A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II.
A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II.
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DOI：
10.1016/s0140-6736(15)00947-2
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发表时间：
2016-02-20
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影响因子：
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通讯作者：
Medical Research Council Cognitive Function and Ageing Collaboration
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作者：
Jagger C;Matthews FE;Wohland P;Fouweather T;Stephan BC;Robinson L;Arthur A;Brayne C;Medical Research Council Cognitive Function and Ageing Collaboration
随着人口老龄化，预期寿命的增加是否意味着优质年份的增加在全世界都具有深远的意义。我们调查了1991年至2011年期间英格兰各种健康预期的变化，每十年的研究设计和方法都相同。来自英格兰三个地理定义中心65岁或以上人群认知功能和衰老研究的基线数据（剑桥郡、纽卡斯尔和诺丁汉）提供了三项健康指标的流行率估计：自我感觉健康（定义为极好-良好、一般或较差）;认知障碍（定义为中度-重度、轻度或无，通过简易精神状态检查评分评估）;和日常生活活动能力障碍（定义为无、轻度或中度-重度）。三个地区的健康预期综合计算的沙利文方法，适用于特定年龄和特定性别的流行率的健康措施的标准寿命表为同一时期。在1991年至2011年期间，65岁时预期寿命的增加（男性4.5岁，女性3.6岁）伴随着无任何认知障碍年数的同等增加（男性4.2年[95%CI 4.2 - 4.3]，女性4.4年[4.3 - 4.5]）以及轻度或中重度认知障碍年数的减少。在自我感觉良好或极佳的健康状况中，也发现了年数的增加（男性为3.8年[95% CI 3.5 - 4.1]，女性为3.1年[2.7 - 3.4]）。无残疾年数的增加远小于自我感觉健康状况良好或无认知障碍的人，尤其是女性（0.5年[0.2 - 0.9]，男性为2.6年[2.3 - 2.9]），主要是因为轻度残疾增加。在过去的二十年中，在英格兰，我们报告了认知障碍的绝对压缩（即减少），自我感知健康的相对压缩（即健康生活的比例正在增加），以及残疾的动态平衡（即，不太严重的残疾正在增加，但更严重的残疾没有）。这些模式的原因尚不清楚，但可能包括过去几十年来肥胖的增加。我们的研究结果对健康服务和延长工作寿命具有广泛的影响。英国医学研究理事会。
Whether rises in life expectancy are increases in good-quality years is of profound importance worldwide, with population ageing. We investigate how various health expectancies have changed in England between 1991 and 2011, with identical study design and methods in each decade. Baseline data from the Cognitive Function and Ageing Studies in populations aged 65 years or older in three geographically defined centres in England (Cambridgeshire, Newcastle, and Nottingham) provided prevalence estimates for three health measures: self-perceived health (defined as excellent–good, fair, or poor); cognitive impairment (defined as moderate–severe, mild, or none, as assessed by Mini-Mental State Examination score); and disability in activities of daily living (defined as none, mild, or moderate–severe). Health expectancies for the three regions combined were calculated by the Sullivan method, which applies the age-specific and sex-specific prevalence of the health measure to a standard life table for the same period. Between 1991 and 2011, gains in life expectancy at age 65 years (4·5 years for men and 3·6 years for women) were accompanied by equivalent gains in years free of any cognitive impairment (4·2 years [95% CI 4·2–4·3] for men and 4·4 years [4·3–4·5] for women) and decreased years with mild or moderate–severe cognitive impairment. Gains were also identified in years in excellent or good self-perceived health (3·8 years [95% CI 3·5–4·1] for men and 3·1 years [2·7–3·4] for women). Gains in disability-free years were much smaller than those in excellent–good self-perceived health or those free from cognitive impairment, especially for women (0·5 years [0·2–0·9] compared with 2·6 years [2·3–2·9] for men), mostly because of increased mild disability. During the past two decades in England, we report an absolute compression (ie, reduction) of cognitive impairment, a relative compression of self-perceived health (ie, proportion of life spent healthy is increasing), and dynamic equilibrium of disability (ie, less severe disability is increasing but more severe disability is not). Reasons for these patterns are unknown but might include increasing obesity during previous decades. Our findings have wide-ranging implications for health services and for extension of working life. UK Medical Research Council.