Abstract
BackgroundPopulation aging accompanied by an increased longevity with disability has raised international concern, especially due to its costs to the health care systems. Chronic diseases are the main causes of physical disability and their simultaneous occurrence in the population can impact the disablement process, resulting in different severity levels. In this study, the contribution of chronic diseases to both mild and severe disability burden in Belgium was investigated.MethodsData on 21 chronic diseases and disability from 35,799 individuals aged 15 years or older who participated in the 1997, 2001, 2004, or 2008 Belgian Health Interview Surveys were analysed. Mild and severe disability were defined based on questions related to six activities of daily living and/or mobility limitations. To attribute disability by severity level to selected chronic diseases, multiple additive hazard models were fitted to each disability outcome, separately for men and women.ResultsA stable prevalence of mild (5 %) and severe (2–3 %) disability was observed for the Belgian population aged 15 years or older between 1997 and 2008. Arthritis was the most important contributor in women with mild and severe disability. In men, low back pain and chronic respiratory diseases contributed most to the mild and severe disability burden, respectively. The contribution also differed by age: for mild disability, depression and chronic respiratory diseases were important contributors among young individuals, while heart attack had a large contribution for older individuals. For severe disability, neurological diseases and stroke presented a large contribution in young and elderly individuals, respectively.ConclusionsOur results indicate that the assessment of the contribution of chronic diseases on disability is more informative if different levels of disability are taken into consideration. The identification of diseases which are related to different levels of disability – mild and severe – can assist policymakers in the definition and prioritisation of strategies to tackle disability, involving prevention, rehabilitation programs, support services, and training for disabled individuals.Electronic supplementary materialThe online version of this article (doi:10.1186/s13690-015-0083-y) contains supplementary material, which is available to authorized users.
Highlights
Population aging accompanied by an increased longevity with disability has raised international concern, especially due to its costs to the health care systems
The contribution differed by age: for mild disability, depression and chronic respiratory diseases were important contributors among young individuals, while heart attack had a large contribution for older individuals
The high contribution of musculoskeletal diseases to the mild and severe disability prevalence shows that intervention strategies to tackle these diseases can be attractive to reduce the disability burden, as they will have an impact on both difficulty and dependence
Summary
Population aging accompanied by an increased longevity with disability has raised international concern, especially due to its costs to the health care systems. Chronic diseases are known to be the main cause of physical disability [1] and to reduce the autonomy of individuals in Several methods have been proposed to assess the disability burden in a population. We determined the major contributors of the disability burden without distinguishing different disability severity levels in Belgium [16]. This distinction can be useful to assist policy makers in the definition of strategies to reduce the disability burden, as the assessment of dependence to perform ADLs can predict institutionalization, the need of home care services, and mortality [2, 6, 17]. Low disabling impacts were observed for diabetes, chronic cystitis, other diseases, and bowel diseases in mildly disabled men and for bowel diseases, stomach ulcer, and other diseases in severely disabled men (Table 4)
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