Life expectancy free of multimorbidity among Brazilian older adults: National Health Survey, 2013

Abstract This study aims to analyze differences in life expectancy with and without multimorbidity (two or more chronic conditions) among older adults in Brazilian states, according to sex and age. Data from the Mortality Information System and population projections from the Brazilian Bureau of Geography and Statistics were used to create life tables for all states by sex. Information on the prevalence of multimorbidity was obtained from the 2013 National Health Survey (PNS). The Sullivan method was used to estimate life expectancy with and without multimorbidity and the proportion of expected life years with multimorbidity. The sample of older adults in the PNS included 11,697 subjects whose mean age was 70.08 years (SD ± 0.09). The proportion of expected years with multimorbidity increases with age (53.6% at age 60, and 57.3% at age 75). Women have higher life expectancy than men, but they live with multimorbidity more years. At age 60, Brazilian women expect to live, on average, 13.5 years with multimorbidity and men 8.3 years. There are major differences in life expectancy with multimorbidity across states – varying from 8.2 to 14.2 years (at age 60). It is important to consider these differences when defining priorities for public policies and public health interventions.

摘要 本研究旨在分析巴西各州老年人按性别与年龄划分的、伴与不伴多重共病（即罹患两种及以上慢性疾病）时的预期寿命差异。本研究采用巴西死亡信息系统（Mortality Information System）的数据与巴西地理与统计局（Brazilian Bureau of Geography and Statistics）的人口预测数据，按性别为各州构建生命表。多重共病患病率信息取自2013年全国健康调查（PNS）。本研究采用沙利文法（Sullivan method）估算伴与不伴多重共病时的预期寿命，以及预期寿命中伴有多重共病的年数所占比例。PNS中的老年人样本共11697名，平均年龄为70.08岁（标准差±0.09）。伴有多重共病的预期年数占比随年龄增长而上升：60岁时为53.6%，75岁时为57.3%。女性预期寿命高于男性，但她们伴随多重共病生存的年数更多。在60岁时，巴西女性平均预期将伴随多重共病生存13.5年，男性则为8.3年。各州间伴随多重共病的预期寿命存在显著差异——60岁人群的该指标从8.2年到14.2年不等。在制定公共政策与公共卫生干预的优先级时，有必要考虑这些差异。