捐助機構： Funded by: 計劃夥伴： Project Partners: 1 Cadenza Symposium 2008 - Successful Ageing

1

捐助機構： Funded by:

計劃夥伴：Project Partners:

Cadenza Symposium 2008 Cadenza Symposium 2008 - Successful Ageing- Successful Ageing

2捐助機構：Funded by:

計劃夥伴： Project Partners:

Well-being Indicators: Well-being Indicators: How Does Hong Kong Compare How Does Hong Kong Compare

with Other Countrieswith Other Countries

Patsy Pui-hing CHAUPatsy Pui-hing CHAUResearch Assistant ProfessorResearch Assistant Professor

CADENZA: A Jockey Club Initiative for SeniorsCADENZA: A Jockey Club Initiative for Seniors

11 October 200811 October 2008



Active Ageing Framework

Introduced by World Health Organization (WHO) in 2002

Policy makers & service providers address the health, social, economic & spiritual needs of seniors to facilitate healthy ageing



Well-being Indicators

Adopt a positive outlook along the lines of the active ageing framework

Highlight aspects that contribute to successful & productive ageing such as healthy lifestyle & active social engagement



Well-being Indicators (con’t)

Well-beingWell-being

Social Networking & Engagement

Demographic Profile

Nutrition & Health-related

Lifestyle

Health StatusFunctional

Status



Benchmarking

Compare with economically developed countries in both the East & the West

Reflect how well seniors in Hong Kong are doing with reference to these countries



Data Sources

Surveys or the population censuses conducted by the government officials/departments

Surveys/studies conducted by the universities, individual researchers or non-government agencies

Owing to space limit, citation of these sources is omitted from this presentation; interested parties could refer to our publication for the full list of references (Chau and Woo, 2008)

Reference: Chau PH and Woo J. (2008). How Well Are Seniors in Hong Kong Doing? An International Comparison. Hong Kong: The Hong Kong Jockey Club.



Interpretation of Statistics

Due to the possible differences in conceptualization & compilation methods, the international comparisons presented can only be interpreted in a broad sense



Demographic Profile



Demographic Profile

People age in unique ways, depending on a large variety of factors, including demographic factors

To address different needs of the ageing population, policy-makers & service providers should understand the profile of the senior population



Life ExpectancyCommonly used to quantify the longevity of a population

Figure 1. Life expectancy at birth, 2006

79.4 79.078.0

75.0

85.5 85.8

82.8

80.8

68

70

72

74

76

78

80

82

84

86

88

Hong Kong Japan Singapore U.S.

Lif

e ex

pect

ancy

at b

irth

(in

yea

r)

.

MaleFemale



Health-Adjusted Life Expectancy (HALE)

Figure 2. Health-Adjusted Life Expectancy (HALE) at birth, 2000

70.371.2

66.8

69.6

65.7

68.3

75.776.3

68.9

73.3

68.8

71.4

62

64

66

68

70

72

74

76

78

Hong Kong Japan Singapore Australia U.S. U.K.

HA

LE

at

bir

th (

in y

ear)

.

Male

Female

Describe the life expectancy with an adjustment for time spent in poor health



Mortality

One of the contributing factors to longer life expectancy is the decline in the mortality rates at all ages



Mortality (con’t)

Figure 3. Age-specific mortality for the population aged 85+, 2005

140.0

156.9

145.8 148.9

176.3

110.40 106.70

125.40133.00

155.20

0

20

40

60

80

100

120

140

160

180

200

Hong Kong Japan Australia U.S. U.K. (2004)

Mor

tali

ty r

ate

(per

1,0

00 p

opul

atio

n)

.

Male

Female



Proportion of Seniors

The proportion of seniors is increasing at a faster rate than any other age groups in the population

In 2007, about 11% (about 705 million) of the world's population is aged 60+

By 2050, it is projected that about 22% (2 billion) of the world's population will be aged 60+



Proportion of Seniors (con’t)

Figure 4. Proportion of population aged 65+

12%

21%

8%

13%12%

16%

25%

28%

15%

21%20%

23%

0%

5%

10%

15%

20%

25%

30%


Pro

port

ion

20062030



Summary

The life expectancy at birth of the Hong Kong population is among the highest in the world

While Japan has been facing ageing issues for many years, Hong Kong will soon catch up



Nutrition & Health-related

Lifestyle



Nutrition and Health-related Lifestyle

Healthy diets & regular, adequate physical activity are major factors in the promotion & maintenance of good health, especially in the prevention of chronic diseases

More importantly, diet & physical activity are modifiable factors in the well-being of seniors



Dietary Habits

It is commonly believed that seniors have to avoid consumption of certain high risk food in order to maintain good health

It seems there is a lack of emphasis on encouraging seniors to consume adequate amounts of nutritious food



Removed all the fat from their food when eating: 48%

Dietary Habits of People Aged 65+ in Hong Kong, 2003-2004

Drankmilk at

least oncea day: 27%

Did not eat high fat food or ate high fat food less than once a week: 69%

Ate ≥2 servings of vegetables a

day: 78%

Ate ≥2 servings of fruits a day:

30%

Ate fish at least once a day: 48% Ate meat at

least once a day: 53%



Physical Activity and Exercise

Appropriate amount of physical activity & exercise is important for all ages, including seniors, to maintain good physical & mental health



Proportion of Seniors having Physical Activities and Exercises, 2004

Singapore28% of

people aged 60-69 exercised regularly

Hong Kong73% of people aged60+ reported havingthe habit of doingexercises regularly

Japan38% of people

aged 65+ reported having the habit

of doing exercises regularly

Australia25% of people aged 65+ repo

rted moderate or highexercise levels in the two weeks preceding

the survey

U.S. 22% of people aged 65+ reported engaging in regular leisure time physical activity



Underweight and Overweight

Being underweight (BMI< 18.5 kg/m2) is a reflection of insufficient nutrition & also makes people more vulnerable to diseases because of their weakened immune systems

Being overweight (BMI ≥25 kg/m2) is well-known for its association with a higher risk of disease, especially cardiovascular diseases

For seniors, the risks of being underweight or overweight are equally important



Underweight and Overweight (con’t)

Figure 5. Proportion of underweight and overweight in population aged 65+

9%

3% 1% 1%

47% 48%

71% 72%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Hong Kong (2003-2004) Australia (2004-2005) U.S. (2003-2004) England (2003)

Per

cent

age

UnderweightOverweight



Smoking

Smoking is hazardous to healthFigure 6. Proportion of daily smokers among population aged 60+, 2004

23%

28%

11%

9%

15%

3%

6%7% 7%

14%

0%

5%

10%

15%

20%

25%

30%

Hong Kong Japan Australia U.S. (aged 65+) U.K.

Per

cent

age

MaleFemale



Summary

The consumption of vegetables & avoidance of high fat food followed the recommended pattern fairly well. However, fruit consumption should be encouraged

Most seniors in Hong Kong had a habit of doing exercise regularly

The prevalence of being overweight among seniors in Hong Kong was lower than that of the other countries, whilst the prevalence of being underweight was higher

Hong Kong had a lower prevalence of female smokers than the other countries. However, the prevalence of male smokers was high



Social Networking & Engagement



Social Networking and Engagement

A healthy social life plays an important part in the well-being of individuals

A healthy social life can be sought actively by social participation

Alternatively, social support can be provided by family, friends & other people through day-to-day interactions



Social Participation

Seniors have a number of opportunities to actively participate in various work or activities which enable them to interact with people in the community



Participation in Formal EmploymentFigure 7. Labour force participation rate among population aged 65+, 2006

10%

29%

22%

12%

20%

10%

2%

13%

8%

4%

12% 12%

0%

10%

20%

30%

40%

Hong Kong Japan Singapore Australia U.S. U.K. (after statepension age)

Per

cent

age

MaleFemale



Participation in Voluntary WorksFigure 8. Voluntary works participation rate among population aged 65+

4%

27%

4%

40%

24%

32%

0%

10%

20%

30%

40%

50%

Hong Kong(2001-2002)

Japan (2001) Singapore (2004) Australia (2004) U.S. (2003) England &Wales (2001)

Per

cent

age



Care Provided by the Seniors

Australia (2003)19% of people aged 65+ were carers to older people & people with disabilities

Hong Kong (2000)22% of people aged 60+ took care of other family members

England & Wales (2001)11% of the population aged 65+ provided unpaid care to family members, friends, neighbours or others



Participation in Social Activities

Australia (2006)61% of people aged 65+ actively participated in a social or support group in the 12 months preceding the survey

Hong Kong (2001-2002)63% of people aged 65+ had participated in some kind of social activity during the 3 months preceding the survey

England (2003)65% of people aged 65-74 & 47% of people aged 75+ attended arts activities in the 12 months preceding the survey



Hong Kong (2005)12% of people aged 60-64 participated in continuing education

Lifelong Learning

England & Wales (2002)51% of people aged 60-69 reported some learning

Japan (2001)27% of people aged 60-64 participated in "studies or research"

Australia (2006-2007)20% of people aged 60-64 participated in structured, taught learning in institutions & organizations

U.S. (1999)20% of people aged 66-74 took at least one adult education class in the year preceding the survey



Care and Support

Care & support is important to seniors, regardless of their physical condition & health status

Caregivers not only provide support in instrumental activities & personal care, but also emotional support to seniors



Care and Support (con’t)

Hong Kong (2004)Among people aged 60+ who had caregivers, 37% & 27% had their children & spouse as the major caregivers respectively

Australia (2003)Among people aged 65+ and receiving assistance, 18% received assistance from partners and 26%-29% from children



Oldest Old Support Ratio

As most of the informal caregivers are aged 50-74, recent research suggested using the oldest old support ratio (the ratio of people aged 50-74 to those aged 85+) to provide information on the number of potential carers per person aged 85+



Oldest Old Support Ratio (con’t)

Figure 9. Oldest old support ratios, 2006

18

14

33

1513 13

0

5

10

15

20

25

30

35


Old

est O

ld S

uppo

rt R

atio



Summary

While the participation of seniors in formal employment, voluntary work & lifelong learning was relatively low in Hong Kong, the participation of seniors in care giving & social activities was comparable to other countries

It was common that the informal caregivers to seniors were their spouse & children

According to the oldest old support ratio, Hong Kong has the largest potential in developing informal caregivers when compared with other countries, except Singapore



Functional Status



Functional Status

While functional decline is commonly misbelieved to be an unavoidable part of ageing, it actually can be prevented or slowed down at any age

Given mild levels of disabilities or impairment, seniors are still able to live independently



Seeing and Hearing

During the ageing process, some people might experience deterioration in seeing and/or hearing abilities



Proportion of Seniors with Visual Impairment

Australia (2004-2005)3% of people aged 65+ reported complete or partial blindness

U.K. (2001)28% of people aged 65+ reported difficulties with their eyesight

Hong Kong (2000)6% of people aged 60+ had problems with vision

U.S. (2004)17% of people aged 65+ reported trouble seeing (with or without glasses/contact lenses)



Proportion of Seniors with Hearing Difficulties

Hong Kong (2000)

4% of people aged

60+ had hearing

difficulties

Australia (2004-2005)

33% of people aged

65+ reported complete

or partial

deafness

U.S. (2004)

40% of people aged65+ reported trouble

hearing(without a

hearing aid)

U.K. (2001)

32% of people aged65+ reported difficulties

with their hearing(with or

without ahearing aid)



Activities of Daily Living (ADL)

The ability of seniors to perform daily activities independently is largely affected by the level of functional status

As suggested by the WHO, disability & functioning are outcomes of interaction between health conditions & contextual factors

The basic ADL are widely used to measure the ability of seniors to perform basic daily tasks independently



Proportion of Seniors without any ADL Limitations

Japan (2002)84% of people aged 66+ reported the ability to perform all 6 tasks (bathing, dressing, eating, getting out of bed or up from or sitting down in a chair, going outside & toileting) independently

Hong Kong (2004)94% of people aged 60+ could perform all 6 tasks (transferring between a bed & a chair, mobility, dressing, eating, toileting & bathing) independently



Instrumental Activities of Daily Living (IADL)

While basic ADL focuses on fundamental functioning, IADL focuses on more complicated tasks, such as cooking & communicating, which integrate proper physical & mental functioning



Proportion of Seniors without any IADL Limitations

Hong Kong (2004)79% of people aged 60+ could perform all 7 tasks (meal preparation, ordinary house work, managing finance, managing medications, phone use, shopping & transportation) independently

Singapore (2004)62% of people aged 60+ did not have any limitations in performing all 8 tasks (doing laundry, doing housework, grocery shopping, preparing meals, getting to places outside the house, managing money, taking medications & using a telephone)



Summary

Vision & hearing problems among seniors in Hong Kong might be less prominent than the other countries studied

The proportion of the senior population who could perform ADL & IADL tasks independently appeared to be higher than Japan & Singapore respectively



Health Status



Health Status

Maintaining a good health status is an important component in an active ageing framework

While some conditions are associated with the ageing process, many illnesses & conditions can be largely prevented by living a healthy lifestyle throughout the course of life



Self-rated Health Status

Self-rated health status is a commonly used subjective measure to describe the general health & well-being of an individual

It is a complex combination of many factors, including observed morbidity, health expectations as well as social & cultural context



Self-rated Health Status (con’t)

Figure 10. Proportion of population reported good-to-excellent health

73%

93%

38%

67%

0%

20%

40%

60%

80%

100%

Hong Kong (2005-2006) Australia (2004-2005)

Per

cent

age

Aged 15-24

Aged 65+



Chronic Illnesses

An important effect of chronic diseases is limitation in functional abilities, which in turn affects one's independence & autonomy

Prevention & postponement of chronic illnesses is an essential part of active ageing

In cases where some chronic illnesses are already present, the aim of active ageing is to reduce or minimize the disabilities caused by these illnesses



Chronic Illnesses (con’t)

Figure 11. Prevalence of selected chronic diseases among the seniors

40%

25%

16%

39%

49%

14%

53%

49%

18%

11%

18%

8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Hypertension Arthritis Diabetes

Per

cent

age

Hong Kong (2004, aged 60+)

Australia (2004-2005, aged 65+)U.S. (2006, aged 65+)

U.K. (2003, aged 65+)



Japan (1999)12% of people

aged 65+

Prevalence of Heart Diseases

Hong Kong (2004)11% of people aged 60+

U.K. (2003)15% of people aged 65+ had coronary h

eart disease

U.S. (2006)31% of people aged 65+



Mortality from Common Chronic Illness

Some chronic illnesses & conditions only lead to functional disability, but some might lead to more serious adverse effects or even death



Leading Causes of Death among the Population Aged 65+

Malignant neoplasma

(964/ 100,000 population)

Hong Kong (2006)

Diseases of heart(569/ 100,000population)

Pneumonia(463/ 100,000population)

Cerebrovasculardiseases

(340/ 100,000population)

Malignant neoplasma

(976/ 100,000 population)

Japan (2005)

Diseases of heart(585/ 100,000population)




Malignant neoplasma

(1,056/ 100,000 population)

Australia (2005)

Ischaemic heart disease


Influenza &Pneumonia




Malignant neoplasma

(1,223/ 100,000 population)

U.K. (2004)

Ischaemic heart disease





Malignant neoplasma

(1,056/ 100,000 population)

U.S. (2005)

Diseases of heart(1,443/ 100,000

population)

Pneumonia(146/ 100,000

population)





Depression

There is growing concern over the psychological health status of seniors

Good psychological health is one of the key components in positive ageing

Poor psychological health may be a life-threatening condition



Prevalence of Depression

Hong Kong: 13% (GDS≥8, aged 65+, 2000)

U.K.: 3%(GDS≥8, aged 75+, 1995-1999)

Japan: 30%(GDS≥6, aged 65+, 2002)

U.S.: 15%(CES-D, aged 65+, 2002)

Singapore: 5%(Geriatric Mental State Schedule, aged 60+, 2003-2004)



Summary

Many seniors had a positive view of their health status

Similar to other countries, hypertension was one of the most prevalent chronic illnesses in Hong Kong

Cancer was the leading cause of death among seniors in Hong Kong, Japan, Australia & the United Kingdom

Differences in the prevalence of depression were observed in different countries, which might be due partly to differences in assessment tools & definitions



Conclusion

The seniors in Hong Kong generally live a healthy & active life

The seniors’ well-being in physical, social & economical terms is of a comparable level to other well developed economies

For characteristics that are relatively less favourable in Hong Kong compared to other countries, more effort should be invested to improve the current situation

For characteristics that compare favourably with other countries, they should be maintained & even taken to a higher standard



Celebrate their

Accomplishments and

Discover their

Effervescence and

Never-ending

Zest as they

Age

No matter how well the seniors in Hong Kong are doing at present, our society can always find ways to help

Documents

捐助機構： Funded by: 計劃夥伴： Project Partners: 1 Cadenza Symposium 2008 - Successful Ageing