Projecting the Number of Elderly with Cognitive Impairment in China Using a Multi-State Dynamic Population Model

Abstract

China is aging rapidly, and the number of Chinese elderly with dementia is expected to rise. This paper projects, up to year 2060, the number of Chinese elderly within four distinct cognitive states. A multi-state population model was developed using system dynamics and parametrized with age–gender-specific transition rates (between intact, mild, moderate and severe cognitive impairment and death) estimated from two waves (2012 and 2014) of a community-based cohort of elderly in China aged ≥65 years (N = 1824). Probabilistic sensitivity analysis and the bootstrap method was used to obtain the 95% confidence interval of the transition rates. The number of elderly with any degree of cognitive impairment increases; with severe cognitive impairment increasing the most, at 698%. Among elderly with cognitive impairment, the proportion of very old elderly (age ≥ 80) is expected to rise from 53% to 78% by 2060. This will affect the demand for social and health services China. Copyright © 2017 System Dynamics Society.