- Disability occurrence is more associated to proximity to death than to age. This suggests that increase in life expectancy will be accompanied with an increase in the age at first onset of disability.
Sub project 2: Disability, mortality and life expectancy among the elderly: The Rotterdam study
- Obesity, a major public health concern, is strongly linked to disability and increases the time spent under disability.
Sub project 3: Compression or expansion of disability: Past trends and scenarios for the future
- Smoking and overweight interact with age and gender in their effect on disability transitions.
- Obesity is associated with higher proportion of life spent in disability, while smoking reduces life expectancy.
Sub project 4: Health of aging populations: Impact on healthcare expenditure and informal care costs
- Disability is the main determinant of elderly long-term care services while age and health status (except mental health and prior hospitalization) do not influence participation in LTC services. So not aging perse will increase LTC expenditures. Forecasting LTC expenditures is instead heavily dependent on the disability status of the elderly, i.e. whether there will be a compression or expansion of disability.
- Elderly living alone have a substantial higher probability to use long-term care services. In light of an individualization of society this causes concern for growing needs of long-term care services in the future.
Sub project 5: Health of aging populations: Impact on costs of pension systems
- Longevity risk depends strongly on the design of the pension plan. We compared plans where participants accrue only old-age pension rights to plans where they accrue both old-age pension rights and partner pension rights. We find that, compared to the alternative, accrual of both old-age and partner pension rights leads to lower longevity risk, even when the insured has the option at retirement date to exchange partner pension rights for old-age pension rights.
Sub project 6: Incentives for investing in a long and healthy life
- The inclusion of unrelated medical costs in life-years gained – which are costs that are an indirect result of an intervention that has successfully prolonged the life of an individual – in guidelines for economic evaluations of health care interventions should become the new standard. Only then it is possible to have more realistic estimations of the cost-effectiveness of prevention.
Update January 21, 2009