A Study of Factors Related to the Dependency Status of Thai Elderly and Projections for 2040

Abstract

The objective of this study was to analyze the situation and associated factors of dependency among Thai older adults and to project the number of dependent older adults in the year 2040 (B.E. 2583). The study utilized secondary data from the Elderly Health Notebook system (Blue Book) of the Department of Health between 2021 and 2024 (B.E. 2564–2567), covering 1,491,881 older adults aged ≥60 years who had undergone the Activities of Daily Living (ADL) assessment. The results showed that the proportion of dependent older adults remained relatively stable during 2022–2024 (B.E. 2565–2567). Among males, the prevalence of homebound older adults was 2.2–2.5% and bedridden older adults were 0.8–0.9%. Meanwhile; among females, the prevalence of homebound older adults was 3.2–3.5% and bedridden older adults were 1.0–1.2%. Multinomial logistic regression analysis revealed that: female older adults had a 1.19 times higher risk of being homebound than males (95%CI: 1.09–1.29). Older adults aged ≥85 years had a 14.03 times higher risk of being homebound (95%CI: 11.03–17.85) and 5.61 times higher risk of being bedridden (95%CI: 3.84–8.19) when compared to the 60–64 age group. Additionally, older adults with low or no physical activity, consumed fruits and vegetables less than 3 days/week, smoked or had a history of smoking, consumed alcohol, had depression, suffered from abnormal oral health; and resided in areas with high PM2.5 levels were found to be associated with an increased risk of dependency. The projection of dependent older adults in 2040 (B.E. 2583) using a deterministic model found that there will be approximately 94,000 homebound males and approximately 210,000 homebound females. For bedridden older adults, the number is projected to increase to approximately 370,000 males and approximately 211,000 females, which reflects a rising trend of dependency, especially in the bedridden male group. This study highlights the importance of using systematic, national-level health databases to analyze risk factors and project the health status of older adults. This information is valuable for surveillance, policy planning, and developing healthcare services to accommodate the future increase in dependent older adults. Further research should investigate the effectiveness of targeted measures to reduce dependency and extend the study to groups approaching old age for a more comprehensive health prognosis.