Compression of disability - privilege of the well-educated

Dorly J. H. Deeg, Institute for Research in Extramural Medicine

Little insight exists into factors that affect longitudinal trajectories of disability other than age and sex. This contribution examines a variety of trajectories using three cycles (t1-t3) of the Longitudinal Aging Study Amsterdam, the Netherlands. Trajectories were determined among both the survivors and the deceased, and predictive ability of age, sex, education, partner status, and physical and mental conditions. Eight trajectories were distinguished, from which the trajectory "not disabled, died t3" (8%) reflects most closely the ideal of compression of disability at the very end of life. This trajectory, however, is experienced by a minority. Factors associated with it were younger age, higher education, living with partner, and not having arthritis. As among these, high education is the only asset that cannot be lost with aging, it is concluded that the highly educated subgroup of the population is the most likely to experience the ideal of compression of morbidity.