RESUMO
The population aging in the region is occurring under scenarios of inequality, raising concerns about how the increase in life expectancy is experienced and what factors affect the quality of life of older adults. This research quantified the differentials of healthy aging in Colombia in 2018 and its association with social indicators through a cross-sectional, descriptive, and correlational observational study. Healthy aging was quantified using the Disability-Free Life Expectancy (DFLE) indicator and later correlated with social indicators and subjected to a Multiple Factor Analysis (MFA). The results showed a healthy life expectancy of 71.5 years for women and 66.9 years for men, with a disability expectancy of 8.3 and 6.4 years, respectively. Negative associations emerged with health problems, disability, lack of medical care, illiteracy, school absenteeism, and poverty, while higher education levels and retirement showed positive associations. The factor analysis by area of residence highlighted urban areas as conducive to healthy aging. In conclusion, the accelerated aging of the Colombian population faces health disparities that policies must address by improving education, economic security, and health services, especially for women and rural areas.
Assuntos
Envelhecimento Saudável , Colômbia , Humanos , Feminino , Masculino , Idoso , Estudos Transversais , Pessoa de Meia-Idade , Condições Sociais , Idoso de 80 Anos ou mais , Expectativa de Vida/tendências , Fatores Socioeconômicos , Qualidade de VidaRESUMO
BACKGROUND: Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown. OBJECTIVE: To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile. METHOD: Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan's method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile. RESULTS: Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively). CONCLUSIONS: This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
Assuntos
Pessoas com Deficiência , Expectativa de Vida Saudável , Indígenas Sul-Americanos , Idoso , Humanos , Chile/epidemiologia , Expectativa de Vida , Pessoa de Meia-Idade , Idoso de 80 Anos ou maisRESUMO
BACKGROUND: Sarcopenia is an important risk factor for disability and dependency at old age. The prevalence of sarcopenia among the Chilean older population is high. OBJECTIVE: To estimate life expectancy, healthy life expectancy and unhealthy life expectancy among sarcopenic and non-sarcopenic older adults from Santiago, Chile. METHODS: A sample of 1,897 community-dwelling older adults aged 60 years or more, living in Santiago, was observed between 5-15 years. Disability was defined as the unhealthy state, assessed through self-reported difficulties in activities of daily living. Sarcopenia was determined via HTSMayor software. Total and marginal life expectancies were estimated using the Interpolated Markov Chain method "IMaCh". RESULTS: At 60 years, estimated life expectancy for sarcopenic and non-sarcopenic older adults was similar (22.7 and 22.5 years, respectively). The proportion of years to be lived with disability was three times greater in sarcopenic adults, compared to non-sarcopenic people. This difference was observed up to 80 years. Non-sarcopenic women had a higher proportion of years to be lived with disabilities compared to non-sarcopenic men of the same age, but this proportion was higher among sarcopenic men, compared to sarcopenic women until 70 years of age. DISCUSSION: People with sarcopenia expect to live a higher proportion of years with disabilities. Sarcopenic men until 70 years expected to live a higher proportion of years with disability, compared to sarcopenic women. Monitoring sarcopenia among older people may help to identify individuals with higher risk of disability onset. Future research should focus on disentangling the mechanisms explaining sex differences.
RESUMO
BACKGROUND: Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. METHODS: The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. RESULTS: At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6-24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4-19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4-18.2). They also had a DFLE (19.4; 95% CI 17.1-21.7) 4 (15.4; 95% CI 14.6-16.1) and 5.2 (14.2; 95% CI 13.4-14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7-30.8) 4.6 (22.7; 95% CI 21.9-23.5) and 5.6 (21.6; 20.6-22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5-23.3; medium: 16.5; 95% CI 15.8-17.1; low: 15.3; 95% CI 14.6-16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. DISCUSSION: Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. CONCLUSION: A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.
Assuntos
Pessoas com Deficiência , Expectativa de Vida , Idoso , Idoso de 80 Anos ou mais , Chile/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Estudos Longitudinais , Masculino , Fatores SocioeconômicosRESUMO
Resumo A expectativa de vida aos 60 anos no Brasil aumentou cerca de 9 anos em pouco mais de meio século. Trata-se de um ganho de sobrevida generalizado, mas que também ocorre de forma heterogênica entre as Grandes Regiões do país. Por outro lado, pouco se sabe, ainda, como os aumentos da expectativa de vida aos 60 anos por região podem ser acompanhados por acréscimos ou decréscimos tanto nos anos vividos com incapacidade, quanto nos vividos livre de incapacidade. O objetivo deste artigo é analisar, para 1998 e 2013, aumentos na Expectativa de Vida Total e suas componentes: Expectativa de Vida Livre de Incapacidade Funcional (EVLI) e com Incapacidade Funcional (EVCI), aos 60, 70 e 80 anos para a população do Brasil e Grandes Regiões. O estudo utilizou informações sobre incapacidade funcional da PNAD de 1998 e PNS de 2013 e empregou o método de Sullivan para estimação da EVLI por sexo e idade. No geral, os resultados mostraram que, entre 1998 e 2013, concomitantemente aos ganhos na EV, ocorreu um crescimento na EVLI. Contudo, os ganhos na EVLI não foram estatisticamente significativos para as regiões Norte e Centro-Oeste. Ou seja, com exceção dessas regiões, além de viver mais, a população idosa de 60 anos poderia esperar viver um número maior de anos com saúde.
Abstract Life expectancy at age 60 in Brazil has increased by around nine years in a little over 50 years. This general gain in life expectancy at national level has been heterogeneous across the country's major regions. Furthermore, little is known about how increases in life expectancy at age 60 across regions influence the number of years lived with some form of associated disability or the number of years lived free from disability. This study aimed to analyze increases in total life expectancy and its components [disability-free life expectancy (DFLE) and disability life expectancy (DLE)] at ages 60, 70, and 80 in Brazil and Major Regions in 1998 and 2013. The study used data on disability obtained from the 1998 National Household Sample Survey (PNAD - acronym in Portuguese) and 2013 National Health Survey (PNS- acronym in Portuguese) and used the Sullivan method to estimate DFLE by sex and age. The findings show that there was an increase in life expectancy and a concomitant increase in DFLE between 1998 and 2013. However, the gains in DFLE were not statistically significant in the North and Center-west regions. This means that, with the exception of the latter regions, in addition to living longer, the Brazils population aged 60 years can expect to live a greater number of healthy years.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Nível de Saúde , Expectativa de Vida/tendências , Pessoas com Deficiência/estatística & dados numéricos , Fatores de Tempo , Brasil , Inquéritos Epidemiológicos , Fatores Etários , Pessoa de Meia-IdadeRESUMO
Objectives: To estimate and compare disability-free life expectancy (DFLE) and current age patterns of disability onset and recovery from disability between the United States and countries in Latin America and the Caribbean. Method: Disability is measured using the activities of daily living scale. Data come from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States. Age patterns of transitions in and out of disability are modeled with a discrete-time logistic hazard model, and a microsimulation approach is used to estimate DFLE. Results: Overall life expectancy for women aged 65 is 20.11 years in Costa Rica, 19.2 years in Mexico, 20.4 years in Puerto Rico, and 20.5 years in the United States. For men, these figures are 19.0 years in Costa Rica, 18.4 years in Mexico, 18.1 years in Puerto Rico, and 18.1 years in the United States. Proportion of remaining life spent free of disability for women at age 65 is comparable between Mexico, Puerto Rico, and the United States, with Costa Rica trailing slightly. Male estimates of DFLE are similar across the four populations. Discussion: Though the older adult population of Latin America and the Caribbean lived many years exposed to poor epidemiological and public health conditions, their functional health in later life is comparable with the older adult population of the United States.
Assuntos
Expectativa de Vida , Idoso , Idoso de 80 Anos ou mais , Costa Rica/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , México/epidemiologia , Porto Rico/epidemiologia , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
AIM: 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.