Skip to main content

Advertisement

SpringerLink
Log in

Characterising Long Term Care Needs among Chinese Older Adults with Cognitive Impairment or ADL Limitations

  • ORIGINAL ARTICLE
  • Published:
Journal of Cross-Cultural Gerontology Aims and scope Submit manuscript

Abstract

This study analyses long-term care needs (LTC) in the context of older adults who face limitations in activities of daily living (ADL) or with cognitive impairment (CI), and thus need aids to fulfil daily activities. Drawing on data from three waves (2002, 2005, 2008/09) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study shows that the older adults aged 65 to 99 with ADL limitation declined over the years from 8% to 5% but those with CI increased from 11% to 17%. Overall, about 16% of the older adults reported LTC needs in the baseline year of 2002, and this subsequently increased to 20% in 2008/09. Results from random-effects parametric survival-time models indicate that social factors such as low income, inadequate medical services, a lack of social support and social activities as well as being spouseless tend to significantly increase the hazard of developing LTC needs for the Chinese older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Afshin, A., Micha, R., Khatibzadeh, S., Fahimi, S., Shi, P., Powles, J., ... Al-Hooti, S. (2015). The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: A comparative risk assessment analysis. BMJ Open, 5(5), 1–16.

    Article  Google Scholar 

  • Arnsberger, P., Fox, P., Zhang, X., & Gui, S. (2000). Population aging and the need for long term care: A comparison of the United States and the People's Republic of China. Journal of Cross-Cultural Gerontology, 15(3), 207–227. https://doi.org/10.1023/a:1006745324079.

    Article  Google Scholar 

  • Cheung, A. K.-L., & Yeung, W.-J. J. (2015). Temporal-spatial patterns of one-person households in China, 1982-2005. Demographic Research, S15(44), 1209–1238.

    Article  Google Scholar 

  • Cheung, K. S. L., Lau, B. H. P., Wong, P. W. C., Leung, A. Y. M., Lou, V. W., Chan, G. M. Y., & Schulz, R. (2015). Multicomponent intervention on enhancing dementia caregiver well-being and reducing behavioral problems among Hong Kong Chinese: A translational study based on REACH II. International Journal of Geriatric Psychiatry, 30(5), 460–469.

    Article  Google Scholar 

  • CLHLS research team. (2000). Weighting method. In the Chinese longitudinal healthy longevity survey project (Ed.), The data book of the 1998 wave of Chinese longitudinal healthy longevity survey Beijing: Peking University Press.

  • Comas-Herrera, A., Wittenberg, R., Pickard, L., & Knapp, M. (2007). Cognitive impairment in older people: Future demand for long-term care services and the associated costs. International Journal of Geriatric Psychiatry, 22(10), 1037–1045. https://doi.org/10.1002/gps.1830.

    Article  Google Scholar 

  • Dai, B., Mao, Z., Mei, J., Levkoff, S., Wang, H., Pacheco, M., & Wu, B. (2013). Caregivers in China: Knowledge of mild cognitive impairment. PLoS One, 8(1), e53928. https://doi.org/10.1371/journal.pone.0053928.

    Article  Google Scholar 

  • De la Maisonneuve, C., & Martins, J. O. (2015). The future of health and long-term care spending. OECD Journal: Economic Studies, 2014(1), 61–96.

    Google Scholar 

  • Du, P. (2015). Long-term care for older persons in China. Paper presented at the SDD-SPPS Project Working Papers Series: Long-term Care for Older Persons in Asia and the Pacific, Bangkok, Thailand.

  • Faraco, G., & Iadecola, C. (2013). Hypertension a harbinger of stroke and dementia. Hypertension, 62(5), 810–817.

    Article  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

    Article  Google Scholar 

  • Francesca, C., Ana, L.-N., Jérôme, M., & Frits, T. (2011). OECD health policy studies help wanted? Providing and paying for long-term care (Vol. 2011): OECD Publishing.

  • Gu, D. (2008). General data quality assessment of the CLHLS. In D. L. P. Y. Zeng, D. A. Vlosky, & D. Gu (Eds.), Healthy longevity in China: Demographic, socioeconomic, and psychological dimensions (pp. 39–59). Dordrecht: Springer.

    Chapter  Google Scholar 

  • Gu, D., & Vlosky, D. A. (2008). Long-term care needs and related issues in China. In J. B. Garner & T. C. Christiansen (Eds.), Social sciences in health care and medicine (pp. 52–84). New York: Nova Science.

    Google Scholar 

  • Handels, R. L., Wolfs, C. A., Aalten, P., Verhey, F. R., & Severens, J. L. (2013). Determinants of care costs of patients with dementia or cognitive impairment. Alzheimer Disease & Associated Disorders, 27(1), 30–36.

    Article  Google Scholar 

  • Hayashi, R. (2015). Long-term Care of Older Persons in Japan. Paper presented at the SDD-SPPS project working papers series: Long-term Care for Older Persons in Asia and the Pacific, Bangkok, Thailand.

  • Hu, H., Li, Y., & Lan, Z. (2015). Estimation and prediction of demand of Chinese elderly long-term care service. Chinese Journal of Population Science, 03, 79–89.

    Google Scholar 

  • Ivey, S. L., Laditka, S. B., Price, A. E., Tseng, W., Beard, R. L., Liu, R., ... Logsdon, R. G. (2013). Experiences and concerns of family caregivers providing support to people with dementia: A cross-cultural perspective. Dementia, 12(6), 806–820. https://doi.org/10.1177/1471301212446872.

    Article  Google Scholar 

  • Lei, P., Feng, Z., & Wu, Z. (2016). The availability and affordability of long-term care for disabled older people in China: The issues related to inequalities in social security benefits. Archives of Gerontology and Geriatrics, 67, 21–27. https://doi.org/10.1016/j.archger.2016.06.018.

    Article  Google Scholar 

  • Leung, A. Y. M., Kwan, C. W., & Chi, I. (2013). Residents with Alzheimer's disease in long-term care facilities in Hong Kong: Patterns of hospitalization and emergency room use. Aging & Mental Health, 17(8), 959–965. https://doi.org/10.1080/13607863.2013.768211.

    Article  Google Scholar 

  • Li, M., Zhang, Y., Zhang, Z., Zhang, Y., Zhou, L., & Chen, K. (2013). Rural-urban differences in the long-term Care of the Disabled Elderly in China. PLoS One, 8, 11. https://doi.org/10.1371/journal.pone.0079955.

    Article  Google Scholar 

  • National Bureau of Statistics of China. (2019). Statistical Communiqué of the People’s Republic of China on the 2018 National Economic and social development. From http://www.stats.gov.cn/english/PressRelease/201902/t20190228_1651335.html. Accessed 11 Aug 2019.

  • Peh, K. C., Ng, W. C., & Low, D. (2015). Long-term Care of Older Persons in Singapore. Paper presented at the SDD-SPPS project working papers series: Long-term Care for Older Persons in Asia and the Pacific, Bangkok, Thailand.

  • Peng, R., Ling, L., & He, Q. (2010). Self-rated health status transition and long-term care need, of the oldest Chinese. Health Policy, 97(2), 259–266. https://doi.org/10.1016/j.healthpol.2010.05.009.

    Article  Google Scholar 

  • Peng, R., Wu, B., & Ling, L. (2015). Undermet needs for assistance in personal activities of daily living among community-dwelling oldest old in China from 2005 to 2008. Research on Aging, 37(2), 148–170. https://doi.org/10.1177/0164027514524257.

    Article  Google Scholar 

  • Penning, M. J., Cloutier, D. S., Nuernberger, K., MacDonald, S. W. S., & Taylor, D. (2016). Long-term care trajectories in Canadian context: Patterns and predictors of publicly funded care. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. https://doi.org/10.1093/geronb/gbw104.

  • Phillips, D. R., Chan, A. C. M., Ong, F. S., & Mehta, K. (2002). Ageing and long-term care: National policies in the Asia-Pacific. Singapore: ISEAS.

    Book  Google Scholar 

  • Research Group of Healthy Longevity in China. (2000). Data collection of the Healthy Longevity Survey in China 1998 (S. Peng Ed. 1 ed.). Beijing: Peking University Press.

  • Rosenmayr, L. (1968). Family relations of the elderly. Journal of Marriage and Family, 30(4), 672–680. https://doi.org/10.2307/349516.

    Article  Google Scholar 

  • Shanas, E. (1979). The family as a social support system in old age. The Gerontologist, 19, 169–174.

    Article  Google Scholar 

  • Smith, J. P., Strauss, J., & Zhao, Y. (2014). Healthy aging in China. The Journal of the Economics of Ageing, 4, 37–43. https://doi.org/10.1016/j.jeoa.2014.08.006.

    Article  Google Scholar 

  • Somanathan, A., Moroz, H., Miake, N., Glinskaya, E., Wiener, J., Feng, Z., & Zheng, N. T. (2016). Chapter 7 long-term Care in Aging East Asia and Pacific. In W. Bank (Ed.), Live long and prosper: Aging in East Asia and the Pacific. Washington: The World Bank Group.

    Google Scholar 

  • Stone, R., Cafferata, G. L., & Sangl, J. (1987). Caregivers of the frail elderly: A National Profile. The Gerontologist, 27(5), 616–626. https://doi.org/10.1093/geront/27.5.616.

    Article  Google Scholar 

  • Swartz, K., Miake, N., & Farag, N. (2012). Long-term care: Common issues and unknowns. Journal of Policy Analysis and Management, 31(1), 139–152. https://doi.org/10.1002/pam.20629.

    Article  Google Scholar 

  • The State Council, T. P. s. R. o. C. (2017). State council on the issuance of "thirteen five" aging development and the National Endowment construction planning system. Beijing: The State Council, The People's Republic of China.

  • Williams, S. W., Zimmerman, S., & Williams, C. S. (2012). Family caregiver involvement for long-term care residents at the end of life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 67(5), 595–604. https://doi.org/10.1093/geronb/gbs065.

    Article  Google Scholar 

  • Wong, Y. C., & Leung, J. (2012). Long-term Care in China: Issues and prospects. Journal of Gerontological Social Work, 55(7), 570–586. https://doi.org/10.1080/01634372.2011.650319.

    Article  Google Scholar 

  • World Bank. (2018). Population ages 65 and above (% of total), Japan. From https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS. Accessed 11 Aug 2019.

  • Wu, B. (2012). A part of social construction, developing a long-term care system for an aging society. China Academy of Social Science Review, A06, 1–2.

    Google Scholar 

  • Wu, B., & Xu, Q. (2007). Community-based long-term Care in Urban Setting. Population Research, 31(3), 61–70.

    Google Scholar 

  • Wu, B., Carter, M. W., Goins, R. T., & Cheng, C. (2005). Emerging Services for Community-Based Long-Term Care in urban China. Journal of Aging & Social Policy, 17(4), 37–60. https://doi.org/10.1300/J031v17n04_03.

    Article  Google Scholar 

  • Wu, B., Mao, Z.-F., & Zhong, R. (2009). Long-term care arrangements in rural China: Review of recent developments. Journal of the American Medical Directors Association, 10(7), 472–477.

    Article  Google Scholar 

  • Wu, Y.-T., Lee, H.-y., Norton, S., Chen, C., Chen, H., He, C., et al. (2013). Prevalence studies of dementia in mainland China, Hong Kong and Taiwan: A systematic review and meta-analysis. PLoS One, 8(6), e66252.

    Article  Google Scholar 

  • Yang, Y., Yeung, W.-J. J., & Feng, Q. (2018). Social exclusion and cognitive impairment-a triple jeopardy for Chinese rural elderly women. Health & Place, 53, 117–127. https://doi.org/10.1016/j.healthplace.2018.07.013.

    Article  Google Scholar 

  • Zeng, Y., & Hesketh, T. (2016). The effects of China's universal two-child policy. The Lancet, 388(10054), 1930–1938. https://doi.org/10.1016/S0140-6736(16)31405-2.

    Article  Google Scholar 

  • Zeng, Y., & Wang, Z. (2014). A policy analysis on challenges and opportunities of population/household aging in China. Journal of Population Ageing, 7(4), 255–281. https://doi.org/10.1007/s12062-014-9102-y.

    Article  Google Scholar 

  • Zeng, Y., Vaupel, J. W., Xiao, Z., Zhang, C., & Liu, Y. (2001). The healthy longevity survey and the active life expectancy of the oldest old in China. Population: an English selection, 95–116.

  • Zeng, Y., Chen, H., & Wang, Z. (2014). Analysis on trends of future home-based care needs and costs for elderly in China. Economic Research Journal, 10, 134–149.

    Google Scholar 

  • Zeng, Y., Chen, H., Wang, Z., & Land, K. C. (2015). Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China. Journal of Aging and Health, 27(3), 519–550. https://doi.org/10.1177/0898264314552690.

    Article  Google Scholar 

  • Zhan, H. J., Feng, Z., Chen, Z., & Feng, X. (2011). The role of the family in institutional long-term care: Cultural management of filial piety in China. International Journal of Social Welfare, 20(s1), S121–S134. https://doi.org/10.1111/j.1468-2397.2011.00808.x.

    Article  Google Scholar 

  • Zhen, Z., Feng, Q., & Gu, D. (2015). The impacts of unmet needs for long-term care on mortality among older adults in China. Journal of Disability Policy Studies, 25(4), 243–251.

    Article  Google Scholar 

Download references

Acknowledgements

Most of the work in this paper was done at the Asia Research Institute (ARI), National University of Singapore. The author would like to acknowledge ARI for its support. This study has also benefited from the comments by Professor Jean Yeung (National University of Singapore) and Professor Zhenzhen Zheng (The Chinese Academy of Social Sciences). Data used for this research was provided by the study entitled “Chinese Longitudinal Healthy Longevity Survey” (CLHLS) managed by the Center for Healthy Aging and Development Studies, Peking University. CLHLS is supported by funds from the U.S. National Institutes on Aging (NIA), China Natural Science Foundation, China Social Science Foundation, and UNFPA.

Author information

Authors and Affiliations

  1. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Yi Yang

Authors
  1. Yi Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yi Yang.

Ethics declarations

Conflict of Interest

The author declares that I have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, Y. Characterising Long Term Care Needs among Chinese Older Adults with Cognitive Impairment or ADL Limitations. J Cross Cult Gerontol 35, 35–47 (2020). https://doi.org/10.1007/s10823-019-09382-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10823-019-09382-8

Keywords

Search

Navigation