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Mortality risk associated with disability: A population-based record linkage study


  • Majer, I.M.
  • Nusselder, W.J.
  • Mackenbach, J.P.
  • Klijs, B.
  • Van Baal, P.H.M.


Objectives: We assessed the association between mortality and disability and quantified the effect of disability-associated risk factors. Methods: We linked data from cross-sectional health surveys in the Netherlands to the population registry to create a large data set comprising baseline covariates and an indicator of death. We used Cox regression models to estimate the hazard ratio of disability on mortality. Results: Among men, the unadjusted hazard ratio for activities of daily living, mobility, or mild disability defined by the Organization for Economic Cooperation and Development at age 55 years was 7.85 (95% confidence interval [CI]=4.36, 14.13), 5.21 (95% CI=3.19, 8.51), and 1.87 (95% CI=1.58, 2.22), respectively. People with disability in activities of daily living and mobility had a 10-year shorter life expectancy than nondisabled people had, of which 6 years could be explained by differences in lifestyle, sociodemographics, and major chronic diseases. Conclusions: Disabled people face a higher mortality risk than nondisabled people do. Although the difference can be explained by diseases and other risk factors for those with mild disability, we cannot rule out that more severe disabilities have an independent effect on mortality.

Suggested Citation

  • Majer, I.M. & Nusselder, W.J. & Mackenbach, J.P. & Klijs, B. & Van Baal, P.H.M., 2011. "Mortality risk associated with disability: A population-based record linkage study," American Journal of Public Health, American Public Health Association, vol. 101(12), pages 9-15.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300361_5
    DOI: 10.2105/AJPH.2011.300361

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    Cited by:

    1. Steven A. Haas & Katsuya Oi & Zhangjun Zhou, 2017. "The Life Course, Cohort Dynamics, and International Differences in Aging Trajectories," Demography, Springer;Population Association of America (PAA), vol. 54(6), pages 2043-2071, December.
    2. van Baal, Pieter H. & Wong, Albert, 2012. "Time to death and the forecasting of macro-level health care expenditures: Some further considerations," Journal of Health Economics, Elsevier, vol. 31(6), pages 876-887.
    3. Richard D Hayes & Chin-Kuo Chang & Andrea C Fernandes & Aysha Begum & David To & Matthew Broadbent & Matthew Hotopf & Robert Stewart, 2012. "Functional Status and All-Cause Mortality in Serious Mental Illness," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-9, September.
    4. Claire Marbot & Delphine Roy, 2015. "Projections du coût de l’APA et des caractéristiques de ses bénéficiaires à l’horizon 2040 à l’aide du modèle Destinie," Économie et Statistique, Programme National Persée, vol. 481(1), pages 185-209.
    5. Josje D. Schoufour & Michael A. Echteld & Heleen M. Evenhuis, 2017. "Comparing two frailty concepts among older people with intellectual disabilities," European Journal of Ageing, Springer, vol. 14(1), pages 63-79, March.
    6. Jung Min Park & Ukchan Oh & Beop-Rae Roh & Yeongmin Moon, 2017. "Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(9), pages 989-996, December.

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