Annals of Long-Term Care: Clinical Care and Aging. 2016;24(6):38.
A new study shows that the increase in life expectancy in the past two decades has been accompanied by an even greater increase in life years free of disability, thanks in large measure to improvements in cardiovascular health and a decrease in vision problems. The study was recently released by the National Bureau of Economic Research.
David Cutler, PhD, professor of Applied Economics, Harvard Medical School (Boston, MA), who led the study, said these findings suggest that “this is good news for the vast bulk of people who can now look forward to a healthier, disability free life, but it’s also good news for medical care because it demonstrates the value of medical spending.”
To measure disability, Dr Cutler and colleagues first turned to the Medicare Current Beneficiary Survey, an annual questionnaire that asks Medicare recipients whether they have difficulty with physical tasks like walking, getting in or out of bed or showering as well as day-to-day tasks like cooking, managing money or doing housework.
By combining those measurements of disability with life expectancy data culled from National Vital Statistics, researchers were able to create a unique measure, not only of overall life expectancy, but how many of those years are likely to be disability-free.
The study found that in 1992, the life expectancy of the average 65-year-old was 17.5 years, 8.9 of which were free from disability. By 2008, total life expectancy had risen to 18.8 years. In addition to the overall increase, the number of disability-free years increased, from 8.9 to 10.7, while the number of disabled years fell, from 8.6 to 8.1.
Driving those changes are two major treatment areas—cardiovascular health and vision treatment. “There has been an incredibly dramatic decline in deaths and disabilities from heart disease and heart failure,” Dr Cutler said. “Some of it is the result of people smoking less, and better diet, but we estimate that as much as half of the improvement is because of medical care, especially statin drug treatment, which is both preventing heart attacks and improving people’s recovery.” Much of the improvement in vision health, he said, can be summed up in a single word: cataracts.
Dr Cutler said there are still questions to answer—particularly about whether these increases hold true across all socio-economic groups and regions, but, ultimately, this study further challenges the idea that old age is a time when health problems and disabilities limit your options. —Amanda Del Signore