Frailty and Forecasts of Active Life Expectancy in the United States

The concept of active life expectancy (ALE) becomes ever more important as it becomes possible to extend the life of impaired, elderly persons. It suggests that, as we endeavor to increase the length of time an individual lives, we be aware of the quality of life gained. To this end, a number of different methods, using different types of data, have been used. One procedure, which is due to Sullivan (1971), combines health survey data with period life tables to provide prevalence based ALE estimates. This has been used to analyze health priorities in, for example, Canada (e.g., Wilkins and Adams, 1983), Japan (Nihon University, 1982), Britain (Bebbington, 1988), and France (Robine et al., 1989; Robine and Ritchie, 1991). Calculations have been performed for the United States using both the Health Interview Survey (e.g., Crimmins et al., 1989) and the National Long Term Care Survey (NLTCS) (e.g., Manton and Stallard, 1991).