Dependence- and Disability-Free Life Expectancy Across Eight Low- and Middle-Income Countries: A 10/66 Study

Abstract

Objective: The objective of this study was to estimate healthy life expectancies in eight low- and middle-income countries (LMICs), using two indicators: disability-free life expectancy (DFLE) and dependence-free life expectancy (DepFLE). Method: Using the Sullivan method, healthy life expectancy was calculated based on the prevalence of dependence and disability from the 10/66 cohort study, which included 16,990 people aged 65 or above in China, Cuba, Dominican Republic, India, Mexico, Peru, Puerto Rico, and Venezuela, and country-specific life tables from the World Population Prospects 2017. Results: DFLE and DepFLE declined with older age across all sites and were higher in women than men. Mexico reported the highest DFLE at age 65 for men (15.4, SE = 0.5) and women (16.5, SE = 0.4), whereas India had the lowest with (11.5, SE = 0.3) in men and women (11.7, SE = 0.4). Discussion: Healthy life expectancy based on disability and dependency can be a critical indicator for aging research and policy planning in LMICs.

Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study

“…Older populations exhibit higher prevalence of chronic diseases, disability, and dependency, and as a consequence of these higher prevalences, national social security and healthcare systems are usually placed under stress (At et al, 2015;Prina et al, 2020;Sousa et al, 2010). With increasing age, the risk of dependency tends to increase as functional or mental impairments result from declines in health.…”

“…Specifically, while in the British study, dependency was operationalized using the interval measure, which is based on the lapsed time between periods when participants might require help (Kingston et al, 2017), in SHARE and for Latin American countries, it was operationalized counting the limitations in daily activities (Monteverde et al, 2016;Rodríguez-Sampayo et al, 2011). Moreover, it has been suggested that to adequately operationalize dependency, in addition to the actual limitations that individuals may experience, it is also necessary to consider information about the daily need for help (Albarrán Lozano et al, 2009;Edjolo et al, 2016;Harwood et al, 2004;Prina et al, 2020). Hence, it could be argued that it is possible to operationalize dependency using information about the need for assistance in performing activities of daily living (ADLs).…”

Population with Long-Term Care Needs in Six Latin American Countries: Estimation of Older Adults Who Need Help Performing ADLs

“…Among Latin American countries, nationally representative estimates of the older population with LTC needs have been made in Uruguay, Chile, Argentina, Mexico, and Costa Rica. There are also studies based on less representative samples, such as in cities or administrative regions [19][20][21][22][23]. These estimates provide a wide range of results that vary in terms of the age threshold used for older adults (60 or 65 years old) and the estimation methodology [24][25][26][27][28].…”

Validation of the multidimensional WHOQOL‐OLD in Ghana: A study among population‐based healthy adults in three ethnically different districts

“…The rapid pace of economic development in low-and middle-income countries (LMICs) has resulted in demographic shifts from younger populations to a more aged population. This is fueled largely by improved health care and increase in life expectancy in many LMICs (Ahmad, 2016;Prina et al, 2020). Improved health of the population in LMICs is accompanied by improved quality of life which also means that more people are living into advanced old age (Ahmad, 2016;Gyasi & Phillips, 2020).…”