Abstract for: Educational attainment and incidence-based projection of functional disability among older Singaporeans
This study projects the number of elderly Singaporeans with functional disability , comparing projection based on incidence estimates not accounting for educational attainment, with incidence estimate taking into consideration educational attainment. The incidence of disability was estimated from the Social Isolation, Health and Lifestyle Survey (SIHLS), a nationally representative survey of community-dwelling Singaporeans aged 60 years (N=5,000). Transition and mortality rates by age, gender, and educational attainment (distinguished by low: primary school or less and high: secondary school or more) were estimated using data from the SIHLS and its follow-up study (Panel on Health and Aging of Singaporean Elderly). A multi-state model was parameterized by linking with the population model. Due to population aging, the elderly population in Singapore is projected to more than double from now to 2040; of these, those with high education will increase from 40 percent now to 90 percent in 2040. Consequently, between now and 2040, the number of individuals aged 60 years or more with ADL and IADL limitations is projected to more than double; but if educational attainment does make a difference in disability transition and mortality, not accounting for the cohort effect of education is likely to overestimate the number of elderly with functional disability.