Objective: To examine changes in the prevalence of mobility limitations and mobile life expectancy of Singaporeans aged 55+. Method: Data came from the cross-sectional 1995 and 2005 National Survey of Senior Citizens (NSSC; n = 4,750 and n = 4,591, respectively). The prevalence-based Sullivan method was used to disaggregate total life expectancy into expected life time without and with mobility limitations. Results: Increases in life expectancy in the city-state were accompanied by increases in the prevalence of mobility limitations—from 3.0% to 5.7% for men and 5.1% to 9.7% for women. The impairments mostly began after age 65 and increased with age particularly at ages 85+. The proportion of life expectancy without mobility limitations declined over time, at all ages, and for both genders, with women still experiencing a higher proportion with mobility problems compared to men. Discussion: The overall results provided support for the expansion of morbidity hypothesis, and we discussed some possible reasons. From a policy perspective, the findings could suggest a need to develop infrastructures that would enable older Singaporeans to remain mobile in a highly urban setting.
Ahacic, A., Parker, M.G., & Thorslund, M. ( 2000). Mobility limitations in the Swedish population from 1968 to 1992: Age, gender and social class differences. Aging, 12, 190-198.
2.
Ahacic, A., Parker, M.G., & Thorslund, M. ( 2003). Mobility limitations 1974-1991: Period changes explaining improvement in the population. Social Science & Medicine , 57, 2411-2422.
3.
Avlund, K., Davidsen, M., & Schultz-Larsen, K. (1995). Changes in functional ability from ages 70 to 75: A Danish longitudinal study. Journal of Aging and Health, 7, 254-282.
4.
Chan, A., & Jatrana, S. ( 2007). Gender differences in health among older Singaporeans . International Sociology, 22, 463.
5.
Chan, K.M., Pang, W.S., Ee, C.H., Ding, Y.Y., & Choo, P. ( 1999). Functional status of the elderly in Singapore . Singapore Medical Journal, 40, 635-638.
6.
Crimmins, E.M. ( 1996). Mixed trends in population health among older adults . Journals of Gerontology, 51B(5), S223.
7.
Crimmins, E.M., Saito, Y., & Ingegneri, D. ( 1989). Changes in life expectancy and disability-free expectancy in the United States. Population and Development Review, 15, 235-267.
8.
Crimmins, E.M., Saito, Y., & Ingegneri, D. ( 1997). Trends in disability-free life expectancy in the United States, 1970-90. Population and Development Review , 23, 555-572.
9.
Department of Statistics Singapore. (2008). Population Trends 2008. Singapore: Author.
10.
Freedman, V.A., Crimmins, E.M., Schoeni, R.F., Spillman, B.C., Aykan, H., Kramarow, E., et al. (2004). Resolving inconsistencies in trends in old-age disability: Report from a technical working group. Demography, 41, 417-441.
11.
Freedman, V.A., Martin, L.G., & Schoeni, R.F. ( 2002). Recent trends in disability and functioning among older adults in the United States: A systematic review. Journal of the American Medical Association, 288, 3137-3146.
12.
Fries, J. ( 1980). Aging, natural death, and the compression of morbidity . New England Journal of Medicine, 303, 130-135.
13.
Fries, J. ( 1989). The compression of morbidity: Near or far? Milbank Quarterly, 67, 208-232.
14.
Gill, T.M., Allore, H.G., Hardy, S.E., & Guo, Z. ( 2006). The dynamic nature of mobility disability in older persons . Journal of the American Geriatrics Society, 54, 248-254.
15.
Gruenberg, E.M. ( 1977). The failure of success. Milbank Memorial Fund Quarterly/Health and Society , 55, 3-24.
16.
Guralnik, J., Ferrucci, L., Pieper, C., Leveille, S., Markides, K., Ostir, G., et al. (2000). Lower extremity function and subsequent disability consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. Journals of Gerontology Series A: Biological and Medical Sciences , 55, 221-231.
17.
Hermalin, A.I. ( 2002). The well-being of the elderly in Asia: A four-country comparative study. Ann Arbor: University of Michigan Press.
18.
Hidajat, M.M., Hayward, M.D., & Saito, Y. ( 2007). Indonesia’s social capacity for population health: The educational gap in active life expectancy. Population Research and Policy Review, 26, 219-234.
19.
Hirvensalo, M., Rantanen, T., & Heikkinen, E. ( 2000). Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population . Journal of the American Geriatrics Society, 48, 493-498.
20.
Iezzoni, L.I., McCarthy, E.P., Davis, R.B., & Siebens, H. ( 2000). Mobility problems and perceptions of disability by self-respondents and proxy respondents. Medical Care, 38, 1051.
21.
Jagger, C., Cox, B., Le Roy, S., & Ehemu. ( 2006, September). Health expectancy calculation by the Sullivan method (3rd ed.). EHEMU Technical Report.
22.
Jette, A.M., Assmann, S.F., Rooks, D., Harris, B.A., & Crawford, S. ( 1998). Interrelationships among disablement concepts . Journals of Gerontology Series A: Biological and Medical Sciences, 53, 395-404.
23.
Johnson, R.J., & Wolinsky, F.D. (1993). The structure of health status among older adults: Disease, disability, functional limitation, and perceived health. Journal of Health and Social Behavior, 34(2), 105-121.
24.
Kramer, M. ( 1980). The rising pandemic of mental disorders and associated chronic diseases and disabilities. Acta Psychiatrica Scandinavica , 62, 382-397.
25.
Kua, E.-H. ( 1991). The functional status of elderly Chinese 75 years and older. Singapore Medical Journal, 32, 221-224.
26.
Lawrence, R.H., & Jette, A.M. ( 1996). Disentangling the disablement process. Journals of Gerontology Series B: Psychological Sciences and Social Sciences , 51, 173-182.
27.
Lee, K.S., & Tan, T.C. ( 1997). Functional status of the elderly in Singapore: The trend over a decade. Annals of the Academy of Medicine Singapore , 26, 727-730.
28.
Liu, J., Chen, G., Song, X., Chi, I., & Zheng, X. ( 2009). Trends in disability-free life expectancy among Chinese older adults. Journal of Aging and Health, 21, 266-285.
29.
Lyyra, T.M., Leskinen, E., & Heikkinen, E. ( 2005). A cohort study found good respiratory, sensory and motor functions decreased mortality risk in older people. Journal of Clinical Epidemiology, 58, 509-516.
30.
Manton, K. ( 1982). Changing concepts of morbidity and mortality in the elderly population. Milbank Memorial Fund Quarterly/Health and Society, 60, 183-244.
31.
Mathers, C. ( 1991). Health expectancies in Australia 1981 and 1988 . Canberra: Australian Government Printing Service.
32.
Melzer, D., & Parahyba, M. ( 2004). Socio-demographic correlates of mobility disability in older Brazilians: Results of the first national survey. Age and Ageing, 33, 253-259.
33.
Ministry of Community Development, Youth and Sports Singapore. (1996). The National Survey of Senior Citizens in Singapore 1995. Singapore: Author .
34.
Ministry of Community Development, Youth and Sports Singapore. (2006). The National Survey of Senior Citizens in Singapore 2005. Singapore: Author .
35.
Netuveli, G., Wiggins, R.D., Hildon, Z., Montgomery, S.M., & Blane, D. ( 2006). Quality of life at older ages: Evidence from the English longitudinal study of aging (Wave 1). Journal of Epidemiology and Community Health, 60, 357.
36.
Ng, T.-P., Niti, M., Chiam, P.-C., & Kua, E.-H. (2006). Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54(1), 21-29.
37.
Parker, M.G., Ahacic, K., & Thorslund, M. ( 2005). Health changes among Swedish oldest old: Prevalence rates from 1992 and 2002 show increasing health problems. Journals of Gerontology Series A: Biological and Medical Sciences, 60, 1351-1355.
38.
Parker, M.G., & Thorslund, M. ( 2007). Health trends in the elderly population: Getting better and getting worse. The Gerontologist, 47, 150.
39.
Persson, G., Danielsson, M., Rosén, M., Alexanderson, K., Lundberg, O., Lundgren, B., et al. (2006). Health in Sweden: The national public health report 2005. Scandinavian Journal of Public Health, 34, 3-10.
40.
Robine, J. M., & Mathers, C. D. (Eds.). (1993). Measuring the compression or expansion of morbidity through changes in health expectancy . In J.-M. Robine, C. D. Mathers, M. Bone , & I. Romieu (Eds.), Calculation of health expectancies: Harmonization, consensus achieved and future perspectives (Vol. 226, pp. 269-286). Montrouge, France: John Libbey Eurotext.
41.
Rogers, A., Rogers, R.G., & Belanger, A. ( 1990). Longer life but worse health? Measurement and dynamics . The Gerontologist, 30, 640-649.
42.
Rubenstein, L.Z., Powers, C.M., & MacLean, C.H. ( 2001). Quality indicators for the management and prevention of falls and mobility problems in vulnerable elders. Annals of Internal Medicine, 135(8,Part2), 686-693.
43.
Saito, Y. ( 2001). Kenko Jotai Betsu Yomyo No Nenji Suii: 1992 Nen, 1995 Nen, 1998 Nen (Changes in health expectancy in Japan: 1992, 1995, and 1998) . Jinko Mondai Kenkyu [Journal of Population Problems] , 57, 31-50. [in Japanese]
44.
Shumway-Cook, A., Ciol, M.A., Yorkston, K.M., Hoffman, J.M., & Chan, L. ( 2005). Mobility limitations in the Medicare population: Prevalence and sociodemographic and clinical correlates. Journal of the American Geriatrics Society, 53, 1217-1221.
45.
Shumway-Cook, A., Patla, A., Stewart, A.L., Ferrucci, L., Ciol, M.A., & Guralnik, J.M. (2005). Assessing environmentally determined mobility disability: Self-report versus observed community mobility . Journal of the American Geriatrics Society, 53, 700-704.
46.
Spillman, B.C. ( 2004). Changes in elderly disability rates and the implications for health care utilization and cost. Milbank Quarterly, 82, 157-194.
47.
Stuck, A.E., Walthert, J.M., Nikolaus, T., Büla, C.J., Hohmann, C., & Beck, J.C. ( 1999). Risk factors for functional status decline in community-living elderly people: A systematic literature review. Social Science and Medicine, 48, 445-469.
48.
Sulander, T.T., Rahkonen, O.J., & Uutela, A.K. ( 2003). Functional ability in the elderly Finnish population: Time period differences and associations, 1985-99. Scandinavian Journal of Public Health, 31(2), 100.
49.
Sullivan, D.F. ( 1971). A single index of mortality and morbidity. HSMHA Health Report, 86, 347-354.
50.
United Nations. (2007). World Economic and Social Survey 2007: Development in an ageing world. New York: Author.
51.
von Bonsdorff, M., Rantanen, T., Laukkanen, P., Suutama, T., & Heikkinen, E. ( 2006). Mobility limitations and cognitive deficits as predictors of institutionalization among community-dwelling older people. Gerontology, 52, 359-365.
52.
Zimmer, Z., & Chappell, N.L. (1994). Mobility restriction and the use of devices among seniors. Journal of Aging and Health , 6, 185-208.
