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Stroke and active life expectancy among older adults in Beijing, China
Xiang-Hua Fang1, Zachary Zimmer, Toshido Kaneda
1Department of Epidemiology and Social Medicine, Xuanwu Hospital, Capital Medical University, [corrected] Beijing, China.
Purpose:
Increasing stroke prevalence, population ageing and economic change in China necessitate a better understanding of the impact of stroke. This study examines the impact of stroke on disability and trends over time.
Method:
Data are from longitudinal surveys conducted in the Beijing municipality from 1992 to 1997 and 2000 to 2004. Multi-state life tables constructed from hazard models are used to estimate life expectancy (LE) and active life expectancy (ALE). The active state is defined using six functional tasks and mortality is determined using interviewer follow-ups.
Results:
LE and ALE are higher among those without stroke. Population-based estimates for the cohort observed beginning in 1992 indicate LE at age 55 of about 17 for those who have had a stroke and about 21 for others, whereas years of active life are about 14 and 19, respectively. Disability status at baseline is important for determining ALE. For those active, LE and ALE patterns are similar regardless of stroke status. For those inactive, the stroke group lives almost their entire lives inactive. Stroke reduces years of life by 20-40%, but active life by up to 90%.
Conclusion:
Trends in ALE among those with stroke suggest possible influences of rapid development, concomitant improvement in health care and an increased focus on disease management.