Gender differences in life expectancy with and without disability among older adults in Ecuador

Disabled life expectancy among older Colombian men and women

Colombia's population is rapidly aging and older adults are living longer, however, we have limited information on the level of disability and number of years older Colombians spend with disability. We estimated age-and-gender specific ADL, IADL and mobility disability prevalence and disabled life expectancy (DLE) and to examined gender differences. Life tables came from the Colombian vital statistics and disability prevalence data came from the cross-sectional 2015 Colombia National Survey of Health, Well-being, and Aging. Disabled life expectancy (DLE) was calculated using Sullivan's method. About one-third to one-half of remaining years will be spent with IADL or mobility disability. The remaining years of life spent with ADL was relatively low at younger ages, but by age 85, about half of remaining life will be spent with disability. Compared to men, women had higher levels of disability and are estimated to spend more years with disability. Gender differences in ADL did not emerge until ages 70 and older. Older Colombians, in particularly women, are estimated to live a significant proportion of their life with disability, particularly IADL and mobility disability. High levels of disability are concerning because the country lacks adequate infrastructure and has limited options for long term care.

The average life expectancy of persons with disabilities in China

The average life expectancy (ALE) of persons with disabilities (PWDs) is much shorter than that of the total population in many countries. However, there have been relatively few empirical studies on the ALE of PWDs in China. This study estimates the ALE and compiles the life tables of PWDs in China using data on 1,359,812 PWDs registered in the Special Surveys of Basic Services and Needs of the Disabled (SSBSND) in K Province in China from 2015 to 2017. The ALE of PWDs at age 20 is 45.2 years (95% CI: 44.7-45.8) for men and 48.1 years (95% CI: 47.6-48.6) for women, which is 15.0 years (men) and 16.5 years (women) lower than that of the entire population. The ALE of those with the most severe disability is only 33.7 years (95% CI: 32.2-45.1) for men and 37.1 years (95% CI: 35.3-38.8) for women. The ALE is relatively short for persons with intellectual and physical disabilities; moderate for those with hearing, speech, and mental disabilities; and relatively long for those with visual and multiple disabilities. Of the PWDs participating in basic old-age insurance (BOI), more than 30% do not live long enough to receive their pensions. As such, because a large proportion of PWDs die before 60 years old, social policies for PWDs should be specially designed.

Restrictions on persons with disabilities for participating in family and community activities

OBJECTIVE

To identify the influence of functional impairments and limitations activities for persons with disabilities to particípate in family and community activities.

METHODS

This is a cross-sectional study with 4 044 persons with disabilities, selected using probabilistic sampling and a door-to-door active search model in 5 towns in the District of Barranquilla. The data were processed with univariate analysis and bivariate analysis to determine the relationship between the study variables.

RESULTS

55.9% of the population were males, 41.6% were between 15 and 44 years of age, and 92.9% belonged to the lower socioeconomic stratum. 82.9% reported mobility limitations and 99% reported barriers to access non-formal learning activities, 98.6% to access public activities, and 97.5% to access productive activities. Individuals with that a lower limitation in exercising the power of reason, particularly thinking, can increase participation in activities with family and friends (OR, 0.8; 95% CI, 0.6-0.9), with the community (OR, 0.7; 95% CI, 0.6-0.9), religious or spiritual activities (OR, 0.8; 95% CI, 0.7-0.9).

CONCLUSIONS

There is a directly proportional relationship between structural impairment with the development of dependency and limited family, social, and work participation in the persons with disabilities.

Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms

Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.

The Life Expectancy Gap between Registered Disabled and Non-Disabled People in Korea from 2004 to 2017

This study aimed to estimate and compare life expectancy at birth among people with and without officially registered disabilities in Korea between 2004 and 2017. We used the National Health Information Database in Korea to obtain aggregate data on the numbers of population and deaths according to calendar year (2004 to 2017), sex, age groups, and officially registered disability status. A total of 697,503,634 subjects and 3,536,778 deaths, including 33,221,916 disabled subjects (829,464 associated deaths), were used to construct life tables. Between 2004 and 2017, life expectancy for people with disabilities increased by 9.1 years in men and 8.3 years in women, while life expectancy for the non-disabled increased by 5.5 years in men and 4.6 years in women. The average life expectancy difference between non-disabled and disabled people was 18.2 years during the study period, decreasing from 20.4 years in 2004 to 16.4 years in 2017. In 2017, the life expectancy of people with the most severe grade of disabilities was 49.7 years, while the life expectancy of people with the least severe grade of disabilities was 77.7 years. The government should implement more effective policies to protect the health of people with officially registered disabilities.

Dependence- and Disability-Free Life Expectancy Across Eight Low- and Middle-Income Countries: A 10/66 Study

Objective: The objective of this study was to estimate healthy life expectancies in eight low- and middle-income countries (LMICs), using two indicators: disability-free life expectancy (DFLE) and dependence-free life expectancy (DepFLE). Method: Using the Sullivan method, healthy life expectancy was calculated based on the prevalence of dependence and disability from the 10/66 cohort study, which included 16,990 people aged 65 or above in China, Cuba, Dominican Republic, India, Mexico, Peru, Puerto Rico, and Venezuela, and country-specific life tables from the World Population Prospects 2017. Results: DFLE and DepFLE declined with older age across all sites and were higher in women than men. Mexico reported the highest DFLE at age 65 for men (15.4, SE = 0.5) and women (16.5, SE = 0.4), whereas India had the lowest with (11.5, SE = 0.3) in men and women (11.7, SE = 0.4). Discussion: Healthy life expectancy based on disability and dependency can be a critical indicator for aging research and policy planning in LMICs.

Health status and associated factors among the community-dwelling elderly women in China

The purpose of this study was to evaluate the health status and associated factors of the elderly women in China. A cross-sectional survey from cluster random sampling method was performed between March 2013 and December 2013. 1910 elderly people aged 60 years and over were selected in a community of Nanjing, China, including 977 elderly women. The self-designed elderly health assessment scale questionnaire was used. The data were analyzed through χ2-test and ordinal logistic regression. The results showed that the older women were higher in proportion than older men, the elderly women had lower in education, higher in divorced or widowed proportions, higher in living alone, and higher in no occupations. The proportion of elderly women suffering from chronic disease was lower than that of elderly men. The proportion of the elderly woman suffering from high cholesterol was higher, lower in high blood pressure. Elderly women were poorer than men in Physiological health, Memory and Multidimensional health status. The elderly women who had older, lower-education level, non-couples living, general employees or workers had poorer Multidimensional health status. This study demonstrated that the health status of elderly women of Nanjing, China were in a vulnerable position, especially some associated factors. We need pay more attention on these in improving the health of elderly women.

Determinants of Health Related Quality of Life in Home Dwelling Elderly Population: Appetite and Nutritional Status

OBJECTIVE

The present study aimed to examine nutritional risk factors such as poor appetite, malnutrition or obesity affecting health related quality of life in elderly.

DESIGN AND PARTICIPANTS

This is a cross-sectional population-based study consisted of 407 elderly (142 men and 265 women) mean aged 71.7±6.54 years.

MEASUREMENTS

Questionnaire including the demographic and general characteristics, health information, nutritional habits was performed by face-to-face interviews. Daily food consumption was assessed using 24-hour dietary recall. Mini Nutrition Assessment (MNA) and Mini Nutrition Assessment-Short Form (MNA-SF) were used for assessment of nutrition status. Appetite was evaluated using the Simplified Nutritional Appetite Questionnaire (SNAQ). Health related life quality scale (Short Form Health Survey -SF36) was used for evalution health related quality of life.

RESULTS

According to MNA and MNA-SF 6.1%; 4.2% of elderly people were malnutrition and 40.3%; 21.9% of them were at risk of malnutrition respectively. Accordingly, SNAQ 28.7% of elderly were risk at loss of weight. Health related quality of life scores of women were significantly lower than men. Good nutritional (MNA-SF) and good appetite (SNAQ) status, increased 1.69, 1.48 fold in the mental component summary scale scores respectively. SNAQ was the best determinant of physical component summary scale score had the greatest positive effect, good appetite status increased approximately 2.2 fold in physical scores. Polypharmacy and high BMI decreased health related quality of life in elderly.

CONCLUSION

Determinants of quality of life are preventable and treatable with early and appropriate interventions in elderly.