Cohort changes in active life expectancy in the U.S. elderly population: experience from the 1982-2004 National Long-Term Care Survey.
OBJECTIVE
To understand declines in chronic disability prevalence in the U.S. elderly population, we examined cohort changes in active life expectancy, a health measure relating population disability and longevity dynamics.


METHODS
We computed active life expectancy and life expectancy using the six National Long-Term Care Surveys done from 1982 to 2004 and linked to continuous-time Medicare service data for the same time period by using a stochastic process model based on disability scores calculated using grade of membership analyses. We simultaneously estimated continuous-time disability dynamic and mortality functions to calculate life tables for specific disability states and for temporally changing mixtures of disability states.


RESULTS
Disability dynamics, measured as changes in grade of membership scores, showed significant variation across two birth cohorts followed for 24 years. Disability dynamics and disability-specific hazard functions were significantly improved in the younger cohort (persons aged 65-74 in 1982).


CONCLUSIONS
Our results, supporting the hypothesis of morbidity compression, indicate that younger cohorts of elderly persons are living longer in better health. The methods describe individual disability transitions and mortality and other factors associated with disability changes, making it possible to better evaluate interventions to promote future declines in disability.
Manton
Kenneth G
KG
Office of the Dean of Arts and Sciences, Campus Box 90408, Duke University, Trent Drive, Durham, NC 27708, USA. KGManton@duke.edu
Gu
XiLiang
X
Lowrimore
Gene R
GR
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006285:Health Planning; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D015993:Life Tables; D008297:Male; D011788:Quality of Life; D017678:Sex Distribution; D013269:Stochastic Processes; D014481:United States / Q000453:epidemiology