using an incidence-mortality model

This paper aims to estimate Russian cancer incidence and mortality derivatives given limited access to medical and demographic data. We use the population model of cancer proposed by J. Duchêne, which is a special case of a well-known multiple-decrement life table that makes it possible to obtain otherwise inaccessible indicators, such as the prevalence of cancer in the population. Applying this model to the publicly available Russian cancer incidence and mortality data, we were able to estimate the following indicators: average age at disease onset, average duration of disease, prevalence of malignant cancer, and average age at death from malignant cancer in Russia. We aimed to determine whether the prevalence of cancer is on the rise in the Russian Federation and, if it is, whether this increase is occurring due to an expansion of morbidity. It was found that the average age at disease onset and the average age at death from it in Russia are increasing, with the primacy of the latter. These processes are in turn resulting in an increase of the average number of years lived with cancer, thus justifying the hypothesis of an expansion of morbidity. This phenomenon, along with the increase in the incidence of malignant cancer, is what is causing the increased cancer prevalence. Groups of cancer localizations with the highest and lowest prevalence were identified, as well as localizations with a visible tendency toward an expansion of morbidity. It was found that in Russia the general trend is towards the expansion of morbidity, expressed by an increase in the number of years lived in an imperfect health condition. Malignant neoplasms of the lip, oral cavity and oesophagus (C00-C15) in females is the only localization for which the expansion of morbidity does not occur. For this localization a compression of morbidity is observed that is an antipode to the expansion. The main limitations and drawbacks of the study are discussed in a separate section.

Living longer: For better or worse? Changes in life expectancy with and without mobility limitation among older persons in India between 1995-1996 and 2004

This study estimates changes in life expectancy with and without mobility limitation to test whether older persons in India experienced compression or expansion of morbidity from the period 1995–1996 to 2004. Age-specific death rates and the prevalence of mobility limitation were obtained from the Sample Registration System and two rounds (1995–1996/2004) of the National Sample Survey. Sullivan’s method was employed to compute life expectancy with and without mobility limitation by gender and by place of residence. From 1995–1996 to 2004, at ages 60, 70, and 80, older men and older rural persons in India experienced a significant increase in life expectancy without mobility limitation and a significant reduction in the proportion of remaining life with mobility limitation, suggesting a compression of morbidity. However, over this same period, older women and older urban persons seem to have experienced an expansion of morbidity with an increase in life expectancy with mobility limitation and an increase in the proportion of remaining life with mobility limitation. These results call for the promotion and maintenance of physical mobility among all older persons in India, with special attention to older women and older urban persons.

Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010

Introduction The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. “Compression” refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. “Expansion” refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE. Methods We estimated LE using mortality and population data from Statistics Canada. We took health-related quality of life (i.e. morbidity) data used to calculate HALE from the National Population Health Survey (1994–1999) and the Canadian Community Health Survey (2000–2010). We built abridged life tables for seven time intervals, covering the period 1994 to 2010 and corresponding to the year of each available survey cycle, for females and males, and for each of the 10 Canadian provinces. National and provincial trends were assessed at birth, and at ages 20 years and 65 years. Results We observed an overall average annual increase in HALE that was statistically significant in both Canadian females and males at each of the three ages assessed, with the exception of females at birth. At birth, HALE increased an average of 0.2% (p = .08) and 0.3% (p $lt; .001) annually for females and males respectively over the 1994 to 2010 period. At the national level for all three age groups, we observed a statistically nonsignificant average annual increase in the proportion of life spent in an unhealthy state, with the exception of men at age 65, who experienced a non-significant decrease. At the provincial level at birth, we observed a significant increase in proportion of life spent in an unhealthy state for Newfoundland and Labrador (NL) and Prince Edward Island (PEI). Conclusion Our study did not detect a clear overall trend in compression or expansion of morbidity from 1994 to 2010 at the national level in Canada. However, our results suggested an expansion of morbidity in NL and PEI. Our study indicates the importance of continued tracking of the secular trends of life expectancy and HALE in Canada in order to verify the presence of compression or expansion of morbidity. Further study should be undertaken to understand what is driving the observed expansion of morbidity in NL and in PEI.

Expansion of morbidity: trends in healthy life expectancy of the elderly population

Objective: to analyze the changes in life expectancy (LE) and disability-free life expectancy (DFLE) in São Paulo's elderly population to assess the occurrence of compression or expansion of morbidity, between 2000 and 2010. Methods: cross-sectional and population survey, based on official data for the city of São Paulo, Brazil, and data obtained from the Health, Well-Being and Aging Survey (SABE). Functional disability was defined as difficulty in performing at least one basic activity of daily living. The Sullivan method was used to calculate LE and DFLE for the years 2000 to 2010. Results: from 2000 to 2010, there was an increase in disabled life expectancy (DLE) in all age groups and both sexes. The proportion of years of life free of disability, at 60 years of age, decreased from 57.94% to 46.23% in women, and from 75.34% to 63.65% in men. At 75 years of age, this ratio decreased from 47.55% to 34.54% in women, and from 61.31% to 56.01% in men. Conclusion: the expansion of morbidity is an ongoing process in the elderly population of the municipality of São Paulo, in the period of 2000-2010. These results can contribute to the development of preventive strategies and planning of adequate health services to future generations of seniors.

Pregnancy-induced hypertension syndrome and cardiovascular risk

Objective: to analyze the changes in life expectancy (LE) and disability-free life expectancy (DFLE) in São Paulo's elderly population to assess the occurrence of compression or expansion of morbidity, between 2000 and 2010. Methods: cross-sectional and population survey, based on official data for the city of São Paulo, Brazil, and data obtained from the Health, Well-Being and Aging Survey (SABE). Functional disability was defined as difficulty in performing at least one basic activity of daily living. The Sullivan method was used to calculate LE and DFLE for the years 2000 to 2010. Results: from 2000 to 2010, there was an increase in disabled life expectancy (DLE) in all age groups and both sexes. The proportion of years of life free of disability, at 60 years of age, decreased from 57.94% to 46.23% in women, and from 75.34% to 63.65% in men. At 75 years of age, this ratio decreased from 47.55% to 34.54% in women, and from 61.31% to 56.01% in men. Conclusion: the expansion of morbidity is an ongoing process in the elderly population of the municipality of São Paulo, in the period 2000-2010. These results can contribute to the development of preventive strategies and planning of adequate health services to future generations of seniors.

Changes in Disability-Free Life Expectancy in Canada between 1994 and 2007

Life expectancy at birth continues to increase in Canada, reaching 81.2 years in 2009. Knowing whether these older years are healthy or disabled is critical for policymakers. We examine changes in disability-free life expectancy for men and women in Canada in 1994 and 2007 using the Sullivan method. We find that increases in life expectancy for men were due to a moderate increase in healthy years and a larger increase in disabled years. The increases in life expectancy for womenwere driven almost completely by increases in disabled years, suggesting an “expansion of morbidity” among women.