From the Guidelines
Life expectancy for patients with chronic medical conditions can be significantly reduced, with a general reduction of 5-10 years compared to the general population, depending on the specific conditions, their severity, and how well they are managed. The impact of chronic conditions on life expectancy varies widely, with well-managed diabetes potentially reducing life expectancy by 5-7 years, and severe heart failure by 10 years or more 1. Multiple coexisting conditions (multimorbidity) have a compounding effect, further reducing life expectancy. Lifestyle factors such as regular physical activity, healthy diet, medication adherence, avoiding tobacco, limiting alcohol, and attending regular medical appointments play a crucial role in improving prognosis 1.
Factors Influencing Life Expectancy
- Severity of the chronic condition
- Age of onset
- Presence of multiple coexisting chronic illnesses
- Level of cognitive and physical functioning
- Presence of end-stage chronic illnesses, such as stage 3–4 heart failure or oxygen-dependent lung disease, chronic kidney disease requiring dialysis, or uncontrolled metastatic cancer 1
Management and Prognosis
Early diagnosis and aggressive management of chronic conditions are essential for preserving life expectancy, as they can prevent or delay complications that contribute to premature mortality 1. The trajectory of chronic disease is not fixed, and with proper management, many patients can maintain good quality of life and function for years despite their conditions. Consideration of patient and caregiver preferences is an important aspect of treatment individualization, and a patient’s health status and preferences may change over time 1.
Key Considerations
- Regular assessment of disease treatment and adjustment of goals as necessary
- Use of A1C as a standard biomarker for glycemic control, with consideration of its limitations in certain patients
- Importance of diabetes self-management education and ongoing diabetes self-management support for older adults and their caregivers 1
From the Research
Life Expectancy for Patients with Chronic Medical Conditions
- Life expectancy for patients with chronic medical conditions can vary significantly depending on the specific condition, age, and number of comorbidities 2, 3, 4.
- For patients with Alzheimer's disease, life expectancy can range from 3 to 10 years, with the main predictor being age 2.
- Patients diagnosed with Alzheimer's in their 60s and early 70s can expect a median life span of 7 to 10 years, while those diagnosed in their 90s can expect a life span of around 3 years or less 2.
- For patients with osteoporosis, the residual life expectancy can be estimated based on age and sex, with a 50-year-old man expected to live around 18.2 years and a 75-year-old man expected to live around 7.5 years 3.
- Women with osteoporosis tend to have a higher life expectancy, with a 50-year-old woman expected to live around 26.4 years and a 75-year-old woman expected to live around 13.5 years 3.
- The presence of multiple chronic conditions can significantly impact life expectancy, with each additional condition resulting in a decline of around 1.8 years in life expectancy 4.
- A 67-year-old individual with no chronic conditions can expect to live around 22.6 additional years, while those with 5 or more chronic conditions can expect to live around 7.7 to 17.6 fewer years 4.
- Clinicians' predictions of patient survival can be inaccurate, with a tendency to overestimate life expectancy, especially in patients with advanced lung cancer 5.
- Patient quality of life and physical symptoms can also influence life expectancy estimates, with some patients overestimating their life expectancy based on their physical condition 6.