title: Comparative study of disability-free life expectancy across six low- and middle-income countries.
abstract: OBJECTIVE
  There is a knowledge gap about the disability-free life expectancy (DFLE) in low- and middle-income countries. The present study aimed to compute and compare DFLE in six such countries, and examine sex differences in DFLE in each country.
  
  
  METHODS
  Based on data from the World Health Organization Study on Global Aging and Adult Health wave 1 survey, we used the Sullivan method to estimate DFLE among persons aged years 50 years and older. Disability was divided into moderate disability and severe disability during the calculation.
  
  
  RESULTS
  Of the six countries, China had the highest DFLE and lowest expected average lifetime with disability. India had the lowest DFLE and highest life years with moderate and severe disability. In each country, women live longer than men, but with more disabilities in both absolute and proportional terms. The huge sex difference in Russia requires special attention. In addition, most of the life expectancy lived with disability was spent with severe disability, rather than moderate disability.
  
  
  CONCLUSIONS
  The study has shed some light on the disparities across the six countries with regard to DFLE at old ages. The low percentage of DFLE in life expectancy in some countries, such as India, calls for effective policies on healthy aging. The "sex disability-survival paradox" in DFLE is supported by our results. To differentiate the severity of disability should be routine in calculating DFLE. Geriatr Gerontol Int 2017; 17: 637-644.
authors.affiliation: Health Systems Research Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa.
authors.forename: Witness
authors.initials: W
authors.lastname: Chirinda
authors.affiliation: Department of Global Health, School of Public Health, Peking University, Beijing, China.
authors.forename: He
authors.initials: H
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003906:Developing Countries; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005260:Female; D005869:Ghana; D006306:Health Surveys; D006801:Humans; D007182:Income; D007194:India; D008017:Life Expectancy; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012426:Russia; D013019:South Africa
keywords: comparative study; disability-free life expectancy; low- and middle-income countries; older people; sex difference