Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Sao Paulo, Brazil

Background: Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in Sao Paulo, Brazil; and discuss the implications for public policies. Methods: The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in Sao Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives twice the percentage for men with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion: Among older adults in Sao Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs. Copyright (C) 2011 by the Jacobs Institute of Women`s Health. Published by Elsevier. Inc.

Control of interceptive actions is based on expectancy of time to target arrival

In this study the hypothesis that interceptive movements are controlled on the basis of expectancy of time to target arrival was tested. The study was conducted through assessment of temporal errors and kinematics of interceptive movements to a moving virtual target. Initial target velocity was kept unchanged in part of the trials, and in the others it was decreased 300 ms before the due time of target arrival at the interception position, increasing in 100 ms time to target arrival. Different probabilities of velocity decrease ranging from 25 to 100% were compared. The results revealed that while there were increasing errors between probabilities of 25 and 75% for unchanged target velocity, the opposite relationship was observed for target velocity decrease. Kinematic analysis indicated that movement timing adjustments to target velocity decrease were made online. These results support the conception that visuomotor integration in the interception of moving targets is mediated by an internal forward model whose weights can be flexibly adjusted according to expectancy of time to target arrival.

The cost of life expectancy and the implicit social valuation of life

A new method of estimating the economic value of life is proposed. Using cross-country data, an equation is estimated to explain life expectancy as a function of real consumption of goods and services. The associated cost function for life expectancy in terms of the prices of specific goods and services is used to estimate the cost of a reduction in age-specific mortality rates sufficient to save the life of one person. The cost of saving a life in OECD countries is as much as 1000 times that in the poorest countries. Ethical implications are discussed.

The Effect of Expectancy of a Threatening Event on Time Perception in Human Adults

Two experiments were conducted to investigate the effect of a threatening stimulus in human adults in a temporal bisection task. In Experiment I. for two anchor duration conditions (400/800 vs. 800/1600 ms), the participants completed trials in which the probe duration was followed by an aversive stimulus or a nonaversive stimulus. The results showed that the duration was judged longer when the participants expected an aversive rather than a nonaversive stimulus. In Experiment 2, the effect of the temporal localization of the aversive stimulus was also tested, with the aversive stimulus being presented at the beginning or at the end of the probe duration. The results revealed a temporal overestimation in each condition compared to the trials in which no aversive stimulus was presented. Furthermore, the temporal overestimation was greater when the expectation for the forthcoming threatening stimulus was longer. This temporal overestimation is explained in terms of a speeding-up of the neural timing system in response to the increase in the arousal level produced by the expectation of a threatening stimulus.

Expectancy-based associative and identity priming in pronunciation

Evidence for expectancy-based priming in the pronunciation task was provided in three experiments. In Experiments 1 and 2, a high proportion of associatively related trials produced greater associative priming and superior retrieval of primes in a subsequent test of memory for primes, whereas high- and low-proportion groups showed comparable repetition benefits in perceptual identification of previously presented primes. In Experiment 2, the low-proportion condition had few associatively related pairs hut many identity pairs. In Experiment 3, identity priming was greater in a high- than a low-identity proportion group, with similar repetition benefits and prime retrieval responses for the two groups. These results indicate that when the prime-target relationship is salient, subjects strategically vary their processing of the prime according to the nature of the prime-target relationship.

Possible consequences of increasing life expectancy in Brazil: the perspective of a European historical demographer

Those over sixty years of age accounted for 6.6% of the total population of Brazil in 1985, in the Federal Republic of Germany this proportion was 20.3% in 1984. As early as 1950 it had been 14.5%. This proportion will not even be reached in Brazil in the year 2000 when persons aged sixty years and older are only projected to make up 8.8% of the total population. Similarly, in 1982/84 life expectancy at birth in the Federal Republic was 70.8 years for men and 77.5 for women; in Brazil the figures for 1980/85 were, by contrast, "only" 61.0 and 66.0. Against this background it is easy to understand why the discussion concerning an ageing society with its many related medical, economic, individual and social problems has been so slow in coming into its own in Brazil. As important as a more intensive consideration of these aspects may be in Brazil at present, they are, nevertheless, only one side of the story. For a European historical demographer with a long-term perspective of three of four hundred years, the other side of the story is just as important. The life expectancy which is almost ten years lower in Brazil is not a result of the fact that no one in Brazil lives to old age. In 1981 people sixty-five years and older accounted for 34.4% of all deaths! At the same time infants accounted for only 22.1% of total mortality. They are responsible, along with the "premature" deaths among youths and adults, for the low, "average" life expectancy figure. In Europe, by contrast, these "premature" deaths no longer play much of a role. In 1982/84 more than half of the women (52.8%) in the Federal Republic of Germany lived to see their eightieth birthdays and almost half of the men (47.3%) lived to see their seventy-fifth. Our biological existence is guaranteed to an extent today that would have been unthinkable a few generations ago. Then, the classic troika of "plague, hunger and war" threatened our forefathers all the time and everywhere. The radical transition from the formerly uncertain to a present-day certain lifetime, which is the result of the repression of "plague, hunger and war", led to unexpected consequences for our living together. Our forefathers were forced to live in closely knit Gemeinschaften in the interest of physical survival and to subordinate their egoistic goals to a common value, but now these pressures have, for the most part, fallen away. Correspondingly, this much more certain EGO has taken center stage. An ever greater number of us chooses to live life as single beings: the number of marriages is lower every year; the number of divorces is on the increase; in Berlin (West) more than half (sic! 52.3%) of all households are already composed on only one person. For the last dozen years the annual number of births in the Federal Republic has been insufficient to ensure population replacement. Not a population explosion but rather the opposite, a population implosion, is our problem. Human beings do not appear to be "social animals", as was axiomatically assumed for so long. They were only forced to behave as such for as long as "plague, hunger and war" forced them to do so. When these life endangering conditions no longer exist and life becomes certain even without their being integrated into a Gemeinschaft then humans suddenly show themselves more and more to be independent single beings. It is not the percentage of the population that is over sixty or sixty-five that is decisive in this context but rather how certain adults perceive their biological lives to be, since they are the ones who organize their lives, who build communities or who are ever more often willing only to enter into means-to-an-end personal unions without lasting or close ties and mutual responsibilities. There are many signs which seem to point to a development in this direction in Brazil as well. More and more adults in Brazil are caught up in the deep-seated transition from an uncertain to a certain lifetime. A third of them die after having reached their sixty-fifth birthday. It therefore seems to me to be high time that one began to give more consideration to the other side of the story in Brazil as well. And who is more suited intensively to consider the long-term perspectives than those engaged in the public health sector in whose competence, after all, such aspects, as "life certainty", "life expectancy" and "age at death" belong?

Trends in healthy life expectancy among older Brazilian women between 1998 and 2008

OBJECTIVE To analyze conditional and unconditional healthy life expectancy among older Brazilian women.METHODS This cross-sectional study used the intercensal technique to estimate, in the absence of longitudinal data, healthy life expectancy that is conditional and unconditional on the individual’s current health status. The data used were obtained from the Pesquisa Nacional por Amostra de Domicílios (National Household Sample Survey) of 1998, 2003, and 2008. This sample comprised 11,171; 13,694; and 16,259 women aged 65 years or more, respectively. Complete mortality tables from the Brazilian Institute of Geography and Statistics for the years 2001 and 2006 were also used. The definition of health status was based on the difficulty in performing activities of daily living.RESULTS The remaining lifetime was strongly dependent on the current health status of the older women. Between 1998 and 2003, the amount of time lived with disability for healthy women at age 65 was 9.8%. This percentage increased to 66.2% when the women already presented some disability at age 65. Temporal analysis showed that the active life expectancy of the women at age 65 increased between 1998-2003 (19.3 years) and 2003-2008 (19.4 years). However, life years gained have been mainly focused on the unhealthy state.CONCLUSIONS Analysis of conditional and unconditional life expectancy indicated that live years gained are a result of the decline of mortality in unhealthy states. This pattern suggests that there has been no reduction in morbidity among older women in Brazil between 1998 and 2008.

Life expectancy without depression increases among Brazilian older adults

ABSTRACT OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness.

The Greying Church: The Impact of Life Expectancy on Religiosity

Many churches are concerned about older and dwindling congregations. We develop a theoretical framework to explain not only the downward trend in church attendance, but also the increase in the proportion of older people in the congregations. Religiosity depends positively on the expected social and spiritual benefits attached to religious adherence, as well as the probability of entering heaven in the afterlife. While otherworldly compensation in terms of salvation and spiritual benefits motivates religiosity, the costs of formal religion in terms of time allocated to communal activities and foregone income work in the opposite direction. We show that higher life expectancy discounts expected benefits in the afterlife and is hence likely to lead to postponement of religiosity. For this reason, religious organizations should be prepared to attract older members to their congregations, while emphasizing contemporaneous religious benefits to increase overall church attendance.

Analysing variations in health expectancy - seminar presentations

A recent report by the Centre for Ageing Research and Development in Ireland (CARDI) entitled Illustrating Ageing in Ireland, North and South found that since the 1920s the number of years males can expect to live rose by about 20 years while the number of years females can expect to live rose by about 24-25 years.  It is not clear, however, if these years of life gained are lived in good health.While there is considerable policy focus on reducing inequalities in life expectancy, much less is known about the variation in health expectancy that exists across the island of Ireland. The debate hinges on our understanding of what is driving the changes in life expectancy, healthy life expectancy and the gap between the two.IPH in association with CARDI, hosted a Health Analysts' Special Interest Group (HASIG) seminar discussing the policy implications of this debate. The seminar introduced the range of health expectancy measures and compared them to life expectancy.  Initial findings from the all-island study of life expectancy and healthy life expectancy were also presented.

Authors' response to 'Limitless longevity': the contribution of rectangularization to the secular increase in life expectancy: an empirical study.

Related article : Letter to the Editor: Karin Modig, Sven Drefahl, and Anders Ahlbon.Limitless longevity: Comment on the Contribution of rectangularization to the secular increase of life expectancy

Changes in the NI life expectancy gap 1999/01 to 2004/06

In Northern Ireland between 1999-01 and 2004-06 male life expectancy at birth increased from 74.8 to 76.2 years (an increase of 1.4 years) and female life expectancy increased from 79.8 to 81.0 years (an increase of 1.3 years). Declining mortality rates due to Coronary Heart Disease, strokes and other circulatory causes, as well as cancer and respiratory disease caused life expectancy to increase.However, these increases were partially offset by increasing mortality rates over time due to accidental deaths, suicides and chronic liver disease and other causes of death (not separately identified).

Life Expectancy and All Age All Cause Mortality Monitoring (Overall and Health Inequalities) - Update to include data for 2007

The latest annual update on life expectancy data and all age all cause mortality rates, with data updated to 2005-07, which are used to monitor progress against Department of Health targets for overall life expectancy in England, and for the gap in life expectancy between the areas with the worst health and deprivation indicators (the Spearhead group) and the England average, was released on 13th November 2008 according to the arrangements approved by the UK Statistics Authority.

Mortality target monitoring (life expectancy and all-age all-cause mortality, overall and inequalities)

The latest annual update on life expectancy data and all age all cause mortality rates, with data updated to 2006-08, which are used to monitor progress against Department of Health targets for overall life expectancy in England, and for the gap in life expectancy between the areas with the worst health and deprivation indicators (the Spearhead group) and the England average, was released on 5th November 2009 according to the arrangements approved by the UK Statistics Authority. �� The key points from the latest release are: �� - The overall life expectancy and all age all cause mortality (AAACM) trends for both males and females are broadly on course to deliver the target of 78.6 years for men and 82.5 years for women by 2010 (2009-11). �� - In 2006-08, life expectancy at birth in England continued to increase for both males and females, and reached its highest level on record at 77.7 years for males and 81.9 years for females. �� - Three-year average AAACM rates for England have fallen in each period since 1995-97. �� - In 2006-08, average life expectancy at birth in the Spearhead Group was 75.8 years for males and 80.4 years for females, having increased in each period since 1995-97. �� - However, England average life expectancy at birth has increased more quickly over this period, and, in 2006-08, the relative gap ��� i.e. percentage difference - in life expectancy at birth between England and the Spearhead Group was wider than at the baseline for the target (1995-97) for both males and females. �� - For males the relative gap was 7% wider than at the baseline (compared with 4% wider in 2005-07), for females 14% wider (compared with 11% wider in 2005-07).�� �� Therefore, the target to narrow the life expectancy gap between the Spearhead Group and the England average, by at least 10% by 2010, remains challenging.��Three-year average AAACM rates for the Spearhead Group have fallen in each period since 1995-97 for both males and females. Download Mortality target monitoring (life expectancy and all-age all-cause mortality, overall and inequalities): update to include data for 2008 (PDF, 683K)Download pre-release access list (PDF, 10k)��