Active life expectancy in people with and without diabetes

Background The aim of the study was to investigate the feasibility of monitoring older people's health by measuring active life expectancy among older people with and without diabetes using routinely collected primary care data. Methods The study comprised the first five rounds of a routine health assessment of those aged 75 years and over belonging to a large Midlands general practice (list size 32 500). A nurse carried out the health assessments in the participant's home. Being active was defined as the ability to perform (without difficulty, help or use of aids) at least six of seven activities of daily living (ADLs). Mortality data were collected through the practice register together with regular linkage to information from the Office for National Statistics. Period health expectancies were calculated for those known or found to be diabetic through the health assessments and for non-diabetic individuals. Results Calculation of active life expectancies (ALE) was based on 2474 persons (212 with and 2262 without diabetes). At all ages, people with diabetes had lower life expectancy and spent fewer years active. The proportion of remaining life spent active was, however, similar for both groups at younger ages, but by age 85 years people with diabetes spent only 32 per cent of remaining life active compared with 42 per cent for those without diabetes. Conclusion Annual health assessments of the over-75s in primary care together with linkage to mortality data provide a feasible method of monitoring older people's health, particularly for subgroups at greater risk of disability. At Strategic Health Authority or Primary Care Trust level these methods can monitor health needs, highlight health inequalities and evaluate intervention strategies.