James N Laditka1, Sarah B Laditka1. 1. a Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , NC , USA.
Abstract
PURPOSE: To estimate associations of eight common health conditions with life expectancy (LE) and disabled life expectancy (DLE), the percentage of life disabled in an activity of daily living. METHODS: Data from the Panel Study of Income Dynamics represented Americans ages 55+ (1999-2011, n = 2118, mean baseline age 63.3, 19 447 person-years). We estimated probabilities of death and disability with multinomial logistic Markov models adjusted for age, sex, race/ethnicity and education. We used the probabilities to create large populations with microsimulations, each individual having a known monthly disability status, age 55 through death. We calculated LE and DLE for the populations, repeating each microsimulation 100 times for confidence intervals. RESULTS: Nearly half (48.8%) of the participants had two or more conditions, 24.7% had three or more, 11.5% had four or more. Having any one condition significantly reduced LE. For example, white women lived to age 87.3 (95% confidence interval 86.5-88.1) with no conditions, 75.8 (70.9-80.7) with heart disease. Multiple conditions did not further reduce LE but often increased DLE, which for white women was 12.2% (11.1-13.2) with no conditions, 39.1% (28.3-49.8) with heart disease and 47.0% (46.9-47.1) with heart disease, diabetes and hypertension. CONCLUSION: The increasing prevalence of multiple chronic conditions may substantially increase disability. Implications for Rehabilitation The growing number of individuals with multiple chronic conditions will greatly increase the prevalence of disability in later life. It is important for rehabilitation science, practice and policy to address this emerging epidemiological transition. Rehabilitation is especially important for people with pre-diabetes, developing heart disease or early stages of other cardiovascular-related diseases as avoiding the development of multiple chronic diseases through increased activity may greatly reduce disability and mortality.
PURPOSE: To estimate associations of eight common health conditions with life expectancy (LE) and disabled life expectancy (DLE), the percentage of life disabled in an activity of daily living. METHODS: Data from the Panel Study of Income Dynamics represented Americans ages 55+ (1999-2011, n = 2118, mean baseline age 63.3, 19 447 person-years). We estimated probabilities of death and disability with multinomial logistic Markov models adjusted for age, sex, race/ethnicity and education. We used the probabilities to create large populations with microsimulations, each individual having a known monthly disability status, age 55 through death. We calculated LE and DLE for the populations, repeating each microsimulation 100 times for confidence intervals. RESULTS: Nearly half (48.8%) of the participants had two or more conditions, 24.7% had three or more, 11.5% had four or more. Having any one condition significantly reduced LE. For example, white women lived to age 87.3 (95% confidence interval 86.5-88.1) with no conditions, 75.8 (70.9-80.7) with heart disease. Multiple conditions did not further reduce LE but often increased DLE, which for white women was 12.2% (11.1-13.2) with no conditions, 39.1% (28.3-49.8) with heart disease and 47.0% (46.9-47.1) with heart disease, diabetes and hypertension. CONCLUSION: The increasing prevalence of multiple chronic conditions may substantially increase disability. Implications for Rehabilitation The growing number of individuals with multiple chronic conditions will greatly increase the prevalence of disability in later life. It is important for rehabilitation science, practice and policy to address this emerging epidemiological transition. Rehabilitation is especially important for people with pre-diabetes, developing heart disease or early stages of other cardiovascular-related diseases as avoiding the development of multiple chronic diseases through increased activity may greatly reduce disability and mortality.
Authors: Holly Q Bennett; Andrew Kingston; Ilianna Lourida; Louise Robinson; Lynne Corner; Carol Brayne; Fiona E Matthews; Carol Jagger Journal: PLoS Med Date: 2022-03-15 Impact factor: 11.613
Authors: Holly Q Bennett; Andrew Kingston; Ilianna Lourida; Louise Robinson; Lynne Corner; Carol Eg Brayne; Fiona E Matthews; Carol Jagger Journal: EClinicalMedicine Date: 2021-07-31
Authors: Mai Stafford; Hannah Knight; Jay Hughes; Anne Alarilla; Luke Mondor; Anna Pefoyo Kone; Walter P Wodchis; Sarah R Deeny Journal: PLoS One Date: 2022-04-01 Impact factor: 3.240