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

Published online

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Ansah, JP; Malhotra, R; Lew, N; Chiu, C-T; Chan, A; Bayer, S; Matchar, DB

Published Date

  • 2015

Published In

Volume / Issue

  • 10 / 5

Start / End Page

  • e0126471 -

PubMed ID

  • 25974069

Pubmed Central ID

  • 25974069

Electronic International Standard Serial Number (EISSN)

  • 1932-6203

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0126471


  • eng

Conference Location

  • United States