Healthy Ageing: tackling the burden of disease and disability in an ageing population

Healthy ageing of individuals is crucial to prevent strong increases in the burden of disease and disability due to population ageing. We aimed to quantify the current burden of disease and disability and assessed which determinants explain the burden of disability. The occurrence of disability increased towards older ages, but there was a particularly strong increase during the last few years of life. Mild disability was strongly related with age (time since birth), whereas severe disability was related most with time to death. This suggests that, when the life expectancy further increases, the years lived with mild disability will increase, whereas the years with severe disability will remain more unchanged. The analysis of determinants showed that diseases such as back pain, peripheral vascular disease and stroke had a high disabling impact and, therefore, contributed much to the burden of disability. Arthritis and heart disease were less disabling but contributed much because of their high prevalence. There was a substantial educational inequality in the burden of disability, which was to a large extent (50%) explained by differences in diseases’ disabling impact. Obese persons could expect to live at least two years more with disability than smokers and heavy drinkers. We concluded that to prevent strong increases in the burden of disability, the onset and disabling impact of chronic conditions should be reduced, while prioritizing low socioeconomic groups. Curtailing the obesity epidemic is urgently needed to increase the prospects for healthy ageing for future generations of elderly.

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