Trends in Disability in a Super-Aging Society: Adapting the Future Elderly Model to Japan

Japan has experienced pronounced population aging, and now has the highest proportion of elderly adults in the world. Yet few projections of Japan’s future demography go beyond estimating population by age and sex to forecast the complex evolution of the health and functioning of the future elderly. This study adapts to the Japanese population the Future Elderly Model (FEM), a demographic and economic Markov microsimulation model that projects the health conditions and functional status of Japan’s elderly population in order to estimate disability, health, and need for long term care. We develop the model based on the recently released multiple waves of the Japan Study of Aging and Retirement (JSTAR) survey, the Japanese version of the Health and Retirement Study-like family of internationally comparable surveys. Using detailed data on a panel of Japanese aged 50-75 starting in 2007, we tailor the health transition matrix of the FEM model to the Japanese context, estimate conditional mortality probabilities consistent with Japanese national vital statistics, and use a state-transition Markov model to project trends in the disability and functioning of Japan’s future elderly population.

Brian K. Chen is Assistant Professor in the Department of Health Services Policy and Management at the Arnold School of Public Health at the University of South Carolina. A health economist, Brian completed his Ph.D. in business administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. Before beginning his current faculty position at the University of South Carolina, Dr. Chen was the 2009-2010 postdoctoral fellow in Asian Health Policy at Shorenstein Asia-Pacific Research Center, and earned a Juris Doctor from Stanford Law School in 1997.