Prospects for the Compression of Morbidity

Although an upper limit to life expectancy has been proposed, most projections are for a continued decline in mortality rates and an increase in life expectancy for the next 50 years. Compression of morbidity can still occur during a period of increasing life expectancy if disability-free life expectancy increases more rapidly than life expectancy. This article considers the prospects for future increases in disability-free life expectancy as the proportion of the population dying at the oldest ages increases. The distribution of age at death is projected to change substantially during the first half of the next century, with many more deaths taking place at the oldest ages. Using current age-specific estimates of disability in the years prior to death, projections are presented that indicate that the shift in the distribution of age at death will lead to an increased number of years spent disabled prior to death for the total population aged 65 and older. It is proposed that a compression of morbidity may not be possible unless there is a reduction in the high rate of disability prior to death in the large segment of the future older population who will die at the oldest ages.