Projection of ADL-Based Disability among Older Singaporeans: Comparing Numbers Based on Prevalence and on Incidence with and without Educational Attainment

John P. Ansah, Duke-NUS Graduate Medical School Singapore
Rahul Malhotra, Duke-NUS Graduate Medical School Singapore
David Matchar, Duke-NUS Graduate Medical School Singapore
Mary Ann Bautista, Duke-NUS Graduate Medical School Singapore

This study projects the number and severity of ADL-based disability among elderly Singaporeans, comparing the prevalence and incidence with and without educational attainment. The prevalence of moderate and severe disability by age and gender was estimated from the Social Isolation, Health and Lifestyle Survey, a nationally representative survey of community-dwelling Singaporeans aged >=60 years. Transition and mortality rates by age, gender and educational attainment (low: primary or less; high: secondary or more) were estimated using data from the SIHLS and its follow-up study (Panel on Health and Aging of Singaporean Elderly). The prevalence-based projection predicted the number of elderly with disability to increase almost fourfold between 2010 and 2040. Corresponding incidence and incidence with educational attainment projections were 25 and 34 percent fewer than the prevalence projection. Severity-wise, the prevalence and incidence projections predicted more elderly with severe disability (60%); incidence with education predicted more elderly with moderate disability (60%).