A comparison of health expectancies over 10 years: implications for elderly service needs in Hong Kong

We aimed to estimate health expectancies at age 65 based on physical and cognitive function in 2001-2002 and 2011-2012 and project future needs for carers from 2021 to 2041.

Data from the Elderly Health Centres (EHCs) of the Department of Health of the Government of Hong Kong comprising of people aged 65 years or older who enrolled between 2001 and 2002 (EHC 2001-2002) and between 2011 and 2012 (EHC 2011-2012) provided proportion estimates for physical impairment (assessed by independence in activities of daily living) and cognitive impairment (assessed by Abbreviated Mental Test/Mini-Mental Status Examination and self-reported doctor diagnosis of dementia). Health expectancies (years lived with/without physical and/or cognitive impairment) were calculated by Sullivan's method. The proportions of physical and/or cognitive impairment were used to project future needs for carers.

Between 2001-2002 and 2011-2012, years lived without physical/cognitive impairment decreased for men but increased for women, both of which were less than the increases in total life expectancy. Men assessed in 2011-2012 (classified as EHC 2011-2012) lived more years with physical and/or cognitive impairment than those assessed in 2001-2002 (classified as EHC 2001-2002), and women in EHC 2011-2012 lived more years with physical impairment, but fewer years with cognitive impairment than those in EHC 2001-2002, and women enrolled in EHC 2011-2012 lived more years with physical impairment, but fewer years with cognitive impairment than those in EHC 2001-2002. As populations age, the number of carers needed is expected to increase from 344,000 in 2021 to 629,000 by 2041, or an increase of 82.9%. Sensitivity analyses excluding the participants who had been assessed in 2011-2012 from EHC 2001-2002 gave similar estimations.

Increased life expectancy was not accompanied by an increase in years lived without physical/cognitive impairment. These findings suggest that people will live longer but could be more dependent, which would have considerable implications for elderly service needs in Hong Kong.