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Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference?

Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference?
Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference?
This study compares projections, up to year 2040, of young-old (aged 60-79) and old-old (aged 80+) with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education)-specific transition probabilities (between active, functional disability and death states) estimated from two waves (2009 and 2011) of a nationally representative survey of community-dwelling Singaporeans aged >/= 60 years (N=4,990). Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy.
Aged Aged, 80 and over *Aging *Disability Evaluation Educational Status Female Forecasting/methods Health Expenditures Health Services Needs and Demand/economics Health Surveys Humans Long-Term Care/economics Male Middle Aged Singapore
1932-6203
e0126471
Ansah, J. P.
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Malhotra, R.
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Lew, N.
6ac3ec01-2bf9-4dbb-bc7f-977e4a9547e0
Chiu, C. T.
94969647-4fe8-40ea-a821-3d7137fdc7bb
Chan, A.
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Bayer, S.
28979328-d6fa-4eb7-b6de-9ef97f8e8e97
Matchar, D. B.
d93302f6-c585-4c64-a58d-c6d63264f928
Ansah, J. P.
b75fc1e9-200f-4333-95d0-75c8af42fe35
Malhotra, R.
6e6f75e3-95ad-4d65-8947-83f7b2519033
Lew, N.
6ac3ec01-2bf9-4dbb-bc7f-977e4a9547e0
Chiu, C. T.
94969647-4fe8-40ea-a821-3d7137fdc7bb
Chan, A.
7d804261-8c16-41e2-b263-cebb332d2d44
Bayer, S.
28979328-d6fa-4eb7-b6de-9ef97f8e8e97
Matchar, D. B.
d93302f6-c585-4c64-a58d-c6d63264f928

Ansah, J. P., Malhotra, R., Lew, N., Chiu, C. T., Chan, A., Bayer, S. and Matchar, D. B. (2015) Projection of young-old and old-old with functional disability: does accounting for the changing educational composition of the elderly population make a difference? PLoS ONE, 10 (5), e0126471. (doi:10.1371/journal.pone.0126471).

Record type: Article

Abstract

This study compares projections, up to year 2040, of young-old (aged 60-79) and old-old (aged 80+) with functional disability in Singapore with and without accounting for the changing educational composition of the Singaporean elderly. Two multi-state population models, with and without accounting for educational composition respectively, were developed, parameterized with age-gender-(education)-specific transition probabilities (between active, functional disability and death states) estimated from two waves (2009 and 2011) of a nationally representative survey of community-dwelling Singaporeans aged >/= 60 years (N=4,990). Probabilistic sensitivity analysis with the bootstrap method was used to obtain the 95% confidence interval of the transition probabilities. Not accounting for educational composition overestimated the young-old with functional disability by 65 percent and underestimated the old-old by 20 percent in 2040. Accounting for educational composition, the proportion of old-old with functional disability increased from 40.8 percent in 2000 to 64.4 percent by 2040; not accounting for educational composition, the proportion in 2040 was 49.4 percent. Since the health profiles, and hence care needs, of the old-old differ from those of the young-old, health care service utilization and expenditure and the demand for formal and informal caregiving will be affected, impacting health and long-term care policy.

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More information

Submitted date: 25 September 2014
Accepted/In Press date: 2 April 2015
Published date: 14 May 2015
Additional Information: Ansah, John P Malhotra, Rahul Lew, Nicola Chiu, Chi-Tsun Chan, Angelique Bayer, Steffen Matchar, David B eng Research Support, Non-U.S. Gov't 2015/05/15 06:00 PLoS One. 2015 May 14;10(5):e0126471. doi: 10.1371/journal.pone.0126471. eCollection 2015.
Keywords: Aged Aged, 80 and over *Aging *Disability Evaluation Educational Status Female Forecasting/methods Health Expenditures Health Services Needs and Demand/economics Health Surveys Humans Long-Term Care/economics Male Middle Aged Singapore
Organisations: Decision Analytics & Risk

Identifiers

Local EPrints ID: 410960
URI: https://eprints.soton.ac.uk/id/eprint/410960
ISSN: 1932-6203
PURE UUID: 2859ee41-f184-4222-b1fe-11fd6127fe9f

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Date deposited: 12 Jun 2017 16:31
Last modified: 13 Mar 2019 19:47

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Contributors

Author: J. P. Ansah
Author: R. Malhotra
Author: N. Lew
Author: C. T. Chiu
Author: A. Chan
Author: S. Bayer
Author: D. B. Matchar

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