Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 153 No. 2 (2023)

Trends in the disability-free life expectancy in Switzerland over a 10-year period: an analysis of survey-based data

  • Laurence Seematter-Bagnoud
  • Giulia Belloni
  • Jonathan Zufferey
  • Sonia Pellegrini
  • Christophe Bula
  • Isabelle Peytremann-Bridevaux
Cite this as:
Swiss Med Wkly. 2023;153:40043


INTRODUCTION: Increasing life expectancy raises concerns whether the years gained will be spent free of disability. Lately, trends across countries have been heterogeneous. This work examined recent trends in disability-free life expectancy and life expectancy with mild  or severe disability in Switzerland.

METHODS: Life expectancy was estimated using national life tables, by sex and 5-year age groups. Based on Sullivan’s method, disability-free life expectancy and life expectancy with disability were computed using information from the Swiss Health Survey on age- and sex-specific prevalence of mild and severe disability. Life expectancy, disability-free life expectancy and life expectancy with disability were estimated in 2007, 2012, and 2017, at 65 and 80 years of age, for both sexes.

RESULTS: Between 2007 and 2017, disability-free life expectancy at 65 and 80 years of age increased by 2.1 and 1.4 years, respectively, in men and by 1.5 and 1.1 years, respectively, in women. Meanwhile, life expectancy with mild disability decreased by 6 months in both sexes at age 65 and in men at age 80, but only 1 month in women at age 80. Life expectancy with severe disability also decreased at both ages, by approximately 6 months in women but only 2 to 3 months in men. The proportion of disability-free life expectancy increased significantly in both sexes and ages. For example, disability-free life expectancy / life expectancy at age 65 increased from 67% (95% confidence interval [CI] 66‒69) to 73% (95% CI 71‒74) in women and from 77% (95% CI 75‒79) to 82% (95% CI 81‒84) in men.

CONCLUSION: From 2007 to 2017, disability-free life expectancy at age 65 and 80 increased in Swiss women and men. These gains outweighed those in life expectancy, reflecting some compression of morbidity.


  1. Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980 Jul;303(3):130–5. DOI:
  2. Manton KG. Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q Health Soc. 1982;60(2):183–244. DOI:
  3. Gruenberg EM. The failures of success. 1977. Milbank Q. 2005;83(4):779–800. DOI:
  4. Lafortune G BG. Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications. OECD health working papers. Paris, France: OECD.
  5. Freedman VA. Recent trends in disability and functioning among older adults in the United States: A systematic review (vol 288, pg 3140, 2002). JAMA. 2003;289(24):3242.Reference has only first page number. Please provide the last page number if article is longer than one page. (Ref. 5 "Freedman, 2003") DOI:
  6. Seematter-Bagnoud L PF. The future of longevity in Switzerland: background and perspectives. Lausanne, Switzerland: Institut universitaire de médecine sociale et préventive; 2010.
  7. Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults—present status and future implications. Lancet. 2015 Feb;385(9967):563–75. DOI:
  8. Rechel BJ, McKee M. Living longer, but in better or worse health? European Observatory on Health Systems and Policies. World Health Organization. Copenhagen, Denmark: Regional Office for Europe; 2020.
  9. Cambois ER. J.M. Les espérances de vie sans incapacité : un outil de prospective en santé publique. Inf Soc. 2014;183(3):106–14. DOI:
  10. Spiers GF, Kunonga TP, Beyer F, Craig D, Hanratty B, Jagger C. Trends in health expectancies: a systematic review of international evidence. BMJ Open. 2021 May;11(5):e045567. DOI:
  11. Brønnum-Hansen H, Eriksen ML, Andersen-Ranberg K, Jeune B. Persistent social inequality in life expectancy and disability-free life expectancy: outlook for a differential pension age in Denmark? Scand J Public Health. 2017 Jun;45(4):459–62. DOI:
  12. Enroth L, Raitanen J, Halonen P, Tiainen K, Jylhä M. Trends of Physical Functioning, Morbidity, and Disability-Free Life Expectancy Among the Oldest Old: Six Repeated Cross-Sectional Surveys Between 2001 and 2018 in the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci. 2021 Jun;76(7):1227–33. DOI:
  13. Sundberg L, Agahi N, Fritzell J, Fors S. Trends in health expectancies among the oldest old in Sweden, 1992-2011. Eur J Public Health. 2016 Dec;26(6):1069–74. DOI:
  14. Jeune B, Eriksen ML, Andersen-Ranberg K, Brønnum-Hansen H. Improvement in health expectancy at ages 50 and 65 in Denmark during the period 2004-2011. Scand J Public Health. 2015 May;43(3):254–9. DOI:
  15. Crimmins EM, Zhang Y, Saito Y. Trends Over 4 Decades in Disability-Free Life Expectancy in the United States. Am J Public Health. 2016 Jul;106(7):1287–93. DOI:
  16. Statistics FOf. Tables de mortalité en Suisse. Neuchâtel, Switzerland: Federal Office for Statistics 2019. Available from:
  17. Statistics FOf. L’enquête suisse sur la santé 2017 en bref. Conception, méthode, réalisation. Neuchâtel, Switzerland: Federal Office for Statistics 2018. Available from:
  18. Seematter-Bagnoud L, Belloni G, Zufferey J, Peytremann-Bridevaux I, Büla C, Pellegrini S. Espérance de vie et état de santé: quelle évolution récente? Neuchâtel, Switzerland: Obsan Bulletin, Swiss Health Observatory; 2021.
  19. Sullivan DF. A single index of mortality and morbidity. HSMHA Health Rep. 1971 Apr;86(4):347–54. DOI:
  20. Jagger C, Van Oyen H, Robine JM. Health expectancy calculation by the Sullivan method: a practical guide. Nihon University Population Research Institute (NUPRI) Research Paper Series 68. 2014.
  21. Barendregt JJ, Bonneux L, van der Maas PJ. How good is Sullivan’s method for monitoring changes in population health expectancies? [Reply]. J Epidemiol Community Health. 1997 Oct;51(5):578–9. DOI:
  22. Observatory SH. Taux de recours aux EMS et maisons pour personnes âgées. Neuchâtel, Switzerland: Swiss Health Observatory 2022 [Available from:
  23. R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2021.
  24. Zaninotto P, Batty GD, Stenholm S, Kawachi I, Hyde M, Goldberg M, et al. Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study. J Gerontol A Biol Sci Med Sci. 2020 Apr;75(5):906–13. DOI:
  25. Valverde JR, Mackenbach J, Bopp M, Brønnum-Hansen H, Deboosere P, Kalediene R, et al. Determinants of educational inequalities in disability-free life expectancy between ages 35 and 80 in Europe. SSM Popul Health. 2021 Jan;13:100740. DOI:
  26. Remund A, Cullati S, Sieber S, Burton-Jeangros C, Oris M; Swiss National Cohort. Longer and healthier lives for all? Successes and failures of a universal consumer-driven healthcare system, Switzerland, 1990-2014. Int J Public Health. 2019 Nov;64(8):1173–81. DOI:
  27. Storeng SH, Øverland S, Skirbekk V, Hopstock LA, Sund ER, Krokstad S, et al. Trends in Disability-Free Life Expectancy (DFLE) from 1995 to 2017 in the older Norwegian population by sex and education: the HUNT Study. Scand J Public Health. 2022 Jul;50(5):542–51. DOI:
  28. Zaninotto P, Head J, Steptoe A. Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US. Sci Rep. 2020 Apr;10(1):6955. DOI:
  29. Oksuzyan A, Brønnum-Hansen H, Jeune B. Gender gap in health expectancy. Eur J Ageing. 2010 Nov;7(4):213–8. DOI:
  30. Locatelli IR. Mortality in Switzerland 2020-2021. Lausanne, Switzerland: Center for Primary Care and Public Health (Unisanté), University of Lausanne 2021.

Most read articles by the same author(s)