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Socioeconomic Disparities in Disability-Free Life Expectancy and Life Expectancy Among Older Chinese Adults From a 7-Year Prospective Cohort Study.

ABSTRACT: Objectives: We examined the magnitude and determinants of socioeconomic disparities in disability-free life expectancy and life expectancy at age 65 (DFLE₆₅ and LE₆₅) in China. Methods: Data from Chinese Longitudinal Healthy Longevity Survey collected during 2011-2018 (8,184 participants aged ≥65) were used. Socioeconomic status (SES) was measured by economic status (ES), and education, respectively. Multistate Markov models and microsimulations were fitted to estimate DFLE₆₅ and LE₆₅. Results: LE₆₅ between high- and low-ES groups differed by 2.20 years for males and 2.04 years for females. The DFLE₆₅ disparity in ES was 1.51 and 1.29 years for males and females, respectively. Not undergoing physical examinations, inadequate fruit/vegetable intake, and stress contributed to 35.10% and 57.36% of DFLE₆₅ disparity in ES, as well as 26.36% and 42.65% of LE₆₅ disparity for males and females, respectively. These disparities in education and ES were of a similar magnitude, while the above factors contributed little to education disparity. Conclusion: Socioeconomic disparities in DFLE₆₅ and LE₆₅ existed in China. Physical examination, fruit/vegetable intake and stress partly explained these disparities.

SUBMITTER: Zhan Y

PROVIDER: S-EPMC9302194 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Religion, Life Expectancy, and Disability-Free Life Expectancy Among Older Women and Men in the United States.

Project description:OBJECTIVES:Existing literature shows religion is associated with health and survival separately. We extend this literature by considering health and survival together using a multistate life table approach to estimate total, disability-free, and disabled life expectancy (LE), separately for women and men, for 2 disability measures, and by 2 indicators of religion. METHOD:Data come from the Health and Retirement Study (1998-2014 waves). Predictors include importance of religion and attendance at religious services. The disability measures are defined by ADLs and IADLs. Models control for sociodemographic and health covariates. RESULTS:Attendance at religious services shows a strong and consistent association with life and health expectancy. Men and women who attend services at least once a week (compared with those who attend less frequently or never) have between 1.1 and 5.1 years longer total LE and between 1.0 and 4.3 years longer ADL disability-free LE. Findings for IADL disability are similar. Importance of religion is related to total and disabled LE (both ADL and IADL), but the differentials are smaller and less consistent. Controlling for sociodemographic and health factors does not explain these associations. DISCUSSION:By estimating total, disability-free, and disabled LE, we are able to quantify the advantage of religion for health. Results are consistent with previous studies that have focused on health and mortality separately.

| S-EPMC6941211 | biostudies-literature

Religious activity, life expectancy, and disability-free life expectancy in Taiwan.

Project description:Research has implicated religious activity as a health determinant, but questions remain, including whether associations persist in places where Judeo-Christian religions are not the majority; whether public versus private religious expressions have equivalent impacts, and the precise advantage expressed as years of life. This article addresses these issues in Taiwan. 3,739 Taiwanese aged 53+ were surveyed in 1999, 2003, and 2007. Mortality and disability were recorded. Religious activities in public and private settings were measured at baseline. Multistate life-tables produced estimates of total life expectancy and activity of daily living (ADL) disability-free life expectancy across levels of public and private religious activity. There is a consistent positive gradient between religious activity and expectancy with greater activity related to longer life and more years without disability. Life and ADL disability-free life expectancies for those with no religious affiliation fit in between the lowest and highest religious activity groups. Results corroborate evidence in the West. Mechanisms that intervene may be similar in Eastern religions despite differences in the ways in which popular religions are practiced. Results for those with no affiliation suggest benefits of religion can be accrued in alternate ways.

| S-EPMC5549130 | biostudies-other

Impact of diabetes on longevity and disability-free life expectancy among older South African adults: A prospective longitudinal analysis.

Project description:AimsWe seek to understand the coexisting effects of population aging and a rising burden of diabetes on healthy longevity in South Africa.MethodsWe used longitudinal data from the 2015 and 2018 waves of the "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI) study to explore life expectancy (LE) and disability-free life expectancy (DFLE) of adults aged 45 and older with and without diabetes in rural South Africa. We estimated LE and DFLE by diabetes status using Markov-based microsimulation.ResultsWe find a clear gradient in remaining LE and DFLE based on diabetes status. At age 45, a man without diabetes could expect to live 7.4 [95% CI 3.4 - 11.7] more years than a man with diabetes, and a woman without diabetes could expect to live 3.9 [95% CI: 0.8 - 6.9] more years than a woman with diabetes. Individuals with diabetes lived proportionately more years subject to disability than individuals without diabetes.ConclusionsWe find large and important decrements in disability-free aging for people with diabetes in South Africa. This finding should motivate efforts to strengthen prevention and treatment efforts for diabetes and its complications for older adults in this setting.

| S-EPMC10023447 | biostudies-literature

Life expectancy and active life expectancy by disability status in older U.S. adults.

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| S-EPMC7518583 | biostudies-literature

Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study.

Project description:BackgroundWe examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States.MethodsWe used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability.ResultsSocioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50.ConclusionsInequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.

| S-EPMC7164527 | biostudies-literature

Gender, nutritional status and disability-free life expectancy among older people in Santiago, Chile.

Project description:This study was aimed to estimate life expectancy (LE), disability-free life expectancy (DFLE) and disabled life expectancy (DLE) among older adults from Santiago, Chile, and to determine the existence of differences by gender and by body mass index (BMI) categories in these indicators.A sample of 1216 people aged 60 or more, from the Chilean cohort of the Study of Health, Ageing and Well-Being was recruited in 2000; two follow-up assessments were carried out in a 10-year period. Functional limitation was assessed through self-report of difficulties in activities of daily living, instrumental activities of daily living and mobility. BMI was determined with measured weight and height. Multistate life tables were employed to estimate LE and healthy life expectancy (HLE).At 60 years, women could expect to live on average an additional 20.4 years (95% CI 19.0-21.6), and men an additional 16.4 years (95% CI 14.9-17.7). Total LE was longer among women at all ages, but they had a higher proportion of disabled years to be lived compared to men, with a difference of 14% at 60 years, and 10% at 90 years. There were no significant differences in LE, DFLE and DLE between BMI categories.Despite a longer LE, Chilean older women expect to live a higher proportion of years with disabilities, compared to men. Public health programs should address factors affecting LE of older men, and those associated with disability among older women.

| S-EPMC5874002 | biostudies-literature

The Impact of Smoking and Obesity on Disability-Free Life Expectancy in Older Australians.

Project description:BackgroundSmoking and obesity are 2 modifiable risk factors for disability. We examine the impact of smoking and obesity on disability-free life expectancy (DFLE) at older ages, using 2 levels of disability.MethodWe used the DYNOPTA dataset, derived by harmonizing and pooling risk factors and disability outcomes from 5 Australian longitudinal aging studies. We defined mobility disability as inability to walk 1 km, and more severe (activities of daily living [ADL]) disability by the inability to dress or bathe. Mortality data for the analytic sample (N = 20 401; 81.2% women) were obtained from Government Records via data linkage. We estimated sex-specific total life expectancy, DFLE, and years spent with disability by Interpolated Markov Chain (IMaCh) software for each combination of smoking (never vs ever), obesity (body mass index ≥30 vs 18.5 to <30), and education (left school age 14 or younger vs age 15 or older).ResultsCompared to those without either risk factor, high educated nonobese smokers at age 65 lived shorter lives (men and women: 2.5 years) and fewer years free of mobility disability (men: 2.1 years; women: 2.0 years), with similar results for ADL disability. Obesity had the largest effect on mobility disability in women; high educated obese nonsmoking women lived 1.3 years less than nonsmoking, not obese women but had 5.1 years fewer free of mobility disability and 3.2 fewer free of ADL disability. Differences between risk factor groups were similar for the low educated.ConclusionsOur findings suggest eliminating obesity would lead to an absolute reduction of disability, particularly in women.

| S-EPMC8202145 | biostudies-literature

Disability-free life expectancy of older French people: gender and education differentials from the PAQUID cohort.

Project description:In countries with low mortality rates, the quality of the years of life is more important to consider than total life expectancy (TLE). Disability-free life expectancy (DFLE) is one of the most relevant indicators of health and the quality of life. This paper aims to estimate TLE and DFLE with four levels of severity of disability and to explore gender and educational differences in older French people. In this cohort study, four levels of disability severity were distinguished, disability being evaluated for mobility, instrumental and basic activities of daily living. For each level, TLE and DFLE were calculated using multi-state models from transition probabilities. From the population of two areas of South West France 3,777 subjects were randomly selected from the electoral rolls. At the baseline, they were aged 65 years and over, living in the community and were interviewed 6 times over the 10-year follow-up. At age 65, women lived longer than men (4.5 extra years), but shorter fully independent lives (-2.2 years). They also lived longer in each of the three degrees of disability (+4.2 years with moderate or severe disability). The higher educated lived longer (1.3 extra years at age 65), with the additional years free of disability. Regardless of age, gender and education, there appeared to be a 1-year incompressible time spent with severe disability. To conclude, these are the first health expectancies based on the longitudinal data for France. Whilst most of the studies were based on cross-sectional data, this paper gives a more realistic indicator of the health and socio-economic inequalities in France in the 1990 s.

| S-EPMC5546347 | biostudies-other

Are Differences in Disability-Free Life Expectancy by Gender, Race, and Education Widening at Older Ages?

Project description:To examine change from 1991 to 2001 in disability-free life expectancy in the age range 60-90 by gender, race, and education in the United States. Mortality is estimated over two 10-year follow-up periods for persons in the National Health Interview Surveys of 1986/1987 and 1996/1997. Vital status is ascertained through the National Death Index. Disability prevalence is estimated from the National Health and Nutrition Examination Surveys of 1988-1994 and 1999-2002. Disability is defined as ability to perform four activities of daily living without difficulty. Disability-free life expectancy increased only among white men. Disabled life expectancy increased for all groups-black and white men and women. Racial differences in disability-free life expectancy widened among men; gender differences were reduced among whites. Expansion of socioeconomic differentials in disability-free life at older ages occurred among white men and women and black women. The 1990s was a period where the increased years of life between ages 60 and 90 were concentrated in disabled years for most population groups.

| S-EPMC5906056 | biostudies-literature

Transitions of disability, disability-free life expectancy and health insurance among adults aged 50 and older in Mexico: a multistate life table analysis.

Project description: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.

| S-EPMC8344280 | biostudies-literature

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