title: Contribution of chronic diseases to the disability burden in a population 15 years and older, Belgium, 1997-2008.
abstract: BACKGROUND
  Age-associated disability reduces quality of life in older populations and leads to wide-range implications for social and health policy. The identification of diseases that contribute to the disability burden is crucial to the development of prevention and intervention strategies to reduce disability. In this study, we assessed the contribution of chronic diseases to the prevalence of disability in Belgium.
  
  
  METHODS
  Data from 35,837 individuals aged 15 years or older who participated in the 1997, 2001, 2004, or 2008 Belgian Health Interview Surveys were used. Disability was defined as difficulties in doing at least one of six activities of daily living (transfer in and out of bed, transfer in and out of chair, dressing, washing hands and face, feeding, and going to the toilet) and/or mobility limitations (ability to walk without stopping less than 200 m). Multiple additive regression models were fitted separately for men and women to estimate the age-specific background disability rate (experienced by everyone, independent of the presence of specific diseases) and disease-specific disability rates (disability rate in subjects who reported selected chronic diseases).
  
  
  RESULTS
  Musculoskeletal, cardiovascular, and respiratory diseases were the main contributors to the disability burden in Belgium. Musculoskeletal diseases were the most prevalent diseases in men and women in all age groups. Neurological diseases and stroke were the most disabling diseases, i.e. caused the highest level of disability among the diseased individuals, in all age groups for men and women, respectively. Back pain was the main cause of disability in men aged 15 to 64 years, while heart attack was the major contributor to the disability prevalence in men aged 65 or older. Likewise, arthritis was the main cause of disability among women across all age groups. Depression was also an important contributor in young subjects (15-54 years). Cancer was not an important contributor to the disability prevalence in Belgium.
  
  
  CONCLUSIONS
  To reduce the burden of disability in Belgium, interventions should target musculoskeletal, cardiovascular and respiratory diseases especially among elderly. Furthermore, attention should also be given to depression in young individuals.
authors: Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. renata.yokota@wiv-isp.be.|Department of Social Research, Interface Demography, Vrije Universiteit Brussel, 1050, Brussels, Belgium. renata.yokota@wiv-isp.be.
authors: Renata T C
authors: RT
authors: Yokota
authors: Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. Nicolas.Berger@wiv-isp.be.|Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK. Nicolas.Berger@wiv-isp.be.
authors: Nicolas
authors: N
authors: Berger
authors: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. w.nusselder@erasmusmc.nl.
authors: Wilma J
authors: WJ
authors: Nusselder
authors: French Institute of Health and Medical Research (INSERM), Montpellier, France. jean-marie.robine@inserm.fr.|École Pratique des Hautes Études, Paris, France. jean-marie.robine@inserm.fr.
authors: Jean-Marie
authors: JM
authors: Robine
authors: Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. Jean.Tafforeau@wiv-isp.be.
authors: Jean
authors: J
authors: Tafforeau
authors: Department of Social Research, Interface Demography, Vrije Universiteit Brussel, 1050, Brussels, Belgium. patrick.deboosere@vub.ac.be.
authors: Patrick
authors: P
authors: Deboosere
authors: Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. Herman.VanOyen@wiv-isp.be.|Department of Public Health, Ghent University, Ghent, Belgium. Herman.VanOyen@wiv-isp.be.
authors: Herman
authors: H
authors: Van Oyen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis; D001530:Belgium; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009140:Musculoskeletal Diseases; D015995:Prevalence; D011788:Quality of Life; D055815:Young Adult