Heterogeneity in healthy aging

Abstract

For a surprisingly large segment of the older population, chronological age is not a relevant marker for understanding, measuring, or experiencing healthy aging. Using the 2003 Medical Expenditure Panel Survey and the 2004 Health and Retirement Study to examine the proportion of Americans exhibiting five markers of health and the variation in health-related quality of life across each of eight age groups, we find that a significant proportion of older Americans is healthy within every age group beginning at age 51, including among those aged 85+. For example, 48% of those aged 51-54 and 28% of those aged 85+ have excellent or very good self-reported health status; similarly, 89% of those aged 51-54 and 56% of those aged 85+ report no health-based limitations in work or housework. Also, health-related quality of life ranges widely within every age group, yet there is only a comparatively small variation in median quality of life across age groups, suggesting that older Americans today may be experiencing substantially different age-health trajectories than their predecessors. Patterns are similar for medical expenditures. Several policy implications are explored.

Keywords: Compression of morbidity; Healthy aging; Quality of life..

Figure 1.

EQ-5D questionnaire (34).

Figure 2.

Proportion of population, by age group: (a) with self-reported health status of excellent or very good; (b) receiving no help with instrumental activities of daily living (IADLs) or activities of daily living (ADLs); (c) with no limitations in work or housework; (d) with none of the top five chronic diseases; (e) with perfect EQ-5D (=1) scores. Sources: 2003 Medical Expenditure Panel Survey; 2004 Health and Retirement Study.

Figure 3.

EQ-5D variation by age. Upper, middle, and lower points indicate the 90th percentile, median, and 10th percentile EQ-5D within each age group: (a) gender is combined; (b) separate ranges by gender. Source: 2003 Medical Expenditure Panel Survey.

Figure 4.

EQ-5D variation by instrumental activities of daily living or activities of daily living (IADL/ADL) status, for four groups: receiving no help with IADLs or ADLs, receiving help with IADLs only, receiving help with ADLs only, and receiving help with both IADLs and ADLs. Upper, middle, and lower points indicate the 90th percentile, median, and 10th percentile EQ-5D within each group; (a) includes individuals of all ages 51 and older; (b) limited to individuals aged 80–84. Source: 2003 Medical Expenditure Panel Survey.

Figure 5.

Medical expenditure variation by age. Upper, middle, and lower points indicate the 90th percentile, median, and 10th percentile of costs within each age group. Source: 2003 Medical Expenditure Panel Survey.