Future life expectancy with disability among elderly Chinese individuals: a forecast based on trends in stroke and dementia

Abstract

ObjectivesThis study aims to predict the life expectancy with disability (LED) of the elderly in China from 2010 to 2030 based on trends in stroke and dementia. Study designThis was a prospective cohort study. MethodsData for 28,667 eligible individuals aged 65+ years were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2002 to 2014. A discrete-time probabilistic Markov model was constructed with nine different health states characterized by the presence or absence of stroke, dementia, disability, or death. Binomial logistic regression was used to estimate the probability of state transition every 3 years based on the survey interval in the CLHLS. The number of disabled individuals was predicted in 2030 using Chinese population data from World Population Prospects 2019 and trends in the incidence and mortality for stroke and dementia as recorded in the CLHLS. A multistate life table was used to predict LED in 2030. ResultsIt is predicted that disability in those aged 65+ years in China will increase from 11.4 million in 2010 to 34.8 million in 2030. Cases associated with stroke and dementia are predicted to increase by 297.9% and 167.8%, respectively, for the 65–79 years age group, and by 402.1% and 247.0%, respectively, for the 80+ year age group. Life expectancy (LE) and LED for 65-year-old individuals are predicted to be 16.1 and 2.2 years in 2030, respectively, with increases of 11.8% and 57.1%, respectively. ConclusionsLED in the elderly is predicted to increase more rapidly than LE from 2010 to 2030, both stroke and dementia increasing the risk of disability.