Key messages

• Longer lifespans can be due to additional years of life being spent in good or poor health, or some combination of the two.
• The ‘health’ of older people can be measured in many ways, including using data on disease prevalence or self-reported health status, but it is perhaps best captured by measures of disability or functional impairment.
• Assessments of whether people in Europe are living longer in better or worse health depend to a large degree on the measure used.
• Most surveys on ageing measure functional independence in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), which are then used to quantify health states and measure changes over time.
• Studies using comparative data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) generally find increases in functional limitations in some countries and decreases in others.
• One overarching finding is that later cohorts of older people have much better cognitive functioning than earlier cohorts.
• There are major health inequities at older age across and within countries.
• While a definitive answer of whether older people in Europe are in better or worse health is impossible to obtain, what is clear is that health systems are important contributors to increases in life expectancies, decreases in severe disability, and better coping and functioning with chronic disease.

Contents

• About the series
• About this brief
• Acknowledgements
• Acronyms
• Executive summary
• Introduction
• Key concepts
  • Expansion of morbidity
  • Compression of morbidity
  • Dynamic equilibrium
  • How to make use of these scenarios?
  • How to measure health and disability?
  • Distinct but related concepts: impairment, disability and handicap
  • Presence of chronic diseases as a measure of health?
  • Compression of functional decline
  • Summary measures of population health
• Latest evidence on subjective and objective health and disability measures
  • What does the academic literature suggest?
  • What do international databases suggest?
  • Comparison of HALE, healthy life years based on activities of daily living and healthy life expectancy based on self-perceived general health
• What explains historical trends and what are the policy implications?
• Conclusions
• References

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