Disability trends in Europe by age-period-cohort analysis: Increasing disability in younger cohorts

Abstract

Background: Several studies have examined trends in disability, but only few have explicitly considered possible age, time period and birth cohort differences simultaneously.

Objective: We examined disability trends in Europe according to age, time period, and birth cohort.

Methods: We used population-based data of Europeans (European Social Survey, N = 228159), aged 15-90 years, covering 15 countries (Belgium, Finland, France, Germany, Great Britain, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland) and spanning a time period from 2002 to 2016.

Results: We found that there were only small overall changes in disability over time periods. However, there were strong U-shaped birth cohort effects, such that younger cohorts born after 1960 experienced higher levels of disability. This U-shaped cohort trend appeared strongest for non-severe disability and was most pronounced in Germany.

Conclusions: Therefore, disability in Europe seemed to generally increase in more recent cohorts, who might thus be at risk to experience more morbidity in the future than previous generations. Future studies should investigate the mechanisms that contribute to these trends, the generalizability of the observed birth cohort effects, and the cross-national differences in time period trends.

Keywords: Age-period-cohort; Disability; Functional limitations; Morbidity; Trends.