316834
Trends in Disability in a Super-Aging Society: Adapting the Future Elderly Model to Japan
Wednesday, November 4, 2015
Brian Chen, JD, PhD,
Arnold School of Public Health, University of South Carolina, Columbia, SC
Karen Eggleston, PhD,
Asia Health Policy Program, Shorenstein Asia Pacific Research Center, Stanford University, Stanford, CA
Lena Shoemaker,
Associate, Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA
Hawre Jalal,
Primary Care and Outcome Research, Stanford University School of Medicine, Stanford, CA
Japan has experienced pronounced population aging, and now has the highest proportion of elderly adults in the world. Yet few projections of Japan’s future demography go beyond estimating population by age and sex to forecast the complex evolution of the health and functioning of the future elderly. This study adapts to the Japanese population the Future Elderly Model (FEM), a demographic and economic Markov microsimulation model that projects the health conditions and functional status of Japan’s elderly population in order to estimate disability, health, and need for long term care. We develop the model based on the recently released multiple waves of the Japan Study of Aging and Retirement (JSTAR) survey. Using detailed data on a panel of Japanese aged 50-75 starting in 2007, we tailor the health transition matrix of the FEM model to the Japanese context, estimate conditional mortality probabilities consistent with Japanese national vital statistics, and use a state-transition Markov model to project trends in the disability and functioning of Japan’s future elderly population. We project that diabetes prevalence will increase to 35 percent by 2040, and almost 40 percent of all Japanese 50+ will have heart disease by 2040. By 2040, more than 35 percent of Japan’s elderly will exhibit 3 or more limitations in instrumental activities of daily living and social functioning; about one in 3 will experience difficulties with 3 or more activities of daily living; and more than one in 4 will suffer limitations in cognitive or intellectual functioning, with significant implications for Japan's health policy.
Learning Areas:
Chronic disease management and prevention
Epidemiology
Provision of health care to the public
Learning Objectives:
Demonstrate how Japan's elderly population will evolve in terms of its aging structure, disability burden, and functional status given current trends.
Design a state-transition Markov simulation model to forecast the complex evolution of the health and functioning of the future elderly in Japan.
Discuss the implications of Japan's super-aging population on long-term and medical insurance programs, as well as pension, fertility, immigration and national defense policies.
Keyword(s): Aging, Disabilities
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a PhD-trained economist and was in charge of the estimation of the health transition matrices based on regression analysis. Interdisciplinary team members from Stanford contributed to the development of the Markov simulation to complete this project, and Dr. Bhattacharya was one of the initial researchers that developed the Future Elderly Model in the United States.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
