Nowossadeck Sonja, Nowossadeck Enno, Tetzlaff Fabian, Tetzlaff Juliane
Deutsches Zentrum für Altersfragen, Manfred-von Richthofen-Str. 2, 12101, Berlin, Deutschland.
Robert Koch-Institut, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 May;67(5):564-571. doi: 10.1007/s00103-024-03875-9. Epub 2024 Apr 22.
The long-term increase in life expectancy raises the question of whether the increased life expectancy is accompanied by an extension of years without health limitations. The study analyzes how life expectancy without functional and mobility limitations from the ages of 46 and 65 and their proportions of remaining life expectancy have changed since 2008.
We analyze data from the German Ageing Survey of the 2008, 2014, and 2020/21 waves. Life expectancy without functional limitations (disability-free life expectancy-DFLE) was calculated using the Sullivan method. Severe functional limitations (using the Global Activity Limitation Indicator-GALI) and mobility limitations (climbing stairs, walking more than 1 km) were examined.
Compression of morbidity in the GALI has been observed in 46- and 65-year-old men since 2014, but not in women of the same age. In terms of mobility, 46- and 65-year-old men show trends towards compression when climbing stairs and 46-year-old men when walking more than 1 km since 2014. The values for women have stagnated for the first two indicators mentioned, but not for 46-year-old women since 2014 when walking more than 1 km.
Our analyses show different trends in DFLE depending on the indicator, age, and gender and do not allow a clear answer to the question of morbidity compression or expansion. We tend to see morbidity compression in men, whereas trends of stagnation or expansion tend to be seen in women. These results signal challenges in maintaining functional health, especially in women, and point to the need for targeted interventions to improve quality of life and healthy life expectancy.
预期寿命的长期增长引发了一个问题，即预期寿命的增加是否伴随着无健康限制年限的延长。本研究分析了自2008年以来，46岁至65岁无功能和行动能力限制的预期寿命及其在剩余预期寿命中所占比例的变化情况。
我们分析了德国老龄化调查2008年、2014年以及2020/21年波次的数据。使用沙利文方法计算无功能限制的预期寿命（无残疾预期寿命-DFLE）。研究了严重功能限制（使用全球活动限制指标-GALI）和行动能力限制（爬楼梯、步行超过1公里）的情况。
自2014年以来，在46岁和65岁男性中观察到了GALI发病率的压缩现象，但同龄女性中未观察到。在行动能力方面，自2014年以来，46岁和65岁男性在爬楼梯时呈现发病率压缩趋势，46岁男性在步行超过1公里时也呈现该趋势。对于上述前两个指标，女性的数值停滞不前，但自2014年以来，46岁女性在步行超过1公里时并非如此。
我们的分析表明，根据指标、年龄和性别不同，无残疾预期寿命呈现出不同趋势，无法对发病率压缩或扩张问题给出明确答案。我们倾向于在男性中看到发病率压缩现象，而在女性中则倾向于看到停滞或扩张趋势。这些结果表明在维持功能健康方面存在挑战，尤其是在女性中，并指出需要有针对性的干预措施来提高生活质量和健康预期寿命。
