40-Year Projections of Disability and Social Isolation of Older Adults for Long-Range Policy Planning in Singapore

Against a rapidly aging population, projections are done to size up the demand for long-term care (LTC) services for long-range policy planning. These projections are typically focused on functional factors such as disability. Recent studies indicate the importance of social factors, for example, socially isolated seniors living alone are more likely to be institutionalized, resulting in higher demand for LTC services. This is one the first known studies to complete a 40-year projection of LTC demand based on disability and social isolation. The primary micro dataset was the Retirement and Health Survey, Singapore's first nationally representative longitudinal study of noninstitutionalized older adults aged 45 to 85 with over 15,000 respondents. Disability prevalence across the mild to severe spectrum is projected to increase five-fold over the next 40 years, and the number of socially isolated elders living alone is projected to grow four-fold. Regression models of living arrangements revealed interesting ethnic differences: Malay elders are 2.6 times less likely to live alone than their Chinese counterparts, controlling for marital status, age, and housing type. These projections provide a glimpse of the growing demand for LTC services for a rapidly aging Singapore and underscore the need to shore up community-based resources to enable seniors to age-in-place.