Suchergebnisse

In a health context, dependence is defined as a lack of autonomy in performing the basic activities of daily living and requiring care giving or significant help from another person. However, this contingency, if present, changes over one's lifetime. Empirical evidence shows that, once this situation occurs, it is almost impossible to return to the previous state and in most cases increases in intensity. In the paper, the evolution of the intensity of this situation is studied for the Spanish population affected by this contingency. Evolution in dependence can be seen as sparsely observed functional data, where we obtain a curve for each individual that is observed at only those points where changes in his or her condition of dependence occur. We use functional data analysis techniques, such as curve registration, functional data depth and distance-based clustering, to analyse this type of data. This approach proves to be useful in this context because it considers the dynamics of the dependence process and provides more meaningful conclusions than simple pointwise or multivariate analysis. We use the sample statistics obtained to predict the future evolution of dependence. The database analysed originates from the 'Survey on disability, personal autonomy and dependence situations' in Spain in 2008. The survey is the largest and most complete survey to be made available in Europe for the study of disability. In addition, the Spanish legislation is one of the most recent in Europe and provides a detailed quantitative scale to assess dependence. In the paper, the scale value according to this legislation has been calculated for each individual included in the survey. Differences between sex, age and the time of first appearance were considered, and a prediction of the future evolution of dependence is obtained.

The aging of population is perhaps the most important problem that developed countries must face in the near future. Dependency can be seen as a consequence of the process of gradual aging. In a health context, this contingency is defined as a lack of autonomy in performing basic activities of daily living that requires the care of another person or significant help. In Europe in general and in Spain in particular, this phenomena represents a problem with economic, political, social and demographic implications. The prevalence of dependency in the population, as well as its intensity and evolution over the course of a person's life are issues of greatest importance that should be addressed. The aim of this work is the estimation of life expectancy free of dependency (LEFD) based on functional trajectories to enhance the regular estimation of health expectancy. Using information from the Spanish survey EDAD 2008, we estimate the number of years spent free of dependency for disabled people according to gender, dependency degree (moderate, severe, major) and the earlier or later onset of dependency compared to a central trend. The main findings are as follows: first, we show evidence that to estimate LEFD ignoring the information provided by the functional trajectories may lead to non-representative LEFD estimates; second, in general, dependency-free life expectancy is higher for women than for men. However, its intensity is higher in women with later onset on dependency; Third, the loss of autonomy is higher (and more abrupt) in men than in women. Finally, the diversity of patterns observed at later onset of dependency tends to a dependency extreme-pattern in both genders.