Chronic conditions and later-life disability

Full title: The contribution of single and multiple chronic conditions to the deteriorating time trends in later-life disability

This involves mapping the deeper drivers of deteriorating later-life quality to identify ways of reversing the current trend of extra-life years lived with disabilities.

We will particularly focus on the impact of long-term conditions and multiple conditions.

Aims

We aim to answer the following questions:

• Are the extra years lived with disability and dependency due to:
  • increased incidence of disability/dependency?
  • reduced ability to return to independence?
  • longer survival with disability/dependency?
• Are the extra years with disability due to individual long-term conditions becoming more prevalent, or more disabling, or because multiple concurrent conditions (multiple conditions) have increased?
• How do the UK trends in disability-free life expectancy differ from other countries? Specifically, has the plateauing of life expectancy at older ages observed in the UK been evident elsewhere in Europe?

Policy relevance

Results from this project will contribute to the evidence base for public health to prevent and postpone the onset of disability and dependency, and could inform the design of intervention studies.

A key aspect of the published report from this project will be finding whether reducing recovery has increased years spent with mild disability and low-level dependency, as opposed to increased dependency and disability.

This work will be useful to the PHE Healthy Ageing Strategy, as well as business, in terms of promoting exercise, strength training and relevant assistive technology aimed at helping older people regain independence.

Delivery timeline

March 2019 – July 2020

Associated publications

• The contribution of single and multiple chronic conditions to the deteriorating time trends in later-life disability
  Part 1: Incidence, recovery or longer survival? – Executive Summary, Full Report (PDF)
• Part 2: Single and Multiple Conditions – Executive Summary, Short Report, Full Report (PDF)  
• Trends in healthy and disability-free life expectancy in the UK and other high-income countries: a systematic review (January 2020) – Executive Summary, Briefing Report, Full Report (PDF)
• Comparison of trends in life expectancy and disability-free life expectancy between the UK and the remaining countries of the EU28 (May 2020) – Executive Summary, Briefing Report, Full Report (PDF)
• Bennett et al (2021) – Healthy ageing for all? Comparisons of socioeconomic inequalities in health expectancies over two decades in the Cognitive Function and Ageing Studies I and II (International Journal of Epidemiology) DOI: 10.1093/ije/dyaa271
• Welsh et al (2021) – Trends in life expectancy and healthy life years at birth and age 65 in the UK, 2008–2016, and other countries of the EU28: An observational cross-sectional study (The Lancet Regional Health – Europe) DOI: 10.1016/j.lanepe.2020.100023
• Bennett et al (2021) – The contribution of multiple long-term conditions to widening inequalities in disability-free life expectancy over two decades: Longitudinal analysis of two cohorts using the Cognitive Function and Ageing Studies (EClinicalMedicine) DOI: 10.1016/j.eclinm.2021.101041
• Bennett et al (2022) – A comparison over 2 decades of disability-free life expectancy at age 65 years for those with long-term conditions in England: Analysis of the 2 longitudinal Cognitive Function and Ageing Studies (PLOS Medicine)  DOI: 10.1371/journal.pmed.1003936
• Spiers GF, Kunonga TP, Beyer F, Craig D, Hanratty B, Jagger C (2021) – Trends in health expectancies: a systematic review of international evidence (BMJ Open) DOI: 10.1136/bmjopen-2020-045567  
• Gerontological Society of America (GSA) Conference 2020 – “Trends in health expectancies by late-life disadvantage” slides
• Gerontological Society of America (GSA) Conference 2020 – “Multi-morbidity, disadvantage and trends in disability free life expectancy” slides