Critical Illness, Major Surgery, and Other Hospitalizations and Active and Disabled Life Expectancy

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Estimates of active and disabled life expectancy are crucial for policy decisions regarding the functional well-being of older populations.
• Understanding how illnesses and injuries impact these estimates is essential for effective public health strategies.

Purpose of the Study:

• To analyze the impact of intervening illnesses and injuries on active and disabled life expectancy in older adults.
• To quantify the reduction in life expectancy without disability due to critical illnesses, hospitalizations, and surgical procedures.

Main Methods:

• A prospective cohort study involving 754 community-living, non-disabled individuals aged 70 years and older.
• Monthly assessments of exposure to critical illness, surgical procedures, and hospitalizations.
• Monthly ascertainment of disability in essential activities of daily living.
• Estimation of active and disabled life expectancy using multistate life tables and a discrete-time Markov process.

Main Results:

• Active life expectancy significantly decreased with an increasing number of critical illness and other hospital admissions.
• For example, at age 70, active life expectancy dropped from 14.6 years without critical illness to 4.0 years with 3+ admissions.
• Nonelective surgical procedures also reduced active life expectancy, while elective procedures did not show a consistent negative impact.

Conclusions:

• Serious intervening illnesses and injuries substantially diminish active life expectancy in older adults.
• Preventive measures and aggressive management of these health events, alongside restorative care, may enhance functional well-being in this demographic.
• These findings underscore the importance of addressing health events to maintain independence and quality of life in aging populations.