Dataset Information

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

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.

SUBMITTER: Alves LC

PROVIDER: S-EPMC6736330 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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

Alves Luciana Correia LC Andrade Flávia Cristina Drumond FCD Corona Ligiana Pires LP Santos Jair Licio Ferreira JLF Duarte Yeda Aparecida De Oliveira YAO

Innovation in aging 20190801 4

<h4>Background and objectives</h4>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) Stud ...[more]

PMID: 31528717

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Project description:BackgroundThe purpose of this study was to estimate individuals' expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d'Ivoire.MethodsPaper-based questionnaires were administered to a sample (n = 267) of older adults residing in the city of Dabou, Côte d'Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals' life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants.ResultsThe mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02, and 77.79 years in the first, second, third, and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component.ConclusionsWe extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly's perception of aging, which could be used to forecast the demand for health services and long-term care needs.

Project description:BackgroundTo plan for pensions and health and social services, future mortality and life expectancy need to be forecast. Consistent forecasts for all subnational units within a country are very rare. Our aim was to forecast mortality and life expectancy for England and Wales' districts.MethodsWe developed Bayesian spatiotemporal models for forecasting of age-specific mortality and life expectancy at a local, small-area level. The models included components that accounted for mortality in relation to age, birth cohort, time, and space. We used geocoded mortality and population data between 1981 and 2012 from the Office for National Statistics together with the model with the smallest error to forecast age-specific death rates and life expectancy to 2030 for 375 of England and Wales' 376 districts. We measured model performance by withholding recent data and comparing forecasts with this withheld data.FindingsLife expectancy at birth in England and Wales was 79·5 years (95% credible interval 79·5-79·6) for men and 83·3 years (83·3-83·4) for women in 2012. District life expectancies ranged between 75·2 years (74·9-75·6) and 83·4 years (82·1-84·8) for men and between 80·2 years (79·8-80·5) and 87·3 years (86·0-88·8) for women. Between 1981 and 2012, life expectancy increased by 8·2 years for men and 6·0 years for women, closing the female-male gap from 6·0 to 3·8 years. National life expectancy in 2030 is expected to reach 85·7 (84·2-87·4) years for men and 87·6 (86·7-88·9) years for women, further reducing the female advantage to 1·9 years. Life expectancy will reach or surpass 81·4 years for men and reach or surpass 84·5 years for women in every district by 2030. Longevity inequality across districts, measured as the difference between the 1st and 99th percentiles of district life expectancies, has risen since 1981, and is forecast to rise steadily to 8·3 years (6·8-9·7) for men and 8·3 years (7·1-9·4) for women by 2030.InterpretationPresent forecasts underestimate the expected rise in life expectancy, especially for men, and hence the need to provide improved health and social services and pensions for elderly people in England and Wales. Health and social policies are needed to curb widening life expectancy inequalities, help deprived districts catch up in longevity gains, and avoid a so-called grand divergence in health and longevity.FundingUK Medical Research Council and Public Health England.

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Dataset Information

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

Publications

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

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