• Istvan M Majer, Wilma J Nusselder, Johan P Mackenbach, Bart Klijs, and van BaalPieter H MPH.
• Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. i.majer@erasmusmc.nl
• Am J Public Health. 2011 Dec 1; 101 (12): e9-15.

ObjectivesWe assessed the association between mortality and disability and quantified the effect of disability-associated risk factors.MethodsWe linked data from cross-sectional health surveys in the Netherlands to the population registry to create a large data set comprising baseline covariates and an indicator of death. We used Cox regression models to estimate the hazard ratio of disability on mortality.ResultsAmong men, the unadjusted hazard ratio for activities of daily living, mobility, or mild disability defined by the Organization for Economic Co-operation and Development at age 55 years was 7.85 (95% confidence interval [CI] = 4.36, 14.13), 5.21 (95% CI = 3.19, 8.51), and 1.87 (95% CI = 1.58, 2.22), respectively. People with disability in activities of daily living and mobility had a 10-year shorter life expectancy than nondisabled people had, of which 6 years could be explained by differences in lifestyle, sociodemographics, and major chronic diseases.ConclusionsDisabled people face a higher mortality risk than nondisabled people do. Although the difference can be explained by diseases and other risk factors for those with mild disability, we cannot rule out that more severe disabilities have an independent effect on mortality.

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