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. 2019 Apr 8;19(1):100.
doi: 10.1186/s12877-019-1110-6.

The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years

Ryan McGrath  1 , Soham Al Snih  2 , Kyriakos Markides  3 , Orman Hall  4 , Mark Peterson  4
Affiliations

The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years

Ryan McGrath et al. BMC Geriatr. .

Abstract

Background: Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States.

Methods: Data from the 1998-2014 waves of the Health and Retirement Study were analyzed. At each wave, participants indicated if they were diagnosed with the following 10 conditions: cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Years lived with a disability and years of life lost to premature mortality were summed for calculating DALYs. Sample weights were utilized in the analyses to make the DALY estimates nationally-representative. Results for the DALYs were presented in thousands.

Results: There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip)-to-178,055 (hypertension) for men and 13,621 (fractured hip)-to-200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined over the study period.

Conclusions: The burden of these health conditions accounted for over a million years of healthy life lost for middle-aged and older Americans over the 16 year study period. Our results should be used to inform healthcare providers and guide health interventions aiming to improve the health of middle-aged and older adults. Moreover, shifting health policy and resources to match DALY trends may help to improve quality of life during aging and longevity.

Keywords: Epidemiology; Longevity; Morbidity; Normative aging.

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Competing interests

The authors have no conflicts of interest to disclose.

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Figures

Fig. 1
Fig. 1
Flow Chart for Exclusions. †Exclusions occurred because races and ethnicities in the other category were stratified
Fig. 2
Fig. 2
The Burden of the Health Outcomes for Middle-Aged and Older Adults Stratified by Sex. Note: Green Bars = Years of Life Lost; Yellow Bars = Years Lived with Disease. COPD = Chronic Obstructive Pulmonary Disease; DALYs = Disability-Adjusted Life Years
See this image and copyright information in PMC

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