Projecting prevalence of frailty and dementia and the economic cost of care in Japan from 2016 to 2043: a microsimulation modelling study
Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation...
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| Vydáno v: | The Lancet. Public health Ročník 7; číslo 5; s. e458 - e468 |
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| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
Elsevier Ltd
01.05.2022
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| ISSN: | 2468-2667, 2468-2667 |
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| Abstract | Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size.
In this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016–43 in the population of Japan aged 60 years and older.
Between 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country.
Japan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap.
Japan Society for the Promotion of Science, Hitachi – the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing. |
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| AbstractList | Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size.
In this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016–43 in the population of Japan aged 60 years and older.
Between 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country.
Japan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap.
Japan Society for the Promotion of Science, Hitachi – the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing. SummaryBackgroundDementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size. MethodsIn this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016–43 in the population of Japan aged 60 years and older. FindingsBetween 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country. InterpretationJapan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap. FundingJapan Society for the Promotion of Science, Hitachi – the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing. Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size.BACKGROUNDDementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size.In this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016-43 in the population of Japan aged 60 years and older.METHODSIn this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016-43 in the population of Japan aged 60 years and older.Between 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country.FINDINGSBetween 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country.Japan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap.INTERPRETATIONJapan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap.Japan Society for the Promotion of Science, Hitachi - the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing.FUNDINGJapan Society for the Promotion of Science, Hitachi - the University of Tokyo Laboratory for a sustainable society, and the National Institute of Ageing. |
| Author | Iijima, Katsuya Kitsuregawa, Masaru Bhattacharya, Jay Kasajima, Megumi Kusaka, Shoki Matsui, Hiroki Goda, Kazuo Eggleston, Karen Son, Bo-Kyung Hashimoto, Hideki Tanaka, Tomoki |
| Author_xml | – sequence: 1 givenname: Megumi surname: Kasajima fullname: Kasajima, Megumi organization: School of Public Health, University of Tokyo, Tokyo, Japan – sequence: 2 givenname: Karen surname: Eggleston fullname: Eggleston, Karen organization: Walter H Shorenstein Asia-Pacific Research Center, Freeman Spogli Institute for International Studies, Stanford University, CA, USA – sequence: 3 givenname: Shoki surname: Kusaka fullname: Kusaka, Shoki organization: Graduate School of Economics, University of Tokyo, Tokyo, Japan – sequence: 4 givenname: Hiroki surname: Matsui fullname: Matsui, Hiroki organization: School of Public Health, University of Tokyo, Tokyo, Japan – sequence: 5 givenname: Tomoki surname: Tanaka fullname: Tanaka, Tomoki organization: Institute of Gerontology, University of Tokyo, Tokyo, Japan – sequence: 6 givenname: Bo-Kyung surname: Son fullname: Son, Bo-Kyung organization: Institute of Gerontology, University of Tokyo, Tokyo, Japan – sequence: 7 givenname: Katsuya surname: Iijima fullname: Iijima, Katsuya organization: Institute of Gerontology, University of Tokyo, Tokyo, Japan – sequence: 8 givenname: Kazuo surname: Goda fullname: Goda, Kazuo organization: Institute of Industrial Science, University of Tokyo, Tokyo, Japan – sequence: 9 givenname: Masaru surname: Kitsuregawa fullname: Kitsuregawa, Masaru organization: Institute of Industrial Science, University of Tokyo, Tokyo, Japan – sequence: 10 givenname: Jay surname: Bhattacharya fullname: Bhattacharya, Jay organization: Center for Primary Care and Outcomes Research, Stanford School of Medicine, CA, USA – sequence: 11 givenname: Hideki surname: Hashimoto fullname: Hashimoto, Hideki email: hidehashim@m.u-tokyo.ac.jp organization: School of Public Health, University of Tokyo, Tokyo, Japan |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 MKa contributed to the study design, model building, and data analysis; interpreted the data; and drafted and revised the manuscript. SK and HM analysed the data for the cost analysis. TT, B-KS, and KI contributed to the acquisition of community-based functional measurement data and related data analysis, and revised the manuscript. KG and MKi contributed to the construction of a high-specification computer simulation environment for dynamic microsimulation. KE and JB contributed to model building and critically revised the manuscript. HH contributed to the study design and data acquisition, reviewed the literature, interpreted the data, and drafted and critically revised the manuscript. MKa and HH accessed and verified the data used in the study, and all authors had access to the verified data. Contributors |
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| SubjectTerms | Aged Aging Dementia - epidemiology Female Frailty - epidemiology Humans Internal Medicine Japan - epidemiology Male Middle Aged Prevalence Public Health |
| Title | Projecting prevalence of frailty and dementia and the economic cost of care in Japan from 2016 to 2043: a microsimulation modelling study |
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