European Journal of Ageing

, Volume 1, Issue 1, pp 37–44

Disability-free life expectancy: a cross-national comparison of six longitudinal studies on aging. The CLESA project

  • N. Minicuci
  • M. Noale
  • S. M. F. Pluijm
  • M. V. Zunzunegui
  • T. Blumstein
  • D. J. H. Deeg
  • C. Bardage
  • M. Jylhä
  • for the CLESA working group
Original Investigation

Abstract

Disability-free life expectancy (DFLE) was compared in six countries taking part in the Cross-national Determinants of Quality of Life and Health Services for the Elderly (CLESA) project. Data from six existing longitudinal studies were used: TamELSA (Tampere, Finland), CALAS (Israel), ILSA (Italy), LASA (The Netherlands), Aging in Leganés (Leganés, Spain) and SATSA (Sweden). A harmonised four-item disability measure (bathing, dressing, transferring, toileting) was used to calculate DFLE; the harmonised measure was dichotomised into ‘independent in all four activities’ vs. ‘dependent in at least one’. Calculations of DFLE were made using the multistate life table approach and the IMaCh program (INED/EuroREVES, http://eurorevesinedfr/imach/) for subjects aged 65–89 years. Prevalence ratios of disability varied significantly across countries, with Italy and Leganés having the highest percentages among men and among women, respectively, while The Netherlands presented the lowest for both sexes. At 75 years of age the estimated total life expectancy among men ranged from 7.8 years in Tampere and Sweden to 9.0 years in Israel; among women it ranged from 9.5 years in Israel to 11.6 years in Italy. For both sexes Italy showed the lowest total life expectancy without disability (72% among men, 61% among women) and Sweden the highest (89% among men and 71% among women). The results yielded a north/south gradient, with residents in Tampere, The Netherlands and Sweden expected to spend a higher percentage of their lives without disability than those in Italy, Israel and Leganés.

Keywords

CLESA project Disability-free life expectancy Cross-national comparison Ageing 

References

  1. Béland F, Zunzunegui MV (1995a) Presentación del estudio ‘Envejecer en Leganés’. Rev Gerontol 5:207–214Google Scholar
  2. Béland F, Zunzunegui MV (1995b) El diseño y la ejecución de la encuesta ‘Envejecer en Leganés’. Rev Gerontol 5:215–231Google Scholar
  3. Crimmins EM (2004) Trends in the health of the elderly. Annu Rev Public Health 25:79–98CrossRefPubMedGoogle Scholar
  4. Crimmins EM, Saito Y (2001) Trends in life expectancy in the United States, 1970–1990: gender, racial, and educational differences. Soc Sci Med 52:1629–1641CrossRefPubMedGoogle Scholar
  5. Deeg DJH, Van Tilburg T, Smit JH, De Leeuw ED (2002) Attrition in the Longitudinal Aging Study Amsterdam: the effect of differential inclusion in side studies. J Clin Epidemiol 55:319–328CrossRefPubMedGoogle Scholar
  6. Gutiérrez-Fisac JL, Gispert R, Sola J (2000) Factors explaining the geographical differences in disability free life expectancy in Spain. J Epidemiol Community Health 54:451–455CrossRefPubMedGoogle Scholar
  7. Janssen F, Mackenbach JP, Kunst AE (2004) NEDCOM. Trends in old-age mortality in seven European countries, 1950–1999. J Clin Epidemiol 57:203–216CrossRefPubMedGoogle Scholar
  8. Jylhä M, Jokela J, Tolvanen E, Heikkinen E, Heikkinen RL, Koskinen S, Leskinen E, Lyyra AL, Pohjolainen P (1992) The Tampere Longitudinal Study on Ageing. Description of the study. Basic results on health and functional ability. Scand J Soc Med Suppl 47:1–4PubMedGoogle Scholar
  9. Jylhä M, Guralnik JM, Ferrucci L, Jokela J, Heikkinen E (1998) Is self-rated health comparable across cultures and genders? J Gerontol B Psychol Sci Soc Sci 53:144–152Google Scholar
  10. Katz S, Downs TD, Cash HR, Grotz RC (1970) Progress in development of the index of ADL. Gerontologist 10:20–30PubMedGoogle Scholar
  11. Katz S, Branch LG, Branson MH (1983) Active life expectancy. N Engl J Med 309:1218–1224PubMedGoogle Scholar
  12. Laditka SB, Wolf DA (1998) New methods for analyzing active life expectancy. J Aging Health 10:214–241Google Scholar
  13. Lièvre A, Brouard N (2003) The estimation of health expectancies from cross-longitudinal surveys. Math Popul Studies 10:211–248Google Scholar
  14. Maggi S, Zucchetto M, Grigoletto F, Baldereschi M, Candelise L, Scarpini E, Scarlato G, Amaducci L (1994) The Italian Longitudinal Study on Aging (ILSA): design and methods. Aging Clin Exp Res 6:464–473Google Scholar
  15. Minicuci N, Noale M (2004) Disability free life expectancy in older Italians. Disabil Rehab (in press)Google Scholar
  16. Minicuci N, Noale M, Bardage C, Blumstein T, Deeg DJH, Gindin J, Jylhä M, Nikula S, Otero A, Pedersen NL, Pluijm SMF, Zunzunegui MV, Maggi S, for the CLESA Working Group (2003) Cross-national determinants of quality of life from six longitudinal studies on aging: the CLESA project. Aging Clin Exp Res 15:187–202PubMedGoogle Scholar
  17. Nikula S, Jylhä M,Bardage C, Deeg DJH, Gindin J, Minicuci N, Pluijm SMF, Rodriguez-Laso A (2003) Are IADLs comparable across countries? Sociodemographic associates of harmonised IADL measures. Aging Clin Exp Res 15:451–459PubMedGoogle Scholar
  18. Pedersen NL, McClearn GE, Plomin R, Nesselroade JR, Berg S, de Faire U (1991) The Swedish Adoption Twin Study of Aging: an update. Acta Genet Med Gemellol (Roma) 40:7–20Google Scholar
  19. Perenboom RJ, Van Herten LM, Boshuizen HC, Van Den Bos GA (2004) Trends in disability-free life expectancy. Disabil Rehabil 26:377–386CrossRefPubMedGoogle Scholar
  20. Rogers A, Rogers RG, Branch LG (1989a) A multistate analysis of active life expectancy. Public Health Rep 104:222–225PubMedGoogle Scholar
  21. Rogers RG, Rogers A, Belanger A (1989b) Active life among the elderly in the United States: multistate life-table estimates and population projections. Milbank Q 67:370–411PubMedGoogle Scholar
  22. Rogers A, Rogers RG, Belanger A (1990) Longer life but worse health? Measurement and dynamics. Gerontologist 30:640–649PubMedGoogle Scholar
  23. Seeman TE, Bruce ML, Mcavay GJ (1996) Social network characteristics and onset of ADL disability: MacArthur studies of successful aging. J Gerontol B Psychol Sci Soc Sci 51:s191–s200PubMedGoogle Scholar
  24. Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health reportsGoogle Scholar
  25. Valderrama-Gama E, Damián J, Ruigómez A, Martín-Moreno JM (2002) Chronic disease, functional status, and self-ascribed causes of disabilities among noninstitutionalized older people in Spain. J Gerontol A Biol Sci Med Sci 57:M716–M721PubMedGoogle Scholar
  26. Valkonen T, Sihvonen AP, Lahelma E (1997) Health expectancy by level of education in Finland. Soc Sci Med 44:801–808CrossRefPubMedGoogle Scholar
  27. Walter-Ginzburg A, Guralnik JM, Blumstein T, Gindin J, Modan B (2001) Assistance with personal care activities among the old-old in Israel: a national epidemiological study. J Am Geriatr Soc 49:1–8CrossRefPubMedGoogle Scholar
  28. Walter-Ginzburg A, Blumstein T, Guralnik JM (2004) The Israeli kibbutz as a venue for reduced disability in old age: lessons from the Cross-sectional and Longitudinal Aging Study. Soc Sci Med 59:389–403CrossRefPubMedGoogle Scholar
  29. Zunzunegui MV, Béland F, Otero A (2001) Support from children, living arrangements, self rated health and depressive symptoms of older people in Spain. Int J Epidemiol 30:1090–1099CrossRefPubMedGoogle Scholar
  30. Zunzunegui MV, Konné A, Johri M, Béland F, Wolfson C, Bergman H (2004) Social networks and self rated health in two French speaking Canadian community dwelling populations over 65. Soc Sci Med 58:2059–2061CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • N. Minicuci
    • 1
  • M. Noale
    • 1
  • S. M. F. Pluijm
    • 2
  • M. V. Zunzunegui
    • 3
  • T. Blumstein
    • 4
  • D. J. H. Deeg
    • 2
  • C. Bardage
    • 5
  • M. Jylhä
    • 6
  • for the CLESA working group
  1. 1.Padua Ageing Unit, Institute of NeuroscienceNational Research CouncilPaduaItaly
  2. 2.Institute for Research in Extramural MedicineVU University Medical CentreAmsterdamThe Netherlands
  3. 3.Centro Universitario de Salud PúblicaUniversidad Autonoma de MadridMadridSpain
  4. 4.Gertner Institute for Epidemiology and Health Policy ResearchChaim Sheba Medical CenterTel-HashomerIsrael
  5. 5.Department of Medical EpidemiologyKarolinska InstituteStockholmSweden
  6. 6.School of Public HealthUniversity of TampereTampereFinland

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