Differences in life expectancy with and without disease using reported, measured, and combined estimates for hypertension and diabetes among older adults in Colombia.
Estimates of prevalence and diseased life expectancy for diabetes and hypertension among older adults in Colombia differ substantially depending on whether reported diagnosis, measured high-risk values, or combined estimates are used, with hypertension showing the largest discrepancies between measures.
Key Findings
Results
Diabetes prevalence estimates varied substantially by measurement method, with the widest gaps occurring in older age groups.
Among men, the widest range occurred at ages 80-84: 22.5% combined, 21.5% reported, and 6.7% measured.
Among women, the widest range occurred at ages 75-79: 34.4% combined, 32.0% reported, and 13.4% measured.
Study used nationally representative data from SABE-Colombia 2015 among adults aged 60 and older.
Three measurement approaches were compared: reported diagnosis, measured high-risk values, and a combined estimate including both indicators.
Results
Diseased life expectancy (DLE) with diabetes at age 60 differed markedly by measurement method for both men and women.
An average man at age 60 was expected to live 3.8 years with diabetes using the combined measure, 3.5 years using reported diagnosis, and 1.5 years using measured data.
An average woman at age 60 had a DLE with diabetes of 5.0 years using the combined measure, 4.6 years using the reported measure, and 2.0 years using measured data.
DLE was estimated using the Sullivan method.
The measured-only estimate produced roughly half the DLE compared to the combined estimate for both sexes.
Results
Hypertension prevalence estimates showed even larger discrepancies between measurement methods than diabetes estimates.
Among men, the widest range occurred at ages 65-69: 64.8% combined, 47.3% reported, and 32.6% measured.
Among women, the widest range also occurred at ages 65-69: 74.0% combined, 63.6% reported, and 28.2% measured.
The gap between combined and measured estimates for hypertension prevalence exceeded 30 percentage points among women aged 65-69.
Reported diagnosis underestimated both prevalence and DLE compared to combined measures for hypertension.
Results
Diseased life expectancy with hypertension at age 60 varied substantially by measurement method for both men and women.
Men at age 60 were expected to live 13.9 years with hypertension using the combined measure, compared with 10.5 years using reported diagnosis and 8.3 years using measured data.
Women at age 60 had a DLE with hypertension of 16.7 years combined, 14.4 years reported, and 8.0 years measured.
The difference between combined and measured DLE for hypertension was 5.6 years for men and 8.7 years for women at age 60.
Women consistently showed higher DLE with hypertension than men across all measurement methods.
Results
Diabetes awareness and treatment were found to be relatively high, while hypertension was substantially underdiagnosed based on reported measures.
The study disaggregated each disease into three categories: controlled, uncontrolled, and unaware.
For diabetes, reported diagnosis closely approximated the combined estimate, suggesting relatively high awareness.
For hypertension, reported diagnosis substantially underestimated prevalence and DLE compared to combined measures, indicating considerable underdiagnosis.
These contrasting patterns suggest different surveillance and treatment gaps for the two conditions among older Colombians.
Discussion
The choice of measurement method has important implications for understanding disease burden and life expectancy with chronic conditions in later life.
Using only measured high-risk values consistently produced the lowest prevalence and DLE estimates for both conditions.
Using only reported diagnosis produced intermediate estimates for diabetes but substantially underestimated hypertension burden.
The combined measure, which includes both reported diagnosis and measured high-risk values, consistently produced the highest prevalence and DLE estimates.
Differences between methods were more pronounced for hypertension than for diabetes across both sexes.
What This Means
This research suggests that how you measure a disease matters enormously when estimating how much of older people's lives are spent living with that condition. Using data from a nationally representative Colombian survey of adults aged 60 and older, researchers calculated the number of years people could expect to live with diabetes or high blood pressure depending on whether they used self-reported diagnoses, actual physical measurements, or a combination of both. They found that relying on any single source of information significantly changed the estimates — sometimes by several years of life spent with disease.
For high blood pressure (hypertension), the gaps between methods were especially large. A 60-year-old woman, for example, was estimated to live anywhere from 8 years (using only physical measurements) to nearly 17 years (using the combined approach) with hypertension — a difference of almost 9 years. This suggests that reported diagnoses alone miss a large share of people who actually have high blood pressure, meaning the true burden of hypertension in older Colombians is likely much higher than official diagnosis records would indicate. For diabetes, the picture was different: reported diagnoses tracked fairly closely with the combined estimate, suggesting that diabetes awareness and treatment in this population are comparatively higher.
This research matters because accurate estimates of disease burden are essential for planning healthcare services, setting public health priorities, and allocating resources — especially as populations age and chronic diseases become more common. If policymakers rely only on self-reported diagnoses, they may significantly underestimate how much of the older population is living with undiagnosed hypertension, leading to inadequate investment in screening and treatment programs. The findings highlight the importance of using multiple data sources when measuring chronic disease prevalence and its impact on healthy aging.
Osuna M, Ruvalcaba L, Crimmins E, Cano C, Ailshire J. (2026). Differences in life expectancy with and without disease using reported, measured, and combined estimates for hypertension and diabetes among older adults in Colombia.. PloS one. https://doi.org/10.1371/journal.pone.0349777