Estimating Disability-Free Life Expectancy among Older Adults Attending an Elderly Care Center in Zawiya, Libya: By Sex, Age, and Functional Disability Severity
DOI:
https://doi.org/10.65405/kebpvy31Keywords:
Older adults; healthy ageing; life expectancy; disability-free life expectancy; functional disability; healthy life expectancy; Activities of Daily Living (ADLs); Instrumental Activities of Daily Living (IADLs); Sullivan method; Libya; Zawiya.Abstract
This study aimed to estimate disability-free life expectancy (DFLE) among older adults aged 60 years and above attending the Elderly Care Center in Zawiya, Libya, by sex, age, and levels of functional disability severity. The study was based on cross-sectional data collected in the field during November and December 2024, in addition to life-table data for the Libyan population for 2024. Functional disability was assessed using Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and was classified according to different levels of severity. The Sullivan method was used to estimate the expected years lived free of disability and the expected years lived with disability.
The sample consisted of 44 older adults, including 19 males and 25 females. The results showed that life expectancy was higher among females than males across all age groups studied; however, this advantage was not consistently reflected in disability-free life expectancy. For ADL-based disability, DFLE at ages 60–64 years was 1.95 years for males compared with 1.73 years for females, while at age 80 years and above, it was 0.27 and 0.31 years, respectively. For severe ADL disability, DFLE was higher among males than females across all age groups. For IADLs, the burden of disability was very high, with an overall disability prevalence of 90.9%, reaching 100% in several age groups. This was reflected in a very low DFLE, reaching zero in some age groups.
The findings indicate that an increase in life expectancy does not necessarily imply a corresponding increase in the number of years lived free of disability. They also highlight the importance of distinguishing between different domains of functional activity and levels of disability severity when assessing health in later life. Given the small sample size and the fact that the study was limited to older adults attending a single center, the findings should be interpreted with caution and should not be generalized to the older population of Libya as a whole.
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References
1. اللجنة الاقتصادية والاجتماعية لغربي آسيا (الإسكوا). (2017). الشيخوخة بكرامة في المنطقة العربية. تقرير السكان والتنمية، العدد الثامن.
2. اللجنة الاقتصادية والاجتماعية لغربي آسيا (الإسكوا) التابعة للأمم المتحدة وفريق واشنطن المعني بإحصاءات الإعاقة, (2018). "الدليل الإقليمي لتحسين جمع البيانات المتعلقة بالإعاقة وتحليلها في البلدان العربية: تطبيق أسئلة فريق واشنطن حول أداء الوظائف".
3. مصلحة الإحصاء والتعداد. (2022). نتائج مسح القوى العاملة 2022. ليبيا.
4. مصلحة الإحصاء والتعداد. (2023). الكتاب الإحصائي 2023. ليبيا.
المراجع الإنجليزية
1. Andrade, F., Guevara, P., Lebrao, M., Duarte, Y. and Santos, J. (2011). "Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Sao Paulo, Brazil". Women Health Issues, PubMed, 21(1): 64-70. doi: 10.1016/j.whi.2010.08.007.
2. Apinonkul, B., Soonthorndhada, K., Vapattanawong, P., Aekplakorn, W. and Jagger, C. (2015). "Gender Differences in Health Expectancies Across the Displacement Process Among Older Thais". Plos One, 10(3): 1-12. https://doi.org/10.1371/journal.pone.0121310.
3. Belon, A., Lima, M., & Barros, M. (2014). Gender differences in healthy life expectancy among Brazilian elderly. Health and Quality of Life Outcomes, 12, 88.
4. Camargos, M., Machado, C., & Rodrigues, R. (2008). Life expectancy among elderly Brazilians in 2003 according to different levels of functional disability. Cadernos de Saúde Pública, 24(4), 845–852.
5. Jagger, C., Cox, B., & Le Roy, S. (2006). Health expectancy calculation by Sullivan method: A practical guide. European Health Expectancy Monitoring Unit, Technical Report No. 3.
6. Jitapunkul, S., Kunanusont, C., Phoolcharoen, W., Suriyawongpaisal, P., & Ebrahim, S. (2003). Disability-free life expectancy of elderly people in a population undergoing demographic and epidemiologic transition. Age and Ageing, 32(4), 401–405.
7. Luy, M. and Minagawa, Y. (2014). "Gender Gaps- Life Expectancy and Proportion of Life in Poor Health". Health reports/ Statistics Canada, Canadian Centre for Health Information, 25 (12): 12-19, Catalogue no.82-003-x.
8. Lawton, P., & Brody, M. (1969). Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist, 9(3), 179–186.
9. Mathers, C. (2002). " Health Expectancies: an overview and Critical Appraisal". Chapter 4.I. In: Murray, c., Salomon, J., Mathers, C. and Lopes, A. (eds.) "Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications". World Health Organization
10. Metwally, S. (2021). Disability-free life expectancy at old ages in Egypt. Journal of Biosocial Science.
11. Sullivan, D. (1971). A single index of mortality and morbidity. HSMHA Health Reports, 86(4), 347–354.
12. Van Oyen, H., Nusselder, W., Jagger, C., Kolip, P., Cambois, E., & Robine, J.-M. (2013). Gender differences in healthy life years within the EU: An exploration of the “health-survival” paradox. International Journal of Public Health, 58(1), 143–155. https://doi.org/10.1007/s00038-012-0361-1.
13. Verbrugge, L. M. (1985)."Gender and Health: An Update on Hypotheses and Evidence". Journal of Health and Social Behavior, 26 (3): 156-182.
14. Verbrugge, L. M. (1989). "The twain meet: Empirical explanations of sex differences in health and mortality". Journal of Health and Social Behavior, 30(3), 282–304. https://doi.org/10.2307/2136961
15. World Health Organization. (1948). " definition of Health " Constitution of the World Health Organization. Geneva: WHO.
16. World Health Organization. (2015). World report on ageing and health. Geneva: WHO.
17. United Nations, Department of Economic and Social Affairs, Population Division. (2024). World Population Prospects: The 2024 Revision
18. Dalla, L. O. B., Karal, Ö., Degirmenci, A., EL-sseid, M. A. M., Essgaer, M., & Alsharif, A. (2025). A comprehensive literature review (LR) on optimization algorithms of sewage water treatment processes. مجلة العلوم الشاملة, 10(37), 3204-3220.
19. Jetlawei, S. S., Dalla, L. O. B., Karal, Ö., Degirmenci, A., EL-sseid, M. A. M., Essgaer, M., & Alsharif, A. (2025). Temporal Intelligence and Algorithmic Equity: A Multi-Phase Framework for Predictive Student Success in Higher Education. مجلة العلوم الشاملة, 9(36), 1574-1595.
20. Hamad, H. F. M., Dalla, L. O. B., Essgaer, M., & Ali, A. M. O. (2026). Predictive Pavement Management for Strategic Transport Corridors: AI-Based Early Detection and Mitigation of Potholes on the Sabha-Ash-Shuwayrif Highway, Libya. Al-Farooq Journal of Sciences, 2(ملحق 3), 417-436.
21. Albakoush, O. R. (2026). The Impact of Social Media Language on the Development of Pragmatic Competence among Young Adult English Learners in Libya. مجلة العلوم الشاملة, 11(ملحق 41), 57-61.
22. Barakat, H. A., & Alhajrasi, S. N. (2026). Exploring Teachers’ Perspectives on Multimodal Phonics Instruction and Jolly Phonics Practices in Early Childhood Education. مجلة العلوم الشاملة, 11(41), 1206-1217.
