Chronic Disease-free Life Expectancy Research Articles

Physical activity attenuated the negative effects of obesity on chronic disease-free life expectancy in rural adults

Physical activity attenuated the negative effects of obesity on chronic disease-free life expectancy in rural adults

Analysis of recent changes in chronic disease-free life expectancy in Algeria.

No official estimates have been published regarding healthy life expectancy in Algeria, and chronic disease-free life expectancy in particular, despite their importance for assessing public health policy effectiveness and predicting social security expenditure. To estimate chronic disease-free life expectancy in Algeria and analyse its changes in recent years, and to determine how morbidity has changed according to age, time, and gender, compared with mortality, following expansion of morbidity, compression of morbidity, or morbidity-mortality balance. We used Sullivan's method to estimate chronic disease-free life expectancy in Algeria using data provided from the Multiple Indicator Cluster Surveys and national life tables published by the Office for National Statistics for 2006, 2012-2013, and 2018-2019. The changes in healthy/unhealthy years compared with life expectancy were analysed. Although Algerian women live an average 1-2 years longer than men, their chronic disease-free life expectancy is 5 years shorter. The gain in life expectancy between 2006 and 2018-2019 was accompanied by a decline in chronic disease-free life expectancy from 62.36 and 57.27 years to 61.13 and 55.64 years for men and women, respectively. Algerians in 2018-2019 lived longer but not healthier than in 2006, and the number of unhealthy life years increased compared with life expectancy. Thus, public health programmes need to be more efficient to increase healthy years faster, or at least at the same pace as life expectancy.

Work stress and loss of years lived without chronic disease: an 18-year follow-up of 1.5 million employees in Denmark

We aimed to examine the association between exposure to work stress and chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. The study population included 1,592,491 employees, aged 30–59 in 2000 and without prevalent chronic diseases. We assessed work stress as the combination of job strain and effort-reward imbalance using job exposure matrices. We used Cox regressions to estimate risk of incident hospital-diagnoses or death of chronic diseases (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and calculated corresponding chronic disease-free life expectancy from age 30 to age 75. Individuals working in occupations with high prevalence of work stress had a higher risk of incident chronic disease compared to those in occupations with low prevalence of work stress (women: HR 1.04 (95% CI 1.02–1.05), men: HR 1.12 (95% CI 1.11–1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI − 0.10 to 0.60) and 0.84 (95% CI 0.56–1.11) years in women and men, respectively. Additional adjustment for health behaviours attenuated these associations among men. We conclude that men working in high-stress occupations have a small loss of years lived without chronic disease compared to men working in low-stress occupations. This finding appeared to be partially attributable to harmful health behaviours. In women, high work stress indicated a very small and statistically non-significant loss of years lived without chronic disease.

1175Work stress and loss of years lived without chronic disease; an 18-year prospective cohort study

Abstract Background Aim: To examine the association of work stress with future chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. Method A population-based prospective register-based cohort study of all employees aged 30-59 in 2000 in Denmark, without chronic diseases at baseline (n = 1,592,491). Using job exposure matrices, we assessed exposure to work stress by a combined measure of job strain and effort-reward imbalance. We estimated the risk of incident hospital-diagnosed chronic disease or death (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and corresponding chronic disease-free life expectancy. Results Individuals working in occupations with high risk of both job strain and effort-reward imbalance had a slightly higher risk of future incident chronic disease compared to those in occupations with low risk of both stressors. The hazard ratio was 1.04 (95% CI 1.02 to 1.05) in women and 1.12 (95% CI 1.11 to 1.14) in men. The corresponding loss in chronic disease-free life expectancy was 0.25 years in women and 0.84 years in men. Conclusion Working in occupations with a high risk of work stress was associated with a small loss of years lived without chronic disease compared to working in occupations with low risk of work stress. Key messages According to our findings, employees in occupations with high risk of work stress live slightly shorter lives free of chronic diseases compared to employees in occupations with low risk of work stress.

Associations of Leisure-Time Physical Activity and Television Viewing with Life Expectancy Cancer-Free at Age 50: The ARIC Study.

Physical activity has been associated with longer chronic disease-free life expectancy, but specific cancer types have not been investigated. We examined whether leisure-time moderate-to-vigorous physical activity (LTPA) and television (TV) viewing were associated with life expectancy cancer-free. We included 14,508 participants without a cancer history from the Atherosclerosis Risk in Communities (ARIC) study. We used multistate survival models to separately examine associations of LTPA (no LTPA, <median, ≥median) and TV viewing (seldom/never, sometimes, often/very often) with life expectancy cancer-free at age 50 from invasive colorectal, lung, prostate, and postmenopausal breast cancer. Models were adjusted for age, gender, race, ARIC center, education, smoking, and alcohol intake. Compared with no LTPA, participants who engaged in LTPA ≥median had a greater life expectancy cancer-free from colorectal [men-2.2 years (95% confidence interval (CI), 1.7-2.7), women-2.3 years (95% CI, 1.7-2.8)], lung [men-2.1 years (95% CI, 1.5-2.6), women-2.1 years (95% CI, 1.6-2.7)], prostate [1.5 years (95% CI, 0.8-2.2)], and postmenopausal breast cancer [2.4 years (95% CI, 1.4-3.3)]. Compared with watching TV often/very often, participants who seldom/never watched TV had a greater colorectal, lung, and postmenopausal breast cancer-free life expectancy of ∼1 year. Participating in LTPA was associated with longer life expectancy cancer-free from colorectal, lung, prostate, and postmenopausal breast cancer. Viewing less TV was associated with more years lived cancer-free from colorectal, lung, and postmenopausal breast cancer. Increasing physical activity and reducing TV viewing may extend the number of years lived cancer-free.

Are We Living Longer and Healthier?

Objective: To examine whether we live healthier as we live longer in Hong Kong, which has one of the highest life expectancies in the world. Methods: Sullivan's method was used to evaluate the chronic disease-free life expectancy (CDFLE), life expectancy in good self-perceived health (GPHLE), and impairment-free life expectancy (IFLE) among population aged 50years and older in Hong Kong in 2007-2016. Results: In spite of the marked improvement in life expectancy in Hong Kong, the increase in GPHLE was much smaller, while CDFLE and IFLE even declined for both genders. The situation was more severe among older population. Discussion: People in Hong Kong live longer but with worsening health. The expansion of chronic diseases, self-perceived poor health, and impairments among older adults calls for more fiscal investments, government attention, and public health policies.

Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US

We examined whether the co-occurrence of four behavioural risk factors (alcohol consumption, smoking, physical inactivity and obesity) is associated with disability-free and chronic disease-free life expectancy similarly in two longitudinal studies of ageing in England and the United States. Data were from 17,351 individuals aged 50+ from the US Health and Retirement Study (HRS) and, 10,388 from the English Longitudinal Study of Ageing (ELSA), from 2002 to 2013. Disability-free life expectancy was estimated using repeat measures of limitations with instrumental activities and activities of daily living and, chronic disease-free life expectancy was based on chronic health conditions. Multistate life table models were used to estimate sex-specific health expectancy at the ages of 50, 60 and 70. In both countries and at all ages, there was a clear gradient towards shorter health expectancy with increasing number of behavioural risk factors. Compared to people with 2+ behavioural risk factors, in both countries, those with no behavioural risk factors could expect to live up to 11 years longer without disability and, up to 12 years longer without chronic conditions. Individual and co-occurring behavioural risk factors were strongly associated with shorter healthy life expectancy in both countries, attesting to the robustness of the contribution of lifestyle factors on health expectancy.

Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study.

BackgroundThere are striking socioeconomic differences in life expectancy, but less is known about inequalities in healthy life expectancy and disease-free life expectancy. We estimated socioeconomic differences in health expectancies in four studies in England, Finland, France and Sweden.MethodsWe estimated socioeconomic differences in health expectancies using data drawn from repeated waves of the four cohorts for two indicators: (i) self-rated health and (ii) chronic diseases (cardiovascular, cancer, respiratory and diabetes). Socioeconomic position was measured by occupational position. Multistate life table models were used to estimate healthy and chronic disease-free life expectancy from ages 50 to 75.ResultsIn all cohorts, we found inequalities in healthy life expectancy according to socioeconomic position. In England, both women and men in the higher positions could expect 82–83% of their life between ages 50 and 75 to be in good health compared to 68% for those in lower positions. The figures were 75% compared to 47–50% for Finland; 85–87% compared to 77–79% for France and 80–83% compared to 72–75% for Sweden. Those in higher occupational positions could expect more years in good health (2.1–6.8 years) and without chronic diseases (0.5–2.3 years) from ages 50 to 75.ConclusionThere are inequalities in healthy life expectancy between ages 50 and 75 according to occupational position. These results suggest that reducing socioeconomic inequalities would make an important contribution to extending healthy life expectancy and disease-free life expectancy.

Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies

ObjectivesPoor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no...

Sleep Duration and Sleep Disturbances as Predictors of Healthy and Chronic Disease-Free Life Expectancy Between Ages 50 and 75: A Pooled Analysis of Three Cohorts.

The aim of this study was to examine the associations of sleep duration and sleep disturbances with healthy and chronic disease-free life expectancy (LE) between ages 50 and 75. Data were drawn from repeated waves of three occupational cohort studies in England, Finland, and Sweden (n = 55,494) and the follow-up ranged from 6 to 18 years. Self-reported sleep duration was categorized into <7, 7-8.5, and ≥9 hours and sleep disturbances into no, moderate, and severe. Health expectancy was estimated with two health indicators: healthy LE based on years in good self-rated health and chronic disease-free LE based on years without chronic diseases. Multistate life table models were used to estimate healthy and chronic disease-free LE from age 50 to 75 years for each category of sleep measures in each cohort. Fixed-effects meta-analysis was used to pool the cohort-specific results into summary estimates. Persons who slept 7-8.5 hours could expect to live 19.1 (95% CI 19.0-19.3) years in good health and 13.5 (95% CI 13.2-13.7) years without chronic diseases between ages 50 and 75. Healthy and disease-free years were 1-3 years shorter for those who slept less than 7 hours or slept 9 hours or more. Persons who did not have sleep disturbances could expect to live 20.4 (95% CI 20.3-20.6) years in good health and 14.3 (95% CI 14.1-14.5) years without chronic diseases between ages 50 and 75. Healthy and disease-free years were 6-3 years shorter for those who reported severe sleep disturbances. Sleeping 7-8.5 hours and having no sleep disturbances between ages 50 to 75 are associated with longer healthy and chronic disease-free LE.

Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study

Background:While many studies have shown associations between obesity and increased risk of morbidity and mortality, little comparable information is available on how body mass index (BMI) impacts health expectancy. We examined associations of BMI with healthy and chronic disease-free life expectancy in four European cohort studies.Methods:Data were drawn from repeated waves of cohort studies in England, Finland, France and Sweden. BMI was categorized into four groups from normal weight (18.5–24.9 kg m−2) to obesity class II (⩾35 kg m−2). Health expectancy was estimated with two health indicators: sub-optimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years for each BMI category.Results:The proportion of life spent in good perceived health between ages 50 and 75 progressively decreased with increasing BMI from 81% in normal weight men and women to 53% in men and women with class II obesity which corresponds to an average 7-year difference in absolute terms. The proportion of life between ages 50 and 75 years without chronic diseases decreased from 62 and 65% in normal weight men and women and to 29 and 36% in men and women with class II obesity, respectively. This corresponds to an average 9 more years without chronic diseases in normal weight men and 7 more years in normal weight women between ages 50 and 75 years compared to class II obese men and women. No consistent differences were observed between cohorts.Conclusions:Excess BMI is associated with substantially shorter healthy and chronic disease-free life expectancy, suggesting that tackling obesity would increase years lived in good health in populations.

Live longer and better? Estimates of healthy life expectancy in the Brazilian population

This study analyzed differences in healthy life expectancy in the elderly based on three health dimensions in Brazil from 1998 to 2008: disability-free life expectancy, healthy life expectancy based on self-rated health, and chronic disease-free life expectancy. The Sullivan method was used, combining life tables from the Brazilian Institute of Geography and Statistics (IBGE) and interval estimates of the prevalence of functional disability, self-rated health, and chronic diseases according to the Brazilian National Household Sample Survey (PNAD, 1998 and 2008). Besides the increase in life expectancy, the study showed significant and similar increases in disability-free life expectancy and healthy life expectancy based on self-rated health at almost all ages. Women had higher life expectancies than men, but expected to live longer with poor health, regardless of the indicator used to measure health. Although the studies measured health differently (making comparisons difficult), women showed a consistent disadvantage in healthy life expectancy.