Healthy life expectancy by frailty state in Europe from 2004 to 2015: findings from SHARE

BACKGROUND

As populations age, the possible consequences of increased frailty are a major concern for the health sector. Here, we investigate how life expectancy with and without frailty has changed during a 10-11-year-period across Europe.

METHODS

The Sullivan method was used to investigate changes in life expectancy with and without frailty in 10 European countries. Frailty status (non-frail, pre-frail and frail) was determined by use of the Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI). Data on frailty prevalence was obtained from 21 698 individuals in wave 1 (2004-05) and 38 859 individuals in wave 6 (2015) of the SHARE. Information on mortality was obtained from the Eurostat Database.

RESULTS

In 2015, women aged 70 spent 25.0% (95% CI: 24.0-26.1) of their remaining life expectancy in a frail state, and the number for men was 11.5% (95% CI: 10.7-12.3). Southern Europeans spent 24.2% (95% CI: 22.9-25.4) of their remaining life expectancy in a frail state and the numbers for Central Europeans and Northern Europeans were 17.0% (95% CI: 16.0-17.9) and 12.2% (95% CI: 10.9-13.5), respectively. From 2004-05 to 2015, life expectancy increased by 1.1 years (from 15.3 to 16.4 years) for 70-year-old Europeans. Similarly, non-frail life expectancy increased by 1.1 years (95% CI: 0.8-1.4), whereas no significant changes in life expectancy in frail states were observed.

CONCLUSIONS

This study suggests that Europeans today spend more years in a non-frail state than Europeans did 10-11 years ago. Our findings reflect a considerable inequality by gender and region.

Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population - A SHARE-based analysis

Aim: International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aim to describe the distribution of these risk factors across Europe. Subject and Methods: Prevalence of risk factors for severe COVID-19 was identified based on interview for 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to app. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (app. 36 million men and 43 million women) had at least two factors and 21.2% (app. 17 million men and 20 million women) had at least three risk factors. The prevalences of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalences of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 disease and thus to decide appropriate strategies to mitigate the pandemic.

Sucrose taste thresholds: age-related differences

Sucrose taste detection thresholds were measured in 71 adults aged 20 to 88 years. A forced-choice, tracking procedure was used to eliminate subject response bias and rinses were included between all stimuli. A significant age-related decrease in sensitivity was observed. However, the loss of sensitivity was not great and elderly people had highly variable thresholds. A similar study on salt taste acuity has been reported from this laboratory demonstrating a small, but statistically significant threshold increment with age. The observation that age-related differences in taste sensitivity are not large is consistent with biological information that taste bud cells are continuously replaced in adult mammals.

Algorithm-derived, computer-generated interpretive comments in the reporting of laboratory tests

The volume of laboratory and other data that physicians encounter daily is more than most can mentally process without oversight or error. Routine use of computer-generated reminders is one solution to this problem that is now widely suggested. We report our experience with the daily use of a user-written program of algorithm-derived, computer-generated comments in the reporting of chemical profiles and routine thyroid function tests in a busy medium-sized privately owned independent clinical laboratory.

A computer system for cytology in a private laboratory using a PDP 8/E minicomputer

A computer software package written in Dibol for a PDP 8/E computer is described that is designed for the needs of the cytology department of a moderate-sized private medical laboratory. Computerized accessioning of cases, report preparation and printing, historical filing, activity summary reports, and direct patient and physician billing are provided by the relatively inexpensive system. The software has been in use for over two years in our cytology department and has resulted in increased efficiency, cost-effectiveness, and quality of reports.