Healthy longevity from incidence-based models More kinds of health than stars in the sky

Healthy longevity (HL) is an important measure of the prospects for quality of life in ageing societies. Incidence-based (cf. prevalence-based) models describe transitions among age classes and health stages. Despite the probabilistic nature of those transitions, analyses of healthy longevity have f...

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Bibliographic Details
Published inDemographic research Vol. 45; pp. 397 - 452
Main Authors Caswell, Hal, van Daalen, Silke
Format Journal Article
LanguageEnglish
Published Rostock Max-Planck-Gesellschaft zur Foerderung der Wissenschaften 01.07.2021
Max Planck Institute for Demographic Research
Max Planck Institut für Demografische Forschung
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Summary:Healthy longevity (HL) is an important measure of the prospects for quality of life in ageing societies. Incidence-based (cf. prevalence-based) models describe transitions among age classes and health stages. Despite the probabilistic nature of those transitions, analyses of healthy longevity have focused persistently on means ("health expectancy"), neglecting variances and higher moments. Our goal is a comprehensive methodology to analyse HL in terms of any combination of health stages and age classes, or of transitions among health stages, or of values (e.g., quality of life) associated with health stages or transitions. We construct multistate Markov chains for individuals classified by age and health stage and use Markov chains with rewards to compute all moments of HL. We present a new and straightforward algorithm to create the multistate reward matrices for occupancy, transitions, or values associated with occupancy or transitions. As an example, we analyse a published model for colorectal cancer. The possible definitions of HL in this simple model outnumber the stars in the visible universe. Our method can analyse any of them; we show four examples: longevity without abnormal cells, cancer-free longevity, and longevity with cancer before or after a critical age.
ISSN:1435-9871
1435-9871
2363-7064
DOI:10.4054/DemRes.2021.45.13