捐助機構： Funded by: 計劃夥伴： Project Partners: 1 Cadenza Symposium Successful Ageing

捐助機構： Funded by: 計劃夥伴： Project Partners: 2 Well-being Indicators: How Does Hong Kong Compare with Other Countries Patsy Pui-hing CHAU Research Assistant Professor CADENZA: A Jockey Club Initiative for Seniors 11 October 2008

捐助機構： Funded by: 計劃夥伴： Project Partners: 3 Active Ageing Framework Introduced by World Health Organization (WHO) in 2002 Policy makers & service providers address the health, social, economic & spiritual needs of seniors to facilitate healthy ageing

捐助機構： Funded by: 計劃夥伴： Project Partners: 4 Well-being Indicators Adopt a positive outlook along the lines of the active ageing framework Highlight aspects that contribute to successful & productive ageing such as healthy lifestyle & active social engagement

捐助機構： Funded by: 計劃夥伴： Project Partners: 5 Well-being Indicators (con’t) Well-being Social Networking & Engagement Demographic Profile Nutrition & Health-related Lifestyle Health Status Functional Status

捐助機構： Funded by: 計劃夥伴： Project Partners: 6 Benchmarking Compare with economically developed countries in both the East & the West Reflect how well seniors in Hong Kong are doing with reference to these countries

捐助機構： Funded by: 計劃夥伴： Project Partners: 7 Data Sources Surveys or the population censuses conducted by the government officials/departments Surveys/studies conducted by the universities, individual researchers or non-government agencies Owing to space limit, citation of these sources is omitted from this presentation; interested parties could refer to our publication for the full list of references (Chau and Woo, 2008) Reference: Chau PH and Woo J. (2008). How Well Are Seniors in Hong Kong Doing? An International Comparison. Hong Kong: The Hong Kong Jockey Club.

捐助機構： Funded by: 計劃夥伴： Project Partners: 8 Interpretation of Statistics Due to the possible differences in conceptualization & compilation methods, the international comparisons presented can only be interpreted in a broad sense

捐助機構： Funded by: 計劃夥伴： Project Partners: 9 Demographic Profile

捐助機構： Funded by: 計劃夥伴： Project Partners: 10 Demographic Profile People age in unique ways, depending on a large variety of factors, including demographic factors To address different needs of the ageing population, policy-makers & service providers should understand the profile of the senior population

捐助機構： Funded by: 計劃夥伴： Project Partners: 11 Life Expectancy Commonly used to quantify the longevity of a population

捐助機構： Funded by: 計劃夥伴： Project Partners: 12 Health-Adjusted Life Expectancy (HALE) Describe the life expectancy with an adjustment for time spent in poor health

捐助機構： Funded by: 計劃夥伴： Project Partners: 13 Mortality One of the contributing factors to longer life expectancy is the decline in the mortality rates at all ages

捐助機構： Funded by: 計劃夥伴： Project Partners: 14 Mortality (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 15 Proportion of Seniors The proportion of seniors is increasing at a faster rate than any other age groups in the population In 2007, about 11% (about 705 million) of the world's population is aged 60+ By 2050, it is projected that about 22% (2 billion) of the world's population will be aged 60+

捐助機構： Funded by: 計劃夥伴： Project Partners: 16 Proportion of Seniors (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 17 Summary The life expectancy at birth of the Hong Kong population is among the highest in the world While Japan has been facing ageing issues for many years, Hong Kong will soon catch up

捐助機構： Funded by: 計劃夥伴： Project Partners: 18 Nutrition & Health-related Lifestyle

捐助機構： Funded by: 計劃夥伴： Project Partners: 19 Nutrition and Health-related Lifestyle Healthy diets & regular, adequate physical activity are major factors in the promotion & maintenance of good health, especially in the prevention of chronic diseases More importantly, diet & physical activity are modifiable factors in the well-being of seniors

捐助機構： Funded by: 計劃夥伴： Project Partners: 20 Dietary Habits It is commonly believed that seniors have to avoid consumption of certain high risk food in order to maintain good health It seems there is a lack of emphasis on encouraging seniors to consume adequate amounts of nutritious food

捐助機構： Funded by: 計劃夥伴： Project Partners: 21 Removed all the fat from their food when eating: 48% Dietary Habits of People Aged 65+ in Hong Kong, Drank milk at least once a day: 27% Did not eat high fat food or ate high fat food less than once a week: 69% Ate ≥2 servings of vegetables a day: 78% Ate ≥2 servings of fruits a day: 30% Ate fish at least once a day: 48% Ate meat at least once a day: 53%

捐助機構： Funded by: 計劃夥伴： Project Partners: 22 Physical Activity and Exercise Appropriate amount of physical activity & exercise is important for all ages, including seniors, to maintain good physical & mental health

捐助機構： Funded by: 計劃夥伴： Project Partners: 23 Proportion of Seniors having Physical Activities and Exercises, 2004 Singapore 28% of people aged exercised regularly Hong Kong 73% of people aged 60+ reported having the habit of doing exercises regularly Japan 38% of people aged 65+ reported having the habit of doing exercises regularly Australia 25% of people aged 65+ reported moderate or high exercise levels in the two weeks preceding the survey U.S. 22% of people aged 65+ reported engaging in regular leisure time physical activity

捐助機構： Funded by: 計劃夥伴： Project Partners: 24 Underweight and Overweight Being underweight (BMI< 18.5 kg/m 2 ) is a reflection of insufficient nutrition & also makes people more vulnerable to diseases because of their weakened immune systems Being overweight (BMI ≥25 kg/m 2 ) is well-known for its association with a higher risk of disease, especially cardiovascular diseases For seniors, the risks of being underweight or overweight are equally important

捐助機構： Funded by: 計劃夥伴： Project Partners: 25 Underweight and Overweight (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 26 Smoking Smoking is hazardous to health

捐助機構： Funded by: 計劃夥伴： Project Partners: 27 Summary The consumption of vegetables & avoidance of high fat food followed the recommended pattern fairly well. However, fruit consumption should be encouraged Most seniors in Hong Kong had a habit of doing exercise regularly The prevalence of being overweight among seniors in Hong Kong was lower than that of the other countries, whilst the prevalence of being underweight was higher Hong Kong had a lower prevalence of female smokers than the other countries. However, the prevalence of male smokers was high

捐助機構： Funded by: 計劃夥伴： Project Partners: 28 Social Networking & Engagement

捐助機構： Funded by: 計劃夥伴： Project Partners: 29 Social Networking and Engagement A healthy social life plays an important part in the well-being of individuals A healthy social life can be sought actively by social participation Alternatively, social support can be provided by family, friends & other people through day-to-day interactions

捐助機構： Funded by: 計劃夥伴： Project Partners: 30 Social Participation Seniors have a number of opportunities to actively participate in various work or activities which enable them to interact with people in the community

捐助機構： Funded by: 計劃夥伴： Project Partners: 31 Participation in Formal Employment

捐助機構： Funded by: 計劃夥伴： Project Partners: 32 Participation in Voluntary Works

捐助機構： Funded by: 計劃夥伴： Project Partners: 33 Care Provided by the Seniors Australia (2003) 19% of people aged 65+ were carers to older people & people with disabilities Hong Kong (2000) 22% of people aged 60+ took care of other family members England & Wales (2001) 11% of the population aged 65+ provided unpaid care to family members, friends, neighbours or others

捐助機構： Funded by: 計劃夥伴： Project Partners: 34 Participation in Social Activities Australia (2006) 61% of people aged 65+ actively participated in a social or support group in the 12 months preceding the survey Hong Kong ( ) 63% of people aged 65+ had participated in some kind of social activity during the 3 months preceding the survey England (2003) 65% of people aged & 47% of people aged 75+ attended arts activities in the 12 months preceding the survey

捐助機構： Funded by: 計劃夥伴： Project Partners: 35 Hong Kong (2005) 12% of people aged participated in continuing education Lifelong Learning England & Wales (2002) 51% of people aged reported some learning Japan (2001) 27% of people aged participated in "studies or research" Australia ( ) 20% of people aged participated in structured, taught learning in institutions & organizations U.S. (1999) 20% of people aged took at least one adult education class in the year preceding the survey

捐助機構： Funded by: 計劃夥伴： Project Partners: 36 Care and Support Care & support is important to seniors, regardless of their physical condition & health status Caregivers not only provide support in instrumental activities & personal care, but also emotional support to seniors

捐助機構： Funded by: 計劃夥伴： Project Partners: 37 Care and Support (con’t) Hong Kong (2004) Among people aged 60+ who had caregivers, 37% & 27% had their children & spouse as the major caregivers respectively Australia (2003) Among people aged 65+ and receiving assistance, 18% received assistance from partners and 26%-29% from children

捐助機構： Funded by: 計劃夥伴： Project Partners: 38 Oldest Old Support Ratio As most of the informal caregivers are aged 50-74, recent research suggested using the oldest old support ratio (the ratio of people aged to those aged 85+) to provide information on the number of potential carers per person aged 85+

捐助機構： Funded by: 計劃夥伴： Project Partners: 39 Oldest Old Support Ratio (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 40 Summary While the participation of seniors in formal employment, voluntary work & lifelong learning was relatively low in Hong Kong, the participation of seniors in care giving & social activities was comparable to other countries It was common that the informal caregivers to seniors were their spouse & children According to the oldest old support ratio, Hong Kong has the largest potential in developing informal caregivers when compared with other countries, except Singapore

捐助機構： Funded by: 計劃夥伴： Project Partners: 41 Functional Status

捐助機構： Funded by: 計劃夥伴： Project Partners: 42 Functional Status While functional decline is commonly misbelieved to be an unavoidable part of ageing, it actually can be prevented or slowed down at any age Given mild levels of disabilities or impairment, seniors are still able to live independently

捐助機構： Funded by: 計劃夥伴： Project Partners: 43 Seeing and Hearing During the ageing process, some people might experience deterioration in seeing and/or hearing abilities

捐助機構： Funded by: 計劃夥伴： Project Partners: 44 Proportion of Seniors with Visual Impairment Australia ( ) 3% of people aged 65+ reported complete or partial blindness U.K. (2001) 28% of people aged 65+ reported difficulties with their eyesight Hong Kong (2000) 6% of people aged 60+ had problems with vision U.S. (2004) 17% of people aged 65+ reported trouble seeing (with or without glasses/contact lenses)

捐助機構： Funded by: 計劃夥伴： Project Partners: 45 Proportion of Seniors with Hearing Difficulties Hong Kong (2000) 4% of people aged 60+ had hearing difficulties Australia ( ) 33% of people aged 65+ reported complete or partial deafness U.S. (2004) 40% of people aged 65+ reported trouble hearing (without a hearing aid) U.K. (2001) 32% of people aged 65+ reported difficulties with their hearing (with or without a hearing aid)

捐助機構： Funded by: 計劃夥伴： Project Partners: 46 Activities of Daily Living (ADL) The ability of seniors to perform daily activities independently is largely affected by the level of functional status As suggested by the WHO, disability & functioning are outcomes of interaction between health conditions & contextual factors The basic ADL are widely used to measure the ability of seniors to perform basic daily tasks independently

捐助機構： Funded by: 計劃夥伴： Project Partners: 47 Proportion of Seniors without any ADL Limitations Japan (2002) 84% of people aged 66+ reported the ability to perform all 6 tasks (bathing, dressing, eating, getting out of bed or up from or sitting down in a chair, going outside & toileting) independently Hong Kong (2004) 94% of people aged 60+ could perform all 6 tasks (transferring between a bed & a chair, mobility, dressing, eating, toileting & bathing) independently

捐助機構： Funded by: 計劃夥伴： Project Partners: 48 Instrumental Activities of Daily Living (IADL) While basic ADL focuses on fundamental functioning, IADL focuses on more complicated tasks, such as cooking & communicating, which integrate proper physical & mental functioning

捐助機構： Funded by: 計劃夥伴： Project Partners: 49 Proportion of Seniors without any IADL Limitations Hong Kong (2004) 79% of people aged 60+ could perform all 7 tasks (meal preparation, ordinary house work, managing finance, managing medications, phone use, shopping & transportation) independently Singapore (2004) 62% of people aged 60+ did not have any limitations in performing all 8 tasks (doing laundry, doing housework, grocery shopping, preparing meals, getting to places outside the house, managing money, taking medications & using a telephone)

捐助機構： Funded by: 計劃夥伴： Project Partners: 50 Summary Vision & hearing problems among seniors in Hong Kong might be less prominent than the other countries studied The proportion of the senior population who could perform ADL & IADL tasks independently appeared to be higher than Japan & Singapore respectively

捐助機構： Funded by: 計劃夥伴： Project Partners: 51 Health Status

捐助機構： Funded by: 計劃夥伴： Project Partners: 52 Health Status Maintaining a good health status is an important component in an active ageing framework While some conditions are associated with the ageing process, many illnesses & conditions can be largely prevented by living a healthy lifestyle throughout the course of life

捐助機構： Funded by: 計劃夥伴： Project Partners: 53 Self-rated Health Status Self-rated health status is a commonly used subjective measure to describe the general health & well-being of an individual It is a complex combination of many factors, including observed morbidity, health expectations as well as social & cultural context

捐助機構： Funded by: 計劃夥伴： Project Partners: 54 Self-rated Health Status (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 55 Chronic Illnesses An important effect of chronic diseases is limitation in functional abilities, which in turn affects one's independence & autonomy Prevention & postponement of chronic illnesses is an essential part of active ageing In cases where some chronic illnesses are already present, the aim of active ageing is to reduce or minimize the disabilities caused by these illnesses

捐助機構： Funded by: 計劃夥伴： Project Partners: 56 Chronic Illnesses (con’t)

捐助機構： Funded by: 計劃夥伴： Project Partners: 57 Japan (1999) 12% of people aged 65+ Prevalence of Heart Diseases Hong Kong (2004) 11% of people aged 60+ U.K. (2003) 15% of people aged 65+ had coronary heart disease U.S. (2006) 31% of people aged 65+

捐助機構： Funded by: 計劃夥伴： Project Partners: 58 Mortality from Common Chronic Illness Some chronic illnesses & conditions only lead to functional disability, but some might lead to more serious adverse effects or even death

捐助機構： Funded by: 計劃夥伴： Project Partners: 59 Leading Causes of Death among the Population Aged 65+ Malignant neoplasma (964/ 100,000 population) Hong Kong (2006) Diseases of heart (569/ 100,000 population) Pneumonia (463/ 100,000 population) Cerebrovascular diseases (340/ 100,000 population) Malignant neoplasma (976/ 100,000 population) Japan (2005) Diseases of heart (585/ 100,000 population) Pneumonia (400/ 100,000 population) Cerebrovascular diseases (456/ 100,000 population) Malignant neoplasma (1,056/ 100,000 population) Australia (2005) Ischaemic heart disease (771/ 100,000 population) Influenza & Pneumonia (65/ 100,000 population) Cerebrovascular diseases (403/ 100,000 population) Malignant neoplasma (1,223/ 100,000 population) U.K. (2004) Ischaemic heart disease (958/ 100,000 population) Pneumonia (336/ 100,000 population) Cerebrovascular diseases (586/ 100,000 population) Malignant neoplasma (1,056/ 100,000 population) U.S. (2005) Diseases of heart (1,443/ 100,000 population) Pneumonia (146/ 100,000 population) Cerebrovascular diseases (337/ 100,000 population)

捐助機構： Funded by: 計劃夥伴： Project Partners: 60 Depression There is growing concern over the psychological health status of seniors Good psychological health is one of the key components in positive ageing Poor psychological health may be a life-threatening condition

捐助機構： Funded by: 計劃夥伴： Project Partners: 61 Prevalence of Depression Hong Kong: 13% (GDS≥8, aged 65+, 2000) U.K.: 3% (GDS≥8, aged 75+, ) Japan: 30% (GDS≥6, aged 65+, 2002) U.S.: 15% (CES-D, aged 65+, 2002) Singapore: 5% (Geriatric Mental State Schedule, aged 60+, )

捐助機構： Funded by: 計劃夥伴： Project Partners: 62 Summary Many seniors had a positive view of their health status Similar to other countries, hypertension was one of the most prevalent chronic illnesses in Hong Kong Cancer was the leading cause of death among seniors in Hong Kong, Japan, Australia & the United Kingdom Differences in the prevalence of depression were observed in different countries, which might be due partly to differences in assessment tools & definitions

捐助機構： Funded by: 計劃夥伴： Project Partners: 63 Conclusion The seniors in Hong Kong generally live a healthy & active life The seniors’ well-being in physical, social & economical terms is of a comparable level to other well developed economies For characteristics that are relatively less favourable in Hong Kong compared to other countries, more effort should be invested to improve the current situation For characteristics that compare favourably with other countries, they should be maintained & even taken to a higher standard

捐助機構： Funded by: 計劃夥伴： Project Partners: 64 Celebrate their Accomplishments and Discover their Effervescence and Never-ending Zest as they Age No matter how well the seniors in Hong Kong are doing at present, our society can always find ways to help