Educational Gradients in Disability among Asia’s Future Elderly: Projections for the Republic of Korea and Singapore

Abstract

Asia is home to the most rapidly aging populations in the world. This study focuses on two countries in Asia that are advanced in terms of their demographic transition: the Republic of Korea and Singapore. We developed a demographic and economic state-transition microsimulation model based on the Korean Longitudinal Study of Aging and the Singapore Chinese Health Study. The model was employed to compare projections of functional status and disability among future cohorts of older adults, including disparities in disability prevalence by educational attainment. The model also projects increasing disparities in the prevalence of activities-of-daily-living disability and other chronic diseases between those with low and high educational attainment. Despite overall increases in educational attainment, all elderly, including those with a college degree, experience an increased burden of functional disability and chronic diseases because of survival to older ages. These increases have significant economic and social implications, including increased medical and long-term care expenditures, and an increased caregiver burden.

Projections of functional dependence among the late middle-aged and older population from 2018-2048 in China: a dynamic microsimulation

“…Second, the time step between the 2015 and 2018 waves was three years, whereas the time step was two years for the 2011-2015 waves. When estimating the event risks of the 14 chronic diseases, sociodemographic characteristics, conditions in the previous wave, and functional status in the last wave were used as predictors, all of which were relatively common predictors in microsimulation studies on population aging [ 8 , 9 , 13 ]. In our analysis, sociodemographic characteristics included age, sex, marriage status, BMI, education, smoking, and drinking.…”

“…A leading example is the Future Elderly Model (FEM), which predicts the functional level of older Americans by simulating their life courses and accruing the outcomes [ 10 , 11 , 15 ]. Since its debut, FEM became a popular tool for forecasting the landscapes of ADL and IADL and was adapted to other economies, including Japan, Singapore, South Korea, Mexico, and several European countries [ 7 – 9 , 13 , 16 , 17 ]. Another famous example is the Population Ageing and Care Simulation (PACSim) model, devised to predict future population size with functional dependency in the United Kingdom [ 12 ].…”