Decreased Proportion of Dementia-Free Life Expectancy in Hong Kong SAR.

BACKGROUND: Estimations of life expectancies (LE) in health and ill health are important for planning future health care support. This study aimed at quantifying whether an increased LE is accompanied by an increase in the duration of life with dementia (DemLE) in Hong Kong SAR. METHODS: Two parameters from a logistic model were used to fit the overall trend of the weighted prevalence of dementia. Abridged age- and sex-specific life tables and Sullivan's method were used to calculate dementia-free LE (DemFLE) for 1998 and 2013. RESULTS: In 2013, among elderly individuals in Hong Kong aged 65 years, men had lived with dementia for 1.8 years and women for 3.6 years. These values are similar to those for subjects aged ≥85 years, while the proportion of DemLE was much greater at advanced ages. Elderly female individuals tend to experience a greater number of years with dementia than males. CONCLUSION: Our results indicate although LE has increased for all older age groups over time, the increase in DemFLE has not been greater than the gain in LE, suggesting an absolute expansion of the burden of dementia to the community between 1998 and 2013. The results suggest that more caregiving resources and manpower will be needed in the future as the population ages.

The well-being of community-dwelling near-centenarians and centenarians in Hong Kong: a qualitative study.

BACKGROUND: Hong Kong has one of the highest life expectancy rankings in the world. The number of centenarians and near-centenarians has been increasing locally and internationally. The relative growth of this population is a topic of immense importance for population and health policy makers. Living long and living well are two overlapping but distinct research topics. We previously conducted a quantitative study on 153 near-centenarians and centenarians to explore a wide range of biopsychosocial correlates of health and "living long". This paper reports a follow-up qualitative study examining the potential correlates of "living well" among near-centenarians and centenarians in Hong Kong. METHODS: Six cognitively, physically, and psychologically sound community-dwelling elders were purposively recruited from a previous quantitative study. Semi-structured interviews were conducted. RESULTS: Four major themes related to living long and well emerged from the responses of the participants: (a) Positive relations with others, (b) Positive events and happiness, (c) Hope for the future, and (d) Positive life attitude. Specifically, we found that having good interpersonal relationships, possessing a collection of positive life events, and maintaining salutary attitudes towards life are considered as important to psychological well-being by long-lived adults in Hong Kong. Most participants perceived their working life as most important to their life history and retired at very old ages. CONCLUSIONS: These findings also shed light on the relationships between health, work, and old age.

Centenarians Today: New Insights on Selection from the 5-COOP Study.

The number of oldest old grew tremendously over the past few decades. However, recent studies have disclosed that the pace of increase strongly varies among countries. The present study aims to specify the level of mortality selection among the nonagenarians and centenarians living currently in five low mortality countries, Denmark, France, Japan, Switzerland, and Sweden, part of the 5-Country Oldest Old Project (5-COOP). All data come from the Human Mortality Database, except for the number of centenarians living in Japan. We disclosed three levels of mortality selection, a milder level in Japan, a stronger level in Denmark and Sweden and an intermediary level in France and Switzerland. These divergences offer an opportunity to study the existence of a trade-off between the level of mortality selection and the functional health status of the oldest old survivors which will be seized by the 5-COOP project.

Increase in common longevity and the compression of mortality: the case of Japan.

This study shows a strong increase in the modal age at death (M) in Japan over a period of 50 calendar years, accompanied by a clear decrease in the standard deviation of ages at death above M (SD(M+)) until the 1990s for men and the mid-1980s for women. For the most recent periods SD(M+) appears to have stopped decreasing, even though M has continued to increase linearly. This stagnation in SD(M+) has been accompanied by stagnation in q(M). The number of deaths at M (d(M)) and the number of deaths at and above M (d(M+)) have increased, but significantly more slowly since the period 1975-79. Since the 1980s an acceleration in the increase of M+kSD(M+), our indicator of the longest life durations, has been essentially due to the pause in SD(M+). Our data do not suggest that we are approaching an upper limit in human longevity.

Three dimensions of the survival curve: horizontalization, verticalization, and longevity extension.

Three dimensions of the survival curve have been developed: (1) "horizontalization," which corresponds to how long a cohort and how many survivors can live before aging-related deaths significantly decrease the proportion of survivors; (2) "verticalization," which corresponds to how concentrated aging-related ("normal") deaths are around the modal age at death (M); and (3) "longevity extension," which corresponds to how far the highest normal life durations can exceed M. Our study shows that the degree of horizontalization increased relatively less than the degree of verticalization in Hong Kong from 1976 to 2001. After age normalization, the highest normal life durations moved closer to M, implying that the increase in human longevity is meeting some resistance.