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Sandoval MH, Portaccio MEA, Albala C. Ethnic differences in disability-free life expectancy and disabled life expectancy in older adults in Chile. BMC Geriatr 2024; 24:116. [PMID: 38297194 PMCID: PMC10829324 DOI: 10.1186/s12877-024-04728-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown. OBJECTIVE To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile. METHOD Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan's method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile. RESULTS Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively). CONCLUSIONS This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
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Affiliation(s)
- Moisés H Sandoval
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
| | | | - Cecilia Albala
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Osuna M, Farina M, Ailshire J. Disabled life expectancy among older Colombian men and women. PLoS One 2024; 19:e0296638. [PMID: 38206966 PMCID: PMC10783758 DOI: 10.1371/journal.pone.0296638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024] Open
Abstract
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.
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Affiliation(s)
- Margarita Osuna
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, United States of America
| | - Mateo Farina
- Department of Human Development and Family Science, Austin, Texas, United States of America
| | - Jennifer Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, United States of America
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Papanova EK, Vorobyeva NM, Kotovskaya YV, Tkacheva ON, Ovcharova LN, Selezneva EV. Healthy Life Expectancy of People Over Age 65: Results of the Russian Epidemiological Study EVCALIPT. ADVANCES IN GERONTOLOGY 2022. [DOI: 10.1134/s2079057022040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Moreno X, Lera L, Márquez C, Albala C. Forecasting Healthy Life Expectancy Among Chilean Community-Dwelling Older Adults With and Without Sarcopenia. Front Med (Lausanne) 2022; 9:841810. [PMID: 35252274 PMCID: PMC8889119 DOI: 10.3389/fmed.2022.841810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sarcopenia is an important risk factor for disability and dependency at old age. The prevalence of sarcopenia among the Chilean older population is high. OBJECTIVE To estimate life expectancy, healthy life expectancy and unhealthy life expectancy among sarcopenic and non-sarcopenic older adults from Santiago, Chile. METHODS A sample of 1,897 community-dwelling older adults aged 60 years or more, living in Santiago, was observed between 5-15 years. Disability was defined as the unhealthy state, assessed through self-reported difficulties in activities of daily living. Sarcopenia was determined via HTSMayor software. Total and marginal life expectancies were estimated using the Interpolated Markov Chain method "IMaCh". RESULTS At 60 years, estimated life expectancy for sarcopenic and non-sarcopenic older adults was similar (22.7 and 22.5 years, respectively). The proportion of years to be lived with disability was three times greater in sarcopenic adults, compared to non-sarcopenic people. This difference was observed up to 80 years. Non-sarcopenic women had a higher proportion of years to be lived with disabilities compared to non-sarcopenic men of the same age, but this proportion was higher among sarcopenic men, compared to sarcopenic women until 70 years of age. DISCUSSION People with sarcopenia expect to live a higher proportion of years with disabilities. Sarcopenic men until 70 years expected to live a higher proportion of years with disability, compared to sarcopenic women. Monitoring sarcopenia among older people may help to identify individuals with higher risk of disability onset. Future research should focus on disentangling the mechanisms explaining sex differences.
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Affiliation(s)
- Ximena Moreno
- Unidad de Nutrición Pública, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile.,Facultad de Psicología, Universidad San Sebastián, Santiago, Chile
| | - Lydia Lera
- Unidad de Nutrición Pública, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile.,Latin Division, Keiser University, Fort Lauderdale, FL, United States
| | - Carlos Márquez
- Unidad de Nutrición Pública, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Cecilia Albala
- Unidad de Nutrición Pública, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
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Kataoka A, Fukui K, Sato T, Kikuchi H, Inoue S, Kondo N, Nakaya T, Ito Y. Geographical socioeconomic inequalities in healthy life expectancy in Japan, 2010-2014: An ecological study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 14:100204. [PMID: 34527999 PMCID: PMC8355904 DOI: 10.1016/j.lanwpc.2021.100204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
Background Area differences in life expectancy (LE) and healthy life expectancy (HLE) in large geographical units have been monitored around the world. Area characteristics may be based on culture, history, socioeconomic status and discrimination in smaller geographical units, so it is important to consider these when looking at health inequality. We aimed to evaluate LE, HLE, and non-healthy life expectancy (NHLE) in 1707 municipalities using Areal Deprivation Index (ADI) in Japan for the first time. Methods We calculated the observed LE, HLE, and NHLE using death, population, and Long-term care insurance data for 2010-2014 and applied the variance weighted least squares model to estimate LE, HLE, and NHLE by 100 percentiles using the standardized ADI. Findings The estimated LE, HLE, and NHLE became lower as the deprivation index worsened: the differences between the most and least deprived areas for HLE were 2·49 years for LE and 2·32 years for HLE in males; 1·22 years for LE and 0·93 years for HLE in females. The observed LE and HLE in the most deprived areas were much lower than other areas. Interpretation Using ADI has enabled us to see the disparity within municipalities precisely. LE and HLE outlier for the 100th percentile might be linked to historical areal deprivation and marginalization. Precise monitoring of socioeconomic status-based health inequalities could help manage these inequalities by identifying the groups most in need of intervention. Funding The Ministry of Education, Science and Culture of Japan (a Grant-in-Aid for Scientific Research [A] No. 20H00040 and 18H04071).
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Affiliation(s)
- Aoi Kataoka
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University.,Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Keisuke Fukui
- Department of Mathematics Program, Graduate School of Advanced Science and Engineering, Hiroshima University
| | - Tomoharu Sato
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University
| | - Tomoki Nakaya
- Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University
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Chan YM, Sahril N, Chan YY, Ab Wahab NA, Shamsuddin N, Ismail MZH. Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126271. [PMID: 34200564 PMCID: PMC8296057 DOI: 10.3390/ijerph18126271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 11/16/2022]
Abstract
Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults' level of independence.
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Affiliation(s)
- Yee Mang Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
- Correspondence:
| | - Norhafizah Sahril
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Ying Ying Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Nor’ Ain Ab Wahab
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Norliza Shamsuddin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia; (N.S.); (Y.Y.C.); (N.A.A.W.); (N.S.)
| | - Muhd Zulfadli Hafiz Ismail
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia;
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Wang S, Hu S, Wang P, Wu Y, Liu Z, Zheng H. Disability-Free Life Expectancy among People Over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094636. [PMID: 33925511 PMCID: PMC8123896 DOI: 10.3390/ijerph18094636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate and compare age trends and the disability-free life expectancy (DFLE) of the population over 60 years old in 2018 in Jiangxi Province, China, by sex and urban-rural areas. METHODS The model life table was employed to estimate the age-specific mortality rate by sex and urban-rural areas, based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province. DFLE and its ratio to life expectancy (LE) were obtained by the Sullivan method. RESULTS In 2018, the DFLE among people over 60 is 17.157 years for men and is 19.055 years for women, accounting for 89.7% and 86.5% of their LE respectively. The DFLE/LE of men is higher than that of women at all ages. LE and DFLE are higher for the population in urban areas than in rural areas. For women, DFLE/LE is higher in urban areas than in rural areas (except at ages 75 and 80). Urban men have a higher DFLE/LE than rural men (except at age 85). The difference in DFLE between men and women over 60 years is 1.898 years, of which 2.260 years are attributable to the mortality rate, and 0.362 years are due to the disability-free prevalence. In addition, the difference in DFLE between urban-rural elderly over 60 years old is mostly attributed to the mortality rate by gender (male: 0.902/1.637; female: 0.893/1.454), but the impact of the disability-free rate cannot be ignored either (male: 0.735/1.637; female: 0.561/1.454). CONCLUSIONS The increase in DFLE is accompanied by the increase in LE, but with increased age, DFLE/LE gradually decreases. With advancing age, the effect of disability on elderly people becomes more severe. The government administration must implement some preventive actions to improve health awareness and the life quality of the elderly. Rural elderly; rural women in particular, need to be paid more attention and acquire more health care.
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Affiliation(s)
- Shengwei Wang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (S.W.); (S.H.); (Y.W.); (Z.L.)
| | - Songbo Hu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (S.W.); (S.H.); (Y.W.); (Z.L.)
| | - Pei Wang
- Department of Statistics, University of Kentucky, Lexington, KY 40536, USA;
- Department of Statistics, Miami University, Oxford, OH 45056, USA
| | - Yuhang Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (S.W.); (S.H.); (Y.W.); (Z.L.)
| | - Zhitao Liu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (S.W.); (S.H.); (Y.W.); (Z.L.)
| | - Huilie Zheng
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (S.W.); (S.H.); (Y.W.); (Z.L.)
- Correspondence:
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Rueda-Salazar S, Spijker J, Devolder D, Albala C. The contribution of social participation to differences in life expectancy and healthy years among the older population: A comparison between Chile, Costa Rica and Spain. PLoS One 2021; 16:e0248179. [PMID: 33711063 PMCID: PMC7954322 DOI: 10.1371/journal.pone.0248179] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/19/2021] [Indexed: 11/18/2022] Open
Abstract
We study the health trajectories of the population aged over 60, comparing between one European and two Latin American countries (Spain, Chile and Costa Rica) which have similar longevity patterns. Our focus is on functional limitation and mortality risks, considering differences by gender, education and social participation. Data come from national panel surveys (EPS, CRELES, SHARE). Multistate modelling is used to estimate transition probabilities between two health states: healthy to unhealthy, unhealthy to healthy as well as the transition to death from healthy or unhealthy states, to estimate the duration of stay in a specific state (computing healthy and unhealthy life expectancies) and the effect of the selected covariates. Results show that older Costa Ricans have the smallest gender gap in life expectancy but women have a lower healthy life expectancy compared to those in Chile and Spain. Participation in social activities leads to higher healthy life expectancy among the elderly in Costa Rica and Spain, whilst there were no relevant educational differences observed in longevity in the analysed countries. To conclude: despite the different patterns observed in health transitions and survival across the three countries, social participation is associated with greater health and longevity among people of old age, with little effect coming from educational attainment. Public policies should therefore be aimed at reducing unhealthy life years and dependency at advanced ages by promoting more engagement in social activities, especially among vulnerable groups who are more likely to experience impairment from a younger age.
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Affiliation(s)
- Sarahí Rueda-Salazar
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Jeroen Spijker
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Daniel Devolder
- Centre d’Estudis Demogràfics (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Cecilia Albala
- Unidad de Nutrición Pública, Instituto de la Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
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Moreno X, Lera L, Moreno F, Albala C. Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study. BMC Geriatr 2021; 21:176. [PMID: 33706709 PMCID: PMC7949249 DOI: 10.1186/s12877-021-02126-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/28/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. METHODS The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. RESULTS At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6-24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4-19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4-18.2). They also had a DFLE (19.4; 95% CI 17.1-21.7) 4 (15.4; 95% CI 14.6-16.1) and 5.2 (14.2; 95% CI 13.4-14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7-30.8) 4.6 (22.7; 95% CI 21.9-23.5) and 5.6 (21.6; 20.6-22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5-23.3; medium: 16.5; 95% CI 15.8-17.1; low: 15.3; 95% CI 14.6-16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. DISCUSSION Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. CONCLUSION A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.
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Affiliation(s)
- Ximena Moreno
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
| | - Lydia Lera
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
- Keiser University, 1900 W Commercial Blvd, Fort Lauderdale, FL 33309 USA
| | - Francisco Moreno
- Universidad de Santiago de Chile, Avenida Libertador Bernardo O’Higgins, 1611 Santiago, Chile
| | - Cecilia Albala
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
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Gott M, Morgan T, Williams L. Gender and palliative care: a call to arms. Palliat Care Soc Pract 2020; 14:2632352420957997. [PMID: 33134926 PMCID: PMC7576896 DOI: 10.1177/2632352420957997] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022] Open
Abstract
There has been a systematic and largely unconscious neglect of gender in
palliative care research, practice and policy. This is despite significant,
although previously uncollated, evidence that gender influences almost all
aspects of end-of-life preferences, experiences and care. The social situations
of women, transgender people and men often differ from one another while also
intersecting in complex ways with sex differences rooted in biology. If
palliative care is to meet its aspiration of providing universal benefit, it
urgently needs to address a range of gender inequalities currently (re)produced
at the level of the laboratory all the way through to government departments. In
this call to arms, we spotlight specific instances where gender inequalities
have been documented, for example, regarding end-of-life caregiving, end-of-life
intervention and palliative care access and benefit. We highlight how gender
inequalities intersect with other social determinants of health including
ethnicity and economic status to exacerbate situations of marginality. We
conclude by offering some practical steps that can be taken to support the
discipline to adopt a more critical gender lens to support more equitable
research, policy and practice.
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Affiliation(s)
- Merryn Gott
- Professor, School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Tessa Morgan
- Department of Public Health and Primary Care and Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Hosokawa R, Ojima T, Myojin T, Aida J, Kondo K, Kondo N. Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176301. [PMID: 32872538 PMCID: PMC7503367 DOI: 10.3390/ijerph17176301] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 12/28/2022]
Abstract
Japan has the highest life expectancy in the world. However, this does not guarantee an improved quality of life. There is a gap between life expectancy and healthy life expectancy. This study aimed to reveal the features of healthy life expectancy across all secondary medical areas (n = 344) in Japan and examine the relationship among healthcare resources, life expectancy, and healthy life expectancy at birth. Data were collected from Japan’s population registry and long-term insurance records. Differences in healthy life expectancy by gender were calculated using the Sullivan method. Maps of healthy life expectancy were drawn up. Descriptive statistics and correlation analysis were used for analysis. The findings revealed significant regional disparities. The number of doctors and therapists, support clinics for home healthcare facilities and home-visit treatments, and dentistry expenditure per capita were positively correlated with life expectancy and healthy life expectancy (correlation coefficients > 0.2). They also revealed gender differences. Despite controlling for population density, inequalities in healthy life expectancy were observed, highlighting the need to promote social policies to reduce regional disparities. Japanese policymakers should consider optimal levels of health resources to improve life expectancy and healthy life expectancy. The geographical distribution of healthcare resources should also be reconstituted.
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Affiliation(s)
- Rikuya Hosokawa
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
- Correspondence: ; Tel.: +81-75-751-4154
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan;
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan;
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan;
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi 980-8575, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan;
- Center for Well-being and Society, Nihon Fukushi University, Aichi 470-3295, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan;
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
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12
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Moreno X, Lera L, Albala C. Disability-free life expectancy and life expectancy in good self-rated health in Chile: Gender differences and compression of morbidity between 2009 and 2016. PLoS One 2020; 15:e0232445. [PMID: 32353089 PMCID: PMC7192428 DOI: 10.1371/journal.pone.0232445] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background Chile has one of the highest life expectancies at 60 years in South America. This study was aimed to determine healthy life expectancies among Chilean older people, according to self-rated health and disability, and to explore gender differences. Methods Data from the National Survey of Health (2009 and 2016) were used to estimate prevalence of less than good self-rated health and disability among people aged 60 years and above. Health expectancies were calculated with the Sullivan method. Results In both years, women expected to live a lower proportion of their life expectancy in good self-rated health (54.5% [95% CI 50.0–58.8] for men and 37.6% [95% CI 34.3–40.8] for women in 2009; 46.1% [95% CI 42.6–49.7] for men and 38.5% [95% CI 35.6–41.4] for women in 2016). Life expectancy in less than good self-rated health increased for men (9.4 years [95% CI 8.4–10.3] in 2009; 11.5 years [95% CI 10.7–12.2]). Women expected to live a lower proportion of their remaining life without disabilities (65.3% [95% CI 61.2–69.4] for men and 44.9% [95% CI 41.9–47.9] for women in 2009; 71.9% [95% CI 68.7–75.0] for men and 61.1% [95% CI 58.5–63.8] for women in 2016). In 2016, disability-free life expectancy increased among women, but they still had a higher life expectancy with mild disability (2.8 years [95% CI 2.3–3.4] for men and 6.0 years [95% CI 5.4–6.7] for women). Conclusions Women expected to spend more years in less than good self-rated health and disabled. There was an expansion of life expectancy in less than good SRH among men and a compression of disability in both sexes. The high proportion of years expected to be lived in less than good self-rated health and gender differences in disability-free life expectancy of older adults should be addressed by public health policies in Chile.
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Affiliation(s)
- Ximena Moreno
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
- * E-mail:
| | - Lydia Lera
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Cecilia Albala
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Albala C. EL ENVEJECIMIENTO DE LA POBLACIÓN CHILENA Y LOS DESAFÍOS PARA LA SALUD Y EL BIENESTAR DE LAS PERSONAS MAYORES. REVISTA MÉDICA CLÍNICA LAS CONDES 2020. [DOI: 10.1016/j.rmclc.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Moreno X, Lera L, Moreno F, Albala C. Life expectancy with and without cognitive impairment among Chilean older adults: results of the National Survey of Health (2003, 2009 and 2016). BMC Geriatr 2019; 19:374. [PMID: 31878877 PMCID: PMC6933700 DOI: 10.1186/s12877-019-1387-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/16/2019] [Indexed: 11/25/2022] Open
Abstract
Background Chile has one of the highest life expectancies within Latin American. This is the first study to determine health expectancies in older populations in Chile, considering cognitive status as a health indicator. Methods We estimated prevalence of cognitive decline among people aged 60 years and over based on the Mini-mental State Examination and the Pfeffer Functional Activities Questionnaire, with data from the National Survey of Health (2003, 2009, 2016). Life expectancy free of cognitive impairment was calculated using the Sullivan method. Results At age 60, life expectancy free of cognitive impairment was more than 3 years longer for women, compared to men of the same age. Life expectancy free from cognitive impairment was higher for both men and women aged 60 in 2016 when compared to 2003 (2.1 and 2 years higher, respectively). Conclusions Longer life expectancy in women was accompanied by more years free of cognitive impairment. Men expected to live a similar proportion of years free of cognitive impairment, compared to women. Common and standardised assessments of health status of older people should be adopted in Latin American studies, to allow for time-trend analyses and international comparisons.
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Affiliation(s)
- Ximena Moreno
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile.
| | - Lydia Lera
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
| | - Francisco Moreno
- University of Santiago (USACH), Avenida Libertador Bernardo O'Higgins 1611, Santiago, Chile.,Environment Ministry, San Martín 73, Santiago, Chile
| | - Cecilia Albala
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, Santiago, Chile
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Adıgüzel E, Acar-Tek N. Nutrition-related parameters predict the health-related quality of life in home care patients. Exp Gerontol 2019; 120:15-20. [PMID: 30822485 DOI: 10.1016/j.exger.2019.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION There is evidence that nutritional status is one of the major factors affecting quality of life. Low quality of life is an important reason that reflects the risk of malnutrition as well as dependency and frailty. OBJECTIVE The present study aimed to examine nutritional risk factors and sociodemographic features affecting health-related quality of life in home care patients. MATERIALS AND METHODS The data of 209 adult or elderly eligible subjects were evaluated in the study. A general questionnaire including sociodemographic and nutritional characteristics, 'Mini Nutritional Assessment (MNA)', 'Short Form-36 (SF-36) health related life quality scale' and '24-hour dietary recall' were applied with face-to-face interview. Anthropometric measurements were performed using standard measurement protocols and, height and weight measurements of bedridden patients were calculated by equality formulas. RESULTS While 52.6% of patients were malnourished according to the MNA, only 7.7% were underweight according to the body mass index (BMI). The SF-36 summary component scores (physical and mental component summary scale scores) of malnourished patients were significantly lower than patients at risk of malnutrition or normal (p < 0.05). There were significant positive correlations between SF-36 physical component summary scale scores were significantly correlated with MNA scores (r = 0.517), BMI (r = 0.140) and daily dietary macronutrient intake (energy (r = 0.328), protein (r = 0.165), carbohydrate (r = 0.305), fat (r = 0.275) and fiber (r = 0.268)) (p < 0.05). Besides there were significant positive correlation between SF-36 mental component summary scale scores and MNA scores (r = 0.719), BMI (r = 0.318), daily dietary macronutrient intake (energy (r = 0.388), protein (r = 0.204), carbohydrate (r = 0.335), fat (r = 0.365) and fiber (r = 0.349)) (p < 0.05). It was also determined that MNA had the greatest positive effect and 'having a caregiver' had the greatest negative effect on the physical and mental component summary scale scores. CONCLUSION Periodic nutritional screening of home care patients is important and necessary for early nutritional intervention and thus prevention of morbidity and mortality.
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Affiliation(s)
- Emre Adıgüzel
- Karamanoglu Mehmetbey University, Faculty of Health Sciences, Department of Nutrition and Dietetics, 70100 Karaman, Turkey.
| | - Nilüfer Acar-Tek
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Beşevler, 06500 Ankara, Turkey
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Prina AM, Wu YT, Kralj C, Acosta D, Acosta I, Guerra M, Huang Y, Jotheeswaran AT, Jimenez-Velazquez IZ, Liu Z, Llibre Rodriguez JJ, Salas A, Sosa AL, Prince M. Dependence- and Disability-Free Life Expectancy Across Eight Low- and Middle-Income Countries: A 10/66 Study. J Aging Health 2019; 32:401-409. [PMID: 30698491 PMCID: PMC7322974 DOI: 10.1177/0898264319825767] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
| | | | | | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican Republic
| | - Isaac Acosta
- National Institute of Neurology and Neurosurgery of Mexico, Mexico City, Mexico
- National Autonomous University of Mexico, Mexico City, Mexico
| | - Mariella Guerra
- Instituto de la Memoria y Desordenes Relacionados, Lima, Perú
| | | | | | | | | | | | - Aquiles Salas
- Universidad Central de Venezuela, Caracas, Venezuela
| | - Ana Luisa Sosa
- National Institute of Neurology and Neurosurgery of Mexico, Mexico City, Mexico
- National Autonomous University of Mexico, Mexico City, Mexico
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