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Disability during the last ten years of life: evidence from a register-based study in Austria

Author

Listed:
  • Erwin Stolz

    (Institute of Social Medicine and Epidemiology, Medical University of Graz)

  • Anna Schultz

    (Institute of Social Medicine and Epidemiology, Medical University of Graz)

  • Julia Zuschnegg

    (Institute of Social Medicine and Epidemiology, Medical University of Graz)

  • Franziska Großschädl

    (Institute of Nursing Science, Medical University of Graz)

  • Thomas E. Dorner

    (Academy for Ageing Research, Haus der Barmherzigkeit)

  • Regina Roller-Wirnsberger

    (Medical University of Graz)

  • Wolfgang Freidl

    (Institute of Social Medicine and Epidemiology, Medical University of Graz)

Abstract

Analyses of late-life disability based on survey data of the oldest old often suffer from non-representative samples due to selective participation and attrition. Here, we use register data on the Austrian long-term care allowance (ALTCA) as a proxy for late-life disability. In this retrospective mortality follow-back study, we analyze receipt of ALTCA, a universal cash benefit based on physician-assessed disability in activities of daily living during the last 10 years of life, among all decedents aged 65 years and over from 2020 in Austria (n = 76,781) and its association with sex, age at death, and underlying cause of death. We find that on average, ALTCA was received for 3.5 and 5.3 years in men and women. At 10 years before death, 10% of men and 25% of women received ALTCA, which increased to 56% and 77% at one year before death. Both the probability and duration of ALTCA increased with age at death and varied by cause of death: Those who died from cancer, myocardial infarction, and external causes of death were less likely to receive ALTCA and for shorter durations, while those who died from dementia, Parkinson’s disease, chronic heart disease, or chronic lung disease were more likely to receive it and longer so. Overall, our register-based estimates of the prevalence of late-life disability were higher than previous survey-based estimates. Policy-makers should be aware that costs of long-term care will rise as life expectancy rises and deaths from dementia and chronic heart disease will likely increase in the rapidly aging European societies.

Suggested Citation

  • Erwin Stolz & Anna Schultz & Julia Zuschnegg & Franziska Großschädl & Thomas E. Dorner & Regina Roller-Wirnsberger & Wolfgang Freidl, 2024. "Disability during the last ten years of life: evidence from a register-based study in Austria," European Journal of Ageing, Springer, vol. 21(1), pages 1-13, December.
  • Handle: RePEc:spr:eujoag:v:21:y:2024:i:1:d:10.1007_s10433-024-00823-z
    DOI: 10.1007/s10433-024-00823-z
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    References listed on IDEAS

    as
    1. Erwin Stolz & Thomas M Gill & Hannes Mayerl & Wolfgang Freidl & Deborah Carr, 2019. "Short-Term Disability Fluctuations in Late Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 74(8), pages 135-140.
    2. Verbrugge, Lois M. & Jette, Alan M., 1994. "The disablement process," Social Science & Medicine, Elsevier, vol. 38(1), pages 1-14, January.
    3. Guralnik, J.M. & LaCroix, A.Z. & Branch, L.G. & Kasl, S.V. & Wallace, R.B., 1991. "Morbidity and disability in older persons in the years prior to death," American Journal of Public Health, American Public Health Association, vol. 81(4), pages 443-447.
    4. Francesco Grippo & Aline Désesquelles & Marilena Pappagallo & Luisa Frova & Viviana Egidi & France Meslé, 2020. "Multi-morbidity and frailty at death: A new classification of death records for an ageing world," Population Studies, Taylor & Francis Journals, vol. 74(3), pages 437-449, September.
    5. Ospina, Raydonal & Ferrari, Silvia L.P., 2012. "A general class of zero-or-one inflated beta regression models," Computational Statistics & Data Analysis, Elsevier, vol. 56(6), pages 1609-1623.
    6. Michael Wagner & Matthias Kuppler & Christian Rietz & Roman Kaspar, 2019. "Non-response in surveys of very old people," European Journal of Ageing, Springer, vol. 16(2), pages 249-258, June.
    7. Susanne Kelfve & Jonas W. Wastesson & Bettina Meinow, 2023. "Length of the period with late life dependency: Does the age of onset make a difference?," European Journal of Ageing, Springer, vol. 20(1), pages 1-9, December.
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