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.

[1]  Sören Möller,et al.  Cross-national comparison of sex differences in ADL and IADL in Europe: findings from SHARE , 2020, European journal of ageing.

[2]  J. Robine,et al.  Women’s excess unhealthy life years: disentangling the unhealthy life years gap , 2019, European journal of public health.

[3]  K. Christensen,et al.  Gender differences in cognitive function and grip strength: a cross-national comparison of four European regions. , 2018, European journal of public health.

[4]  J. Robine,et al.  Frailty and Associated Factors among Centenarians in the 5-COOP Countries , 2018, Gerontology.

[5]  J. Robine,et al.  What is the duration of life expectancy in the state of frailty? Estimates in the SIPAF study , 2017, European Journal of Ageing.

[6]  Jenny Ploeg,et al.  Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies , 2017, Age and ageing.

[7]  N. Agahi,et al.  Trends in health expectancies among the oldest old in Sweden, 1992-2011. , 2016, European journal of public health.

[8]  Matteo Cesari,et al.  Frailty: An Emerging Public Health Priority. , 2016, Journal of the American Medical Directors Association.

[9]  C. Brayne,et al.  A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II , 2016, The Lancet.

[10]  E. Crimmins,et al.  Past, Present, and Future of Healthy Life Expectancy. , 2015, Cold Spring Harbor perspectives in medicine.

[11]  S. Leng,et al.  Frailty syndrome: an overview , 2014, Clinical interventions in aging.

[12]  C. Jagger,et al.  Cross-national disparities in sex differences in life expectancy with and without frailty. , 2014, Age and ageing.

[13]  Kenneth Rockwood,et al.  Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans. , 2013, Age and ageing.

[14]  Axel Börsch-Supan,et al.  Data Resource Profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). , 2013, International journal of epidemiology.

[15]  S. Iliffe,et al.  Frailty in elderly people , 2013, The Lancet.

[16]  R. Kenny,et al.  The frailty index in Europeans: association with age and mortality. , 2012, Age and ageing.

[17]  J. Robine,et al.  Gender differences in healthy life years within the EU: an exploration of the “health–survival” paradox , 2012, International Journal of Public Health.

[18]  A. Oksuzyan,et al.  Gender gap in health expectancy , 2010, European journal of ageing.

[19]  Rose Anne Kenny,et al.  A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE) , 2010, BMC geriatrics.

[20]  Elias Mossialos,et al.  Health in the European Union: Trends and Analysis , 2010 .

[21]  J. Vaupel,et al.  Ageing populations: the challenges ahead , 2009, The Lancet.

[22]  J. Spagnoli,et al.  Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[23]  J. Vaupel,et al.  Continued Reductions in Mortality at Advanced Ages , 2008 .

[24]  S. Demarest,et al.  Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004 , 2008, European journal of ageing.

[25]  S. Soneji,et al.  On the Estimation of Disability-Free Life Expectancy , 2007, Journal of the American Statistical Association.

[26]  A. Börsch-Supan,et al.  A new comprehensive and international view on ageing: introducing the ‘Survey of Health, Ageing and Retirement in Europe’ , 2005, European journal of ageing.

[27]  James W. Vaupel,et al.  DEMOGRAPHY: Enhanced: Broken Limits to Life Expectancy , 2002 .

[28]  F. Matthews,et al.  Gender Differences in Life Expectancy Free of Impairment at Older Ages , 2002, Journal of women & aging.

[29]  C. Jagger.  Compression or expansion of morbidity--what does the future hold? , 2000, Age and ageing.

[30]  Carol Jagger,et al.  Health Expectancy Calculation by the Sullivan Method: A Practical Guide , 1999 .

[31]  W. Nusselder.  Compression or expansion of morbidity? A life-table approach , 1998 .

[32]  K G Manton,et al.  Changing concepts of morbidity and mortality in the elderly population. , 1982, The Milbank Memorial Fund quarterly. Health and society.

[33]  J F Fries,et al.  Aging, natural death, and the compression of morbidity. , 1980, The New England journal of medicine.

[34]  E. Gruenberg,et al.  The failures of success. , 1977, The Milbank Memorial Fund quarterly. Health and society.

[35]  R. Kenny,et al.  The SHARE frailty instrument for primary care predicts incident disability in a European population-based sample. , 2011, Quality in primary care.

[36]  L. Fried,et al.  Frailty in older adults: evidence for a phenotype. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.