Mohammed T. Abou-Saleh

Principles and Practice of Geriatric Psychiatry.Editors: Professor John R. M. Copeland, Dr Mohammed T. Abou-Saleh and Professor Dan G. BlazerCopyright & 2002 John Wiley & Sons LtdPrint ISBN 0-471-98197-4 Online ISBN 0-470-84641-074 PRINCIPLES AND PRACTICE OF GERIATRIC PSYCHIATRYStudy of the Elderly. New York: Oxford University Press, 1991:159–81.16. Magaziner J, Simonsick EM, Kashner TM et al. Patient–proxyresponse comparability on measures of patient health and functionalstatus. J Clin Epidemiol 1988; 41: 1065–74.17. Guralnik JM, Branch LG, Cummings SR, Curb JD. Physicalperformance measures in aging research. J Gerontol Med Sci 1989;44: M141–6.18. Weiner JM, Hanley RJ, Clark R, Van Nostrand JF. Measuring theactivities of daily living: comparisons across national surveys. JGerontol Soc Sci 1990; 45: S229–37.19. Kramarow E, Lentzner H, Rooks R et al. Health and AgingChartbook. Health, United States, 1999. Hyattsville, MD: NationalCenter for Health Statistics, 1999.20. National Center for Health Statistics, Hing E, Sekscenski E, StrahanG. The National Nursing Home Survey; 1985 summary for theUnited States. Vital and Health Statistics, Series 13, No. 97. DHHSPublication No. (PHS) 89-1758. Washington, DC: US GovernmentPrinting Office, 1989.21. Fries JF. Aging, natural death and the compression of morbidity. NEngl J Med 1980; 303: 130–5.22. Katz S, Branch LG, Branson MH et al. Active life expectancy. N EnglJMed1983; 309: 1218–24.23. Land KC, Guralnik JM, Blazer DG. Estimating increment-decrementlife tables with multiple covariates from panel data: The case of activelife expectancy. Demography 1994; 31: 297–319.24. Manton KG, Stallard E, Corder LS. The dynamics of dimensions ofage-related disability 1982–1994 in the US elderly population. JGerontol Biol Sci 1998; 53: B59–70.25. Crimmins EM, Saito Y, Reynolds SL. Further evidence on recenttrends in the prevalence and incidence of disability among olderAmericans from two sources: the LSOA and the NHIS. J GerontolSoc Sci 1997; 52: S59–71.26. Freedman VA, Martin LG. Understanding trends in functionallimitations among older Americans. Am J Public Health 1998; 88:1457–62.27. Manton KG, Corder L, Stallard E. Chronic disability trends inelderly United States populations: 1982–1994. Proc Natl Acad SciUSA 1997; 94: 2593–8.28. Waidmann T, Manton KG. International Evidence on DisabilityTrends among the Elderly. Washington DC: Office of Disability,Aging and Long Term Care Policy, DHHS, 1998.29. Manton KG, Corder L, Stallard E. Changes in the use of personalassistance and special equipment from 1982 to 1989: results from the1982 and 1989 NLTCS. Gerontologist 1993; 33: 168–76.30. Singer BH, Manton KG. The effects of health changes on projectionsof health service needs for the elderly population of the United States.Proc Natl Acad Sci USA 1998; 95: 15618–22.31. Schneider EL, Guralnik JM. The ageing of America: impact on healthcare costs. J Am Med Assoc 1990; 263: 2335–40.Health Expectancy: Monitoring Changes in Population HealthCarol JaggerUniversity of Leicester, UKThe increasing life expectancies experienced by many countriesover the last decade have made the debate about the quality andquantity of years lived at older ages particularly relevant forconditions such as dementia, where the prevalence rises steeplywith age. Health expectancies were developed to address thequestion of whether or not longer life is accompanied with adecrease in the quality of life, and they extend the concept of lifeexpectancy to morbidity and disability by providing a means ofdividing life expectancy into life spent in various states of goodand bad health. Being independent of the size of populations andof their age structure, health expectancies thus allow directcomparison of the different groups that constitute populations:sexes, socioprofessional categories, regions.As health expectancy combines a life expectancy with a healthmeasure, there are as many possible health expectancies as healthmeasures; for example, disability-free life expectancy, active lifeexpectancy (based on independence in Activities of Daily Living),healthy life expectancy (based on good perceived health) ordementia-free life expectancy. Bone et al. 1 reports values for theseand other health expectancies for the UK from two longitudinalstudies of older people (the Melton Mowbray Ageing Project andthe Nottingham Longitudinal Study of Activity and Aging) andfrom national cross-sectional studies. Dementia-free life expectancyat age 65 years has now been calculated for five countries:France, UK, Belgium, Eire and The Netherlands 2 . Despitedifference in life expectancies between countries (ranging formen from 13.5 years in Eire to 15.4 years in France and forwomen from 16.9 years in Eire to 19.7 years in France), womencan expect to live between one and two years and men between 0.5and 0.7 years of their remaining life with dementia.Today, estimates of health expectancy (generally disability-freelife expectancy) are available for 49 countries 3 , although comparisonsacross time and between countries are still problematic dueto the lack of harmonisation of measures and study designs.REVES (Re´seau Espérance de Vie en Sante´: the InternationalResearch Network on Health Expectancy) is an internationalorganization of researchers, clinicians and health plannersaddressing these issues as well as developing and recommendingmethods of calculation and furthering the use of healthexpectancy as a tool for health planning.REFERENCES1. Bone MR, Bebbington AC, Jagger C et al. Health Expectancy and ItsUses. London: HMSO, 1995.2. Jagger C, Ritchie K, Bronnun-Hansen H et al. Mental healthexpectancy: the European perspective. A synopsis of resultspresented at the Conference of the European Network for theCalculation of Health Expectancies (Euro–REVES). ActaPsychiatrica Scandinavica, 1998; 98: 85–91.3. Robine JM, Romieu I, Cambois E. Health expectancy indicators. BullWHO 1999; 77(2): 181–5.