Assessing morbidity compression in two cohorts from the Health and Retirement Study

Background: Increases in life expectancy are hypothesised to be associated with shorter proportional time spent with morbidity (compression of morbidity). We assessed whether this has occurred among older adults in the USA during the 1990s and 2000s. Methods: We used data from the Health and Retirement Study to estimate a morbidity score based on eight chronic conditions and compare it (1) prospectively between two age-matched cohorts in 1992 and 2004 over a 6-year follow-up, and (2) retrospectively in the three waves prior to death among respondents who die in (1998 2004) and (2004 2010). Results: Prospective assessment shows significantly higher prevalence in 6 of eight chronic conditions in the 2000s, with 37 higher diabetes prevalence. A retrospective evaluation shows significantly higher prevalence in 7 of eight chronic conditions in the three waves prior to death for (2004 2010) versus (1998 2004), with 41 higher prevalence of arthritis. Importantly, the farther away from time of death, the higher the average number of chronic conditions in (2004 2010). Conclusions: Using the largest longitudinal ageing study in the USA, we found no clear evidence of compression of morbidity as measured by self-reported chronic disease. Older adults in the USA may be experiencing greater disease burden in recent times.