Healthy life expectancy by frailty state in Europe from 2004 to 2015: findings from SHARE

Nielsen, Camilla R.; Ahrenfeldt, Linda Juel; Jeune, Bernard; Christensen, Kaare; Lindahl-Jacobsen, Rune

doi:10.1093/eurpub/ckab012

Cited by 20 publications

(17 citation statements)

References 28 publications

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“…Frail older adults had a total LE reduction of 2.19 years and a reduction of robust LE of 3.87 years compared with robust older adults in China. These findings further confirm the previous findings that frailty can reduce LE [9][10][11][12]32] and the LE of older adults in the robust category [9][10][11][12].…”

Section: Discussionsupporting

confidence: 91%

“…Regarding the focus of this study, we found that the total LE of older adults at age 65 years in China was 14.74 years, which was lower than the LE of older adults in 10 European countries (16.4 years at age 70 years) [9], 15 European countries (21.4 years at age 65 years) [10], France (18.3 years for women and 14.8 years for men at age 70 years) [11], and Brazil (15.4 years at age 65 years) [12]. On average, older adults in China are expected to be in robust, pre-frail or frail status for 4.18, 7.46 or 3.10 years, respectively.…”

Section: Discussionmentioning

confidence: 65%

“…There are two models for measuring frailty [2], the phenotype model and the cumulative deficit model, both of which classify frailty as robust, pre-frailty and frailty [7,8]. To date, a few studies have estimated total LE with and without frailty using cross-sectional data by the Sullivan method based on the phenotype model [9][10][11][12]. However, the phenotype model does not include cognitive impairment, a highly prevalent condition associated with functional decline and disability [2].…”

Section: Introductionmentioning

confidence: 99%

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Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Gao

Wang

et al. 2023

BMC Med

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Background Little is known about life expectancy (LE) with or without frailty. We aimed to estimate the total LE and duration of the state of frailty in China. Methods This study included older adults aged 65 years and older from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Frailty status was classified into robust, pre-frailty and frailty based on a cumulative deficit model. Total and specific frailty state LEs at 65 years of age were estimated and stratified by demographic characteristics, behaviours, and psychosocial factors using continuous-time multistate modelling. Results The total LE of older adults aged 65 years in China was 14.74 years on average (95% CI: 14.52–14.94), of which 4.18 years (95% CI: 4.05–4.30) were robust, 7.46 years (95% CI: 7.31–7.61) pre-frail and 3.10 years (95% CI: 3.01–3.20) frail. Older adults with higher robust LE included men (4.71 years, 95% CI: 4.56–4.88), married older adults (4.41 years, 95% CI: 4.27–4.56), those engaging in physical activity (4.41 years, 95% CI: 4.23–4.59), those consuming fruits daily (4.48 years, 95% CI: 4.22–4.77) and those with high social participation (4.39 years, 95% CI: 4.26–4.53). Increased educational attainment were gradually associated with increased robust LE. Conclusions Frailty may lead to a reduced total LE and robust LE of older adults in China. In addition to finding inequalities in total and robust LEs by socioeconomic status, our findings also highlight that healthy behaviours and social participation may ease frailty-related reductions in total and robust LE. Our findings imply that national life-course strategies aimed at frailty screening and psychosocial and behavioural interventions could be important for health aging in China.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

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Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Gao

Wang

et al. 2023

BMC Med

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“…An explanation could be that men in our sample had less physical and mental symptoms, less limitations in (I)ADL and less mobility problems. This might be a reflection of the evidence that a higher proportion of older European women are in a frail state [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Goal-based outcomes of hospitalisation of older adults are predicted by gender, confidence, quality of life and type of goals

2022

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Purpose Although patient-reported outcome measures (PROMs) might reflect relevant outcomes from patient perspective, they do not always reflect what the individual patient finds important. Our objectives were to assess which PROM was best suited to evaluate patient-relevant outcomes of hospitalisation and to assess which factors predicted this PROM. Methods A longitudinal study was conducted among hospitalised older patients. Three PROMs were compared with the anchor question ‘How much have you benefited from the admission?’: a general quality of life measure: EQ-5D; a measure of daily functioning: Katz-15 and a goal-based measure: achievement of self-defined goals. Predictors were examined using logistic regression analyses. Results We had 185 cases with baseline and follow-up. Accomplishment of self-defined goals showed a large correlation with the anchor question, whereas EQ-5D and Katz-15 showed no significant correlations. The final regression model had four predictors: being man, having higher confidence in goal achievement and good/excellent quality of life increased the odds for goal accomplishment, while having goals in the category alleviating complaints reduced the odds. Conclusion Accomplishment of individual goals represented the benefit experienced by participants best. Subjective indicators of health and functioning are better predictors of goal accomplishment than objective ones. According to participant experience, the hospital appeared successful in managing disease-specific problems, but less successful in ameliorating complaints. Medical decision-making should not only be based on medical indicators, but the input of the patient is at least as important. Quality of life, goals and confidence should be discussed. More attention is needed for symptom experience.

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“…Sullivan method [ 28 ] was applied to calculate the HLE in patients with advanced schistosomiasis within each 5-year age interval based on life tables and disability data of patients [ 19 ]. This method is widely used in the estimation of HLE for its straightforward and succinctness [ 29 – 31 ]. In this study, HLE represents the schistosomiasis-free life expectancy for advanced cases.…”

Section: Methodsmentioning

confidence: 99%

Life expectancy and healthy life expectancy of patients with advanced schistosomiasis in Hunan Province, China

et al. 2023

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Background Few studies have investigated the change in life expectancy (LE) and the healthy lifespan among patients with advanced schistosomiasis. This study was to evaluate the LE and healthy life expectancy (HLE) for patients and assess the mechanism responsible for the LE inequality. Methods We utilized data from a dynamic advanced schistosomiasis cohort (10,362 patients) for the period from January 2008 to December 2019 in Hunan Province, China, to calculate the LEs of patients, and made a comparison with that of general population (19,642 schistosomiasis-free individuals) in the schistosomiasis endemic areas. LEs were estimated from 15 years of age by constructing period life tables. Arriaga’s decomposition method was applied to quantify the influence of the age structure on the difference in LE. HLE for advanced schistosomiasis patients was calculated by using Sullivan method with age-specific disability weight. The LE and HLE were calculated for both males and females to perform further analyses on gender gap. Results The estimated LE for advanced schistosomiasis patients aged 15–19 was 49.51 years (48.86 years for males and 51.07 years for females), which was 20.14 years lower compared with general population (69.65 years), and the LE gap between patients and general population decreased with age. The largest age-specific mortality contribution to the gap (32.06%) occurred at age 80–84 years. Women had a lower LE and HLE than men at age ≥ 60 years (both gender gaps in LE and HLE < 0). For advanced schistosomiasis patients, the gender gap in LE was largely attributed to the difference in mortality among those under the age of 55; the age-specific mortality in women exerted positive influence on the gap at age 25–64 and 75–79 years, with the contribution rate ranging from 0.59% to 57.02%, and made the negative contribution at other age groups. Conclusions The LE of advanced schistosomiasis patients was still much lower compared with general population. Strengthened prevention strategies and targeted treatments are needed to reduce morbidity and mortality due to advanced schistosomiasis, especially for younger population and elderly female patients.

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Healthy life expectancy by frailty state in Europe from 2004 to 2015: findings from SHARE

Cited by 20 publications

References 28 publications

Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Goal-based outcomes of hospitalisation of older adults are predicted by gender, confidence, quality of life and type of goals

Life expectancy and healthy life expectancy of patients with advanced schistosomiasis in Hunan Province, China

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