The burden of diseases on disability-free life expectancy in later life.
BACKGROUND
The consequences of diseases in later life have been judged predominantly through mortality, resulting in an emphasis on the fatal rather than the nonfatal disabling conditions. We use a longitudinal study with follow-up at 2, 6, and 10 years to assess the impact of different diseases on both total life expectancy (TLE) and disability-free life expectancy (DFLE).


METHODS
The Medical Research Council Cognitive Function and Ageing Study investigators interviewed 13,004 people aged 65 years and older from five U.K. centers starting in 1991. Persons aged 75 years and older were oversampled. Disability (mild, moderate, and severe) was assessed through basic Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales at baseline and at follow-ups at 2, 6, and 10 years. TLE and DFLE were compared for persons with and without each of nine conditions.


RESULTS
At age 65, men had a TLE of 15.3 years of which 12.1 (79%) were free of any disability, whereas women of the same age had an average TLE of 19.4 years, 11.0 years (57%) disability-free. Men (women) aged 65 years without stroke had 4.8 (4.6) more years of TLE and 6.5 (5.8) more years DFLE. Without diabetes, men (women) lived 4.4 (5.6) years longer and had 4.1 (5.1) years disability-free.


CONCLUSIONS
More disability-free years were gained than total life years in persons free of stroke, cognitive impairment, arthritis, and/or visual impairment at baseline. This finding suggests that elimination of these conditions would result in a compression of disability.
Jagger
Carol
C
Department of Health Sciences, University of Leicester, Leicester, United Kingdom. cxj@le.ac.uk
Matthews
Ruth
R
Matthews
Fiona
F
Robinson
Thompson
T
Robine
Jean-Marie
JM
Brayne
Carol
C
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology / Q000503:physiopathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology / Q000503:physiopathology; D014786:Vision Disorders / Q000453:epidemiology / Q000503:physiopathology