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Research Urban and Regional Studies Institute PRC

Modeling the effect of risk factors on healthy ageing

Principal researcher

Mieke Reuser

Type of research

PhD research


Dr Luc Bonneux and Professor Frans Willekens


Royal Dutch Academy of Science (KNAW) fund for Demography-Epidemiology-Actuarial Science (DEA)


September 2006 – May 2010

Public Defence

October 28, 2010. 14.45 Academic Building, Groningen.

Summary of the project

The aim of this project is to study the effect of risk factors on mortality and morbidity at middle and old age. With increasing life expectancy it is unsure whether the number of years people live with disability will increase or decrease. Several risk factors and choices made in a people's life course influence the timing of a transition to disability and the duration of stay in that situation. It turns out that for example, being obese does not significantly increase mortality but does increase the chance to physical and perhaps also cognitive disability. Smoking on the other hand is much more fatal and therefore shortens the disabled life span.

In this Phd research I will focus on the middle and older age population of age 55 and over. Based on longitudinal data from the US Health and Retirement Survey (HRS), cohort biographies can be modelled by means of multistate models and shed light on the influence of risk factors on health transitions to mild and severe physical disability, cognitive decline or death. Based on these models one can predict the health status of the elderly population in the future. One useful application for example would be to project the need for long-term care for elderly in the future.



  • Reuser, M. "The effect of risk factors on disability. A multistate analysis of the U.S. Health and Retirement Study", PhD dissertation, September 2010.
  • Reuser, M., Bonneux, L. and F. Willekens. 2010."The duration of cognitive impairment in the U.S. Health and Retirement Study. A multistate life table analysis." Submitted
  • Reuser, M. F. Willekens and L. Bonneux. 2010. "Analytical sensitivity analysis of the multistate life table. A new tool in public health research." Submitted
  • Li, Q., M. Reuser, C. Kraus & J. Alho (2009), Ageing of a giant: a stochastic population forecast for China, 2006-2060. Journal of Population Research 26 (1): 21-50.
  • Reuser, M., L.G. Bonneux & F.J. Willekens (2009), Smoking kills, obesity disables: a multistate approach of the US Health and Retirement Survey. Obesity 17 (4): 783-789.
  • Reuser, M. (2008), Dementie: keerzijde van een lang leven. Demos 24 (10): 1-3.
  • Reuser, M., L. Bonneux & F. Willekens (2008), The burden of mortality of obesity at middle and old age is small; a life table analysis of the US Health and Retirement Survey. European Journal of Epidemiology 23 (9): 601-607.
  • Reuser, M. (2008), Fat chance! A closer look at the effect of overweight on mortality. Demos 24 (Special Issue): 10-11.
  • Reuser, M. (2007), Maak je niet dik! Het effect van overgewicht op sterfte nader onderzocht. Demos 23 (10): 5-7.
  • Bonneux, L. and M. Reuser (2007), Overgewicht en sterfterisico: geen samenhang tussen overgewicht op middelbare en oudere leeftijd en verhoogde sterfte. Nederlands Tijdschrift voor Geneeskunde 151 (50): 2764-9.


  • "The effect of obesity, smoking and education on care dependence at middle and old age: a multistate approach". Paper presented at the PAA, 17-19 April 2008, Session 'Obesity, Health, and Mortality'.
  • "The effect of risk factors on cognitive impairment: a life table approach". Paper presented at the EPC, 9-12 July 2008, Session 'Mental health'.

Last modified:08 March 2017 2.45 p.m.