Gender disparities in multi-state health transitions and life expectancy among the ≥50-year-old population: A cross-national multi-cohort study.

Autor:	Talifu Z; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China., Guo S; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China., Su B; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China., Wu Y; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China., Wang Y; Nuffield Department of Population Health, University of Oxford, Oxford, UK., Liu J; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China., Luo Y; Department of Global Health, School of Public Health, Peking University, Beijing, China., Zheng X; School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.; APEC Health Science Academy, Peking University, Beijing, China.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2024 Sep 06; Vol. 14, pp. 04156. Date of Electronic Publication: 2024 Sep 06.
DOI:	10.7189/jogh.14.04156
Abstrakt:	Background: Understanding how disability progresses with ageing is important for shaping policies aimed at improving older adults' quality of life, especially when considering the global trends in ageing, life expectancy (LE), and gender disparity. We aimed to assess the health transition probabilities of daily living activities and their implications on LE and gender gaps in global middle-aged and elderly populations. Methods: In this multi-cohort study with a sample of 74 101 individuals aged ≥50 years, we analysed data from six international cohorts: the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS) in the USA, the Mexican Longitudinal Study of Ageing (MHAS), the Korean Longitudinal Study of Ageing (KLoSA), and the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimated probabilities between robust health; disabilities related to instrumental activities of daily living (IADL) and basic activities of daily living (BADL); and mortality through multi-state Markov models. We included gender as a covariate in the models to calculate hazard ratios (HRs), while we calculated LE within the distinct health states of robust health, IADL disabilities, BADL disabilities, and mortality using the stochastic population analysis for complex events (SPACE) microsimulation. Results: Women had higher progressions to disability (IADL: HR = 1.392; BADL: HR = 1.356) compared to men, who conversely showed lesser progression from IADL to BADL disability (HR = 0.856) and lower mortality rates (span of HRs = 0.232-0.692). LE at age 50 favoured women (32.16-38.22 years) over men (28.99-33.58 years), yet they spent more time in states of disability. We otherwise observed significant regional and gender disparities in healthy LE. Conclusions: We identified ageing patterns in which longer lives are often coupled with extended periods of disability. Pronounced gender and regional differences indicate a need for targeted health interventions to address inequities and improve seniors' quality of life. Our findings highlight the necessity for policy interventions focussed on health equity to more completely respond to the demographic shift towards older populations. Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests. (Copyright © 2024 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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