Skip to main content

Advertisement

SpringerLink
Log in

Trends in disability-free life expectancy at age 65 in France: consistent and diverging patterns according to the underlying disability measure

  • Original Investigation
  • Published:
European Journal of Ageing Aims and scope Submit manuscript

Abstract

Disability-free life expectancy estimates (DFLE) are summary measures to monitor whether a longer life expectancy (LE) is associated with better health or whether additional years of life are years of poor health or disability. Disability is a generic term defined as the impact of disease or injury on the functioning of individuals. It covers various situations from the rather common functional limitations to restrictions in daily activities and finally dependency. Disentangling these dimensions is essential to monitor future needs of care and assistance; but this is not always feasible since surveys do not systematically cover a large range of disability dimensions in their questionnaires. This study aims to cover different disability dimensions by using data from different French population surveys. We computed ten disability-free life expectancies, based on both specific and generic disability indicators from four population health surveys, in order to describe and compare trends and patterns for France over the 1980s and the 1990s. We used the Sullivan method to combine prevalence of disability and life tables. In 2000, two thirds of total LE at age 65 are years with physical or sensory functional limitations and 10% are years with restrictions in personal care activities. Trends in DFLE over the two last decades seem to have remained stable for moderate levels of disability and to have increased for more severe levels of disability or activity restrictions. We found that patterns are consistent from one survey to the other when comparing indicators reflecting similar disability situations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Agree E (1999) The influence of personal care and assistive devices on the measurement of disability. Soc Sci Med 48(4):427–443

    Article  Google Scholar 

  • Auvray L, Doussin A, Le Fur P (2003) Santé, soins et protection sociale en 2002: Enquête Santé et Protection Sociale (ESPS), France [Health, care and social protection in 2002: survey on health and social protection, France]. Rapport IRDES 1509 (2003/12), Paris, pp 181

  • Barberger-Gateau P, Rainville C, Letenneur L, Dartigues J-F (2000) A hierarchical model of domains of disablement in the elderly: a longitudinal approach. Disabil Rehabil 22(7):308–317

    Article  Google Scholar 

  • Cambois E, Robine J-M, Mormiche P (2007) Did the prevalence of disability in France really fall in the 1990s? A discussion of questions asked in the French health survey. Population E 62(2):313–326

    Google Scholar 

  • Cambois E, Robine JM, Romieu I (2005) Risks of restrictions in personal care activities at older ages: determining the concurrent role of functional limitations, age, sex and place of residence. Disabil Rehabil 27(15):871–883

    Article  Google Scholar 

  • Doussin A, Le Fur P, Dumesnil S (2002) Enquête Santé et Protection Sociale (ESPS) : méthode et déroulement de l’enquête. [“Health, health care and insurance survey” (ESPS): methodology and process of the survey”] Rapport IRDES 1401, (2002/12), Paris, pp 190

  • Eurostat (1997) ECHP working group: response rates for the first three waves of the ECHP Doc PAN 92/97

  • Fougeyrollas P, Majeau P (1991) Le processus de production des handicaps: comment utiliser le modèle conceptuel: exemple. Réseau international CIDIH 4(3)

  • Freedman VA, Agree EM, Martin LG, Cornman JC (2006) Trends in the use of assistive technology and personal care for late-life disability 1992–2001. Gerontologist 46:124–127

    Google Scholar 

  • Freedman VA, Crimmins E, Schoeni RF, Spillman BC, Aykan H, Kramarow E, Land K, Lubitz J, Manton K, Martin LG, Shinberg D, Waidman T (2004) Resolving inconsistencies in trends in old-age disability: report from a technical working group. Demography 41(3):417–441

    Article  Google Scholar 

  • Hendershot GE (2006) Survey measurement of disability: a review of international activities and recommendations. In: Altman B, Barnartt S (eds) International views on disability measures: moving toward comparative measurement. Elsevier, Oxford, pp 17–40

    Google Scholar 

  • Imai K, Soneji S (2007) On the estimation of disability-free life expectancy: Sullivan’s method and its extension. J Am Stat Assoc 102(480):1199–1211

    Article  Google Scholar 

  • Jagger C, Arthur A, Spiers N, Clarke M (2001) Patterns of onset of disability in activities of daily living with age. J Am Geriatr Soc 49(4):404–409

    Article  Google Scholar 

  • Jagger C, Cox B, Le Roy S, EHEMU group (2006) Health expectancy calculation by the Sullivan method, 3rd edn. EHEMU Technical Report [downloaded from http://www.ehemu.eu/; training material and calculation guide]

  • Katz S, Ford A, Moskowitz R, Jackson B, Jaffe M (1963) Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAMA 185(12):914–919

    Google Scholar 

  • Lawrence R, Jette A (1996) Disentangling the disablement process. J Gerontol Soc Sci 51B(4):S173–S182

    Google Scholar 

  • Lawton M, Brody E (1969) Assessment of older people: self-maintenance and instrumental activities of daily living. Gerontologist 9:179–186

    Google Scholar 

  • Nagi S (1965) Some conceptual issues in disability and rehabilitation. In: Sussman M (ed) Sociology and rehabilitation. American Sociological Association, Washington, pp 100–113

    Google Scholar 

  • Office for National Statistics (ONS) (2006) Report: health expectancies in the UK, 2002. Health Stat Q 29:59–62

    Google Scholar 

  • Parker MG, Ahacic K, Thorslund M (2005) Health changes among Swedish oldest old: prevalence rates from 1992 and 2002 show increasing health problems. J Gerontol Med Sci 60(10):1351–1355

    Google Scholar 

  • Perenboom RJ, Van Herten LM, Boshuizen HC, Van Den Bos GA (2004) Trends in disability-free life expectancy. Disabil Rehabil 26(7):377–386

    Article  Google Scholar 

  • Robine J-M, Michel J-P (2004) Looking forward for a general theory on population aging. J Gerontol A Biol Sci Med Sci 59:590–597

    Google Scholar 

  • Robine JM, Mormiche P (1994) Estimation de la valeur de l’espérance de vie sans incapacité en France en 1991 [Estimation of the value of disability-free life expectancy in France in 1991]. Solidarité Santé 1:17–36

    Google Scholar 

  • Robine JM, Ravaud J-F, Cambois E (1997) General concepts of disablement. In: Hamerman D (ed) Osteoarthritis: public health implication for an aging population. John Hopkins University Press, Baltimore, pp 63–83

    Google Scholar 

  • Robine JM, Romieu I, Michel JP (2003) Trends in health expectancies. In: Robine JM, Jagger C, Mathers C, Crimmins E, Suzman R (eds) Determining health expectancies. Wiley, Chichester, pp 75–101

    Google Scholar 

  • Rodgers W, Miller B (1997) A comparative analysis of ADL questions in surveys of older people. J Gerontol B 52B (special issue):21–36

  • Sagardui-Villamor J, Guallar-Castillon P, Garcia-Ferruelo M, Banegas JR, Rodriguez-Artalejo F (2005) Trends in disability and disability-free life expectancy among elderly people in Spain: 1986–1999. J Gerontol A Biol Sci Med Sci 60:1028–1034

    Google Scholar 

  • Smith LA, Branch LG, Scheer PA, Wetle T, Evans DE, Hebert L, Taylor JO (1990) Short-term variability of measures of physical function in older people. J Am Geriatr Soc 38:993–998

    Google Scholar 

  • Spillman BC (2004) Changes in elderly disability rates and the implications for health care utilization and cost. Milbank Q 82(1):157–194

    Article  Google Scholar 

  • Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health Rep 86(4):347–354

    Google Scholar 

  • Tager IB, Swanson A, Satariano WA (1998) Reliability of physical performance and self-reported functional measures in an older population. J Gerontol Med Sci 53A(4):M295–M300

    Google Scholar 

  • Van Oyen H, van der Heyden J, Perenboom RC, Jagger C (2006) Monitoring population disability: evaluation of a new Global Activity Limitation Indicator (GALI). Soz Praventivmed 51:153–161

    Article  Google Scholar 

  • Verbrugge L (1997) A global disability indicator. J Aging Stud 11:337–362

    Article  Google Scholar 

  • Verbrugge L, Jette A (1994) The disablement process. Soc Sci Med 38:1–14

    Article  Google Scholar 

  • Verbrugge L, Rennert C, Madans J (1997) The great efficacy of personal and equipment assistance in reducing disability. Am J Public Health 87(3):384–392

    Article  Google Scholar 

  • Wiener JM, Hanley RJ, Clark R, Van Nostrand JF (1990) Measuring the activity of daily living: comparison across national surveys. J Gerontol Soc Sci 45(6):S229–S237

    Google Scholar 

  • Wolf DA, Hunt K, Knickman J (2005) Perspectives on the recent decline in disability at older ages. Milbank Q 83:365–395

    Article  Google Scholar 

  • Wood P, Badley E (1978) An epidemiological appraisal of disablement. In: Bennett A (ed) Recent advances in community medicine. Churchill Livingstone, Edinburgh, pp 149–173

    Google Scholar 

  • World Health Organization (WHO) (1980) International classification of impairments, disabilities, and handicaps. WHO, Geneva

    Google Scholar 

  • World Health Organization (WHO) (2001) International classification of functioning, disability and health: ICF. WHO, Geneva

    Google Scholar 

Download references

Acknowledgements

This study was funded by the Research and Statistics Department of the French Ministry of Health (DREES).

Author information

Authors and Affiliations

  1. Unité “Mortalité, santé, épidémiologie”, Institut National d’Études Démographiques (INED), 133 Bd Davout, 75020, Paris, France

    Emmanuelle Cambois

  2. Equipe “Démographie et santé”, Inserm/Univ Montpellier, centre Val d’Aurelle, Parc Euromédecine, 34298, Montpellier Cedex 05, France

    Aurore Clavel, Isabelle Romieu & Jean-Marie Robine

Authors
  1. Emmanuelle Cambois
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aurore Clavel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Isabelle Romieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Marie Robine
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emmanuelle Cambois.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cambois, E., Clavel, A., Romieu, I. et al. Trends in disability-free life expectancy at age 65 in France: consistent and diverging patterns according to the underlying disability measure. Eur J Ageing 5, 287–298 (2008). https://doi.org/10.1007/s10433-008-0097-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10433-008-0097-1

Keywords

Search

Navigation