Situation of the Thai Elderly(Health situations)

Life expectancy at birth (e0) at 60 years (e60) and at 80 years (e80)

Advances in medicines have resulted in falling trend in mortality across all segments of the population. The life expectancy at birth (e0) or the average number of years an infant is expected to live, according to the United Nations’ World Population Prospects: The 2012 Revision, will have increased from approximately 78 years in 2010 to 82 in 2040 for female infants, and 71 to 77 for male infants (Figure1.3)

Mortality also declines among the elderly population, resulting in a longer life.Their average number of living years at age 60 (life expectancy at 60 years) and at age 80 (life expectancy at 80 years) continues to increase. The life expectancy at 60 years for female will grow from 23 in 2010 to 26 years in 2040; and the life expectancy at 80 years from 9 to 10. For the male elderly, the life expectancy at 60 years and the life expectancy at 80 years will grow from 20 to 23 years and 8 to 9 years respectively during the same period.

A comparison by gender reveals that female has a longer life expectancy at 60 years and 80 years than male. However, the gender-based disparity seems to diminish with age (Figure1.3).

Self-perceived health status in the elderly population
Self-perceived health status is one of the indices widely used to provide overall health status of the elderly. Figure 1.4 reveals the number of population aged over 60 who rate themselves as having good or excellent health in 2007 and 2011, classified by age group, gender, and residential area. It is found that the percentage of self-perceived good or excellent health status decreases both in the urban and rural settings. Moreover, the percentage of positive self-assessed health varies across age and gender, with a higher proportion of early-elderly compared with late-elderly as well as male compared with female elderly.

Figure1.1 reveals the percentage of self-rated good health, classified by province in 2011. Interestingly, over 60 percent of the elderly in Chumphon and Ranong provinces self-rated their health as good or excellent, exceeding the country average.

Health issues in the elderly population

One of the most common age-related health issues affecting everyday life of the elderly is vision impairment, which can cause accidents and falls. In 2011, 47.4 percent of the elderly are reported to suffer from eye issues. The number increases slightly from 2007. Severity of conditions seems to intensify with age. Vision impairment is found more commonly in women than men and in those living in the urban than rural areas.

Hearing impairment in the elderly is also common. In 2011, 15 percent of the elderly suffers from hearing issues, similar to the previous year survey. Hearing conditions also deteriorate with age, with more women than men and those living in the rural than urban areas suffering from hearing deficiency problem.

Falls can have a serious effect on the elderly and are a significant cause of immobility. Falls may be caused by the elder’s poor general physical conditions and deteriorating compensatory mechanisms, or by the indoor and outdoor environment. The Surveys of Older Persons in Thailand in 2007 and 2011 (Table1.2) reveal that cases of fall in the elderly drop slightly from 10.3 to 8.6 percent. The risk of falling increases with age, and is greater for women than for men, as well as for those in the urban than rural areas. However, falls seem to decrease across all age groups, especially female elderly, according to a comparison between the 2007 and 2011 surveys.

Despite the positive trend, fall prevention should be planned, for example, by improving safety inside and outside the home of older persons.

Bowel incontinence is another health issue which has been increasing among the elderly population, especially the late-elderly, female elderly, and rural living elderly (Table1.2).

Mental health of the elderly population
Mental health is another important aspect of elderly health status. As part of the Survey of Elderly in Thailand in 2011, a 15-item mental health test has been conducted. Each item scored between 0-3 points. The average scores for the Thai elderly stood at 32.0 points, which was within the average range for Thais (Standardized mean scores ranged between 27.0 and 34.0). The results showed that male elderly scored higher than female (scoring 32.5 and 31.6 respectively). When considering the scores by age group, the early-elderly scored higher than those in the mid- and late-elderly groups (scoring 32.2, 31.7, and 31.7 respectively) (Figure1.5).

Happiness Index
A poll conducted on the elderly respondents during the past 3 months reveals that in 2011 the elderly Happiness Index averages at 7.4 points from the 10-point scale  Figure1.6). The Happiness Index tends to decrease slightly with age. The survey clearly shows that the late-elderly (aged 80 and over) in the rural areas tend to be least happy, compared with other elderly groups.