A better understanding of ‘active life expectancy’ in older adults

Most older adults give priority to maintaining the ability to bathe, dress, walk and perform household tasks as they get older. Yet a lot still needs to be understood about the causes of disability in this age group. In a new Yale study published in Jama Network OpenResearchers investigated the differences in active and disabled life expectancy in the elderly who experience illness and injury.

Active life expectancy is the expected number of years that a person will live without disability, and disabled life expectancy is the number of years that people need help to perform daily activities. Together his active life expectancy and disabled life expectancy are the same as total life expectancy.

“Age, cognitive disorders and physical vulnerability can make the elderly more vulnerable, but these factors do not lead directly to disabilities,” says Thomas Gill, MD, Humana Foundation Professor of Medicine (Geriatrics) at the Yale School of Medicine (YSM), professor of Halthemiology)

“In this study we tried to build on our earlier work that shows that having a disease or injury leads to hospitalization has a more pronounced harmful effect on being 85 years old in contrast to 75.”

For the study, the researchers used data from the Yale Precipitating Events Project, a unique longitudinal study by community lives elderly with monthly assessments of functional status and complete determination of intermediate diseases and injuries for more than 23 years.

The researchers discovered that, in 754, initially non -disabled persons aged 70 and older, active life expectancy consistently decreased as the number of hospital admissions increased for critical illness, important non -selective surgery and other reasons than reasons or large surgery, but not for major elective operation.

“Maintaining the independent function is a highly appreciated outcome in older adults,” says Lauren Ferrante, MD, MHS, associate professor of medicine (lung, critical care and sleeping medicine) at YSM and co-author of the article. “This research sheds light on health events, such as critical diseases, which are most consistent for active and disabled life expectancy that clinicians can help to focus on recovering interventions after discharge from the hospital.”

The findings suggest that the active life expectancy for people older than 70 is considerably reduced in the setting of serious diseases and injuries, the researchers said. Yet there are several ways to reduce the chance of being disabled, according to Gill.

“Many of these hospital admissions can be prevented, for example,” he says. “Older people can be vaccinated against flu and other infections, manage chronic conditions through drugs and take steps to prevent traps.”

If it is admitted to the hospital, there are strategies, such as the prevention of delirium and mobilizing elderly patients, who can reduce the risk of long -term hospital enclosures, Gill adds.

“Older people do not want to spend a large part of their remaining lifespan,” says Gill. “Fortunately, there are numerous possibilities to intervene on an individual and a system level to help these people retain functional independence.”