CHANGE IN DISABILITY-FREE LIFE EXPECTANCY FOR AMERICANS 70 YEARS OLD AND OLDER
CHANGE IN DISABILITY-FREE LIFE EXPECTANCY FOR AMERICANS 70 YEARS OLD AND OLDER
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DOI：
10.1353/dem.0.0070
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发表时间：
2009-08-01
期刊：
影响因子：
3.5
通讯作者：
Brouard, Nicolas
中科院分区：
文献类型：
--
作者：
Crimmins, Eileen M.;Hayward, Mark D.;Brouard, Nicolas
在本文中，我们使用 1984 年至 2000 年从组成老龄化纵向研究 I 和 II 的两个队列收集的纵向数据来研究无残疾预期寿命的变化。使用基于马尔可夫的多状态生命表方法计算有和没有 ADL 和/或 IADL 残疾的预期寿命。在 70 岁时，后来的队列中的无残疾预期寿命在 10 年期间增加了 0.6 年，这与总预期寿命的增加相同，两者的增加在统计上都略有显着。 IADL 和 ADL 残疾的平均预期寿命没有变化。无残疾预期寿命的变化是由于两个调查队列中残疾发生率的下降和残疾康复率的增加所致。在 80 岁之后的后期队列中，ADL 残疾人的年龄特异性死亡率显着下降。IADL 残疾人和非残疾人的死亡率没有显着变化。 70 岁时患有 ADL 残疾的人的总预期寿命和无残疾预期寿命均大幅延长。这些结果表明，努力预防和延缓残疾以及促进残疾康复对于延长无残疾的预期寿命非常重要。结果还表明，虽然发病率的降低和康复工作的增加有助于降低人口残疾患病率，但残疾人死亡率的下降也是残疾患病率上升的一个力量。
In this article, we examine changes in life expectancy free of disability using longitudinal data collected from 1984 through 2000 from two cohorts who composed the Longitudinal Studies of Aging I and II. Life expectancies with and without ADL and/or IADL disability are calculated using a Markov-based multistate life table approach. At age 70, disability-free life expectancy increased over a 10-Year period by 0.6 of a year in the later cohort, which was the same as the increase in total life expectancy, both increases marginally statistically significant. The average length of expected life with IADL and ADL disability did not change. Changes in disability-free life expectancy resulted from decreases in disability incidence and increases in the incidence of recovery from disability across the two survey cohorts. Age-specific mortality among the ADL disabled declined significantly in the later cohort after age 80. Mortality for the IADL disabled and the nondisabled did not change significantly. Those with ADL disability at age 70 experienced substantial increases in both total life expectancy and disability-free life expectancy. These results indicate the importance of efforts both to prevent and delay disability and to promote recovery from disability for increasing life expectancy without disability. Results also indicate that while reductions in incidence and increases in recovery work to decrease population prevalence of disability, declining mortality among the disabled has been a force toward increasing disability prevalence.