Publications by authors named "H P Van de Water"

Health expectancy and the problem of substitute morbidity.

Philos Trans R Soc Lond B Biol Sci

December 1997

During the past century, the developed world has not only witnessed a dramatic increase in life expectancy (ageing), but also a concomitant rise in chronic disease and disability. Consequently, the tension between 'living longer' on the one hand and health-related 'quality of life' on the other has become an increasingly important health policy problem. The paper deals with two consequences of this so-called epidemiological transition in population health.

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The measurement of life expectancy in terms of either good or poor health is a novel approach to studying the health of the population in Bulgaria. The pilot study reported here-carried out among people aged > or = 60 years in a middle-sized Bulgarian town-was designed to obtain information on the years of functional restrictions expected among the elderly. In accordance with the answers to a series of questions (recommended by WHO), subjects were categorized as disabled, handicapped, or having different states of perceived health.

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To gain an insight into the burden of dementia in an aging society, life expectancy with dementia and its counterpart dementia-free life expectancy (DemFLE) in The Netherlands are presented. Sullivan's method was used to calculate DemFLE. For elderly living either independently or in homes for the elderly prevalence figures on dementia were obtained from the Rotterdam Elderly Study (RES; n = 7528); for elderly in nursing homes the SIG Nursing home Information System was used.

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This article presents health expectancy calculations from Bulgaria for 1976-1992. The calculations are based on mortality statistics and data from a national information system from the Expert Medical Commissions on Working Capacity about loss of working capacity. Following internationally accepted terminology, the most appropriate term for the health expectancies presented here is "occupational handicap-free life expectancy' (OHFLE).

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