This article demonstrates that disabled life expectancies that are based on conventional multistate life-table methods are significantly underestimated because of the assumption of no changes in functional status between age x and death. We present a new method to correct the bias and apply it to data from a longitudinal survey of about 9,000 oldest-old Chinese aged 80–105 collected in 1998 and 2000. In our application, the age trajectories of disability (activities of daily living—ADL), status-specific death rates, and the probabilities of transitions between ADL states of the oldest-old were investigated for the first time in a developing country. In this article, we report estimates of bias-corrected disabled and active life expectancies of the Chinese oldest-old and demonstrate patterns of large differences associated with initial status, gender, and advances in ages. Using combined information on ADL disabilities and length of having been bedridden before dying, we analyze gender and age patterns of the extent of morbidity before dying among the oldest-old and their implications for debates on the hypothesis of compression of morbidity.
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This article is based on data that were derived from the Chinese Longitudinal Healthy Longevity Survey, which was supported by Grant P01 AG 08761 from the National Institute on Aging awarded to Duke University and Chinese matching input toward personnel costs and some local expenses. The Max Planck Institute for Demographic Research provided support for international training. We greatly appreciate the invaluable comments provided by the three anonymous referees and the editor. An earlier version of this article was presented at a seminar of the International Union for the Scientific Study of Population, entitled “Increasing Longevity: Causes, Consequences and Prospects,” Rockefeller University, New York, October 20–22, 2003; we are grateful to E.M. Crimmins and J.M. Robine for their useful comments.
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Yi, Z., Danan, G. & Land, K.C. A new method for correcting under-estimation of disabled life expectancy and an application to the chinese oldest-old. Demography 41, 335–361 (2004). https://doi.org/10.1353/dem.2004.0018
- Health Expectancy
- Healthy Life Expectancy
- Active Life Expectancy
- Chinese Longitudinal Healthy Longevity Survey
- Multistate Life Table