Journal Article

Aging and the compression of disability in Portugal

There are competing hypotheses about the relationship between aging and health. One is that increased longevity is spent in poor health with a high prevalence of chronic illness. Another is that increased longevity has been accompanied by a decreasing prevalence of disabling conditions. Research has provided evidence supporting both and no rationale has been advanced for these conflicting findings. Building on the conceptual differences between disability and morbidity, this article proposes that a higher prevalence of chronic diseases is not irreconcilable with lower levels of disability. Using four cross sections of a national health survey, we study the evolution of the number of days bedridden, a concrete measure of disability.  Results show that the older population is spending progressively less time incapacitated in bed: both the probability to be bedridden and the average number of days confined to bed significantly decreased over time for the same age groups. This reduction in the likelihood to be bedridden is robust when population subgroups are considered, and it occurs despite an overall increase in the number of people diagnosed with chronic diseases. The findings, tipping the balance in favor of a disability compression hypothesis, suggest that aging may be less burdensome than often assumed.

Published in a peer-reviewed journal of the Population Council.