Multidimensional disability/mortality trajectories at ages 65 and over: The impact of state dependence

How dependent is life expectancy at age 65 on one’s degree of disability or specific types of functional limitations? Are there significant sex differences? For closed-cohorts of males and females in different disability/functional-status status at age 65, how do their age and disability-specific functional statuses evolve with increasing age? These questions are addressed by analyzing multidimensional disability/mortality trajectories generated using a two-component stochastic process model applied to multivariate longitudinal data from the 1982 to 1994 National Long Term Care Surveys. In this model, one component process describes the temporal and age dynamics of a person’s functional state and the other describes the risk of death as a function of a person’s age and stochastically evolving position in the functional-status state space. Large differences were found in life expectancy among closed cohorts of persons who, at age 65, are in one of seven basic disability/functional-status states, identified by a multivariate analysis. Large differences between males and females in life expectancy for the origin-specific cohorts were also found. While females starting in most states tend to live longer, they are not as likely to return to the healthy, nondisabled state - females also tend to go into institutions at a higher rate than males.

Duke Scholars

Author Kenneth G. Manton Trinity College of Arts & Sciences

Author Kenneth C. Land Sociology