Changes of Health Status and Institutionalization Among Older Adults in China

J Aging Health. 2015 Oct;27(7):1223-46. doi: 10.1177/0898264315577779. Epub 2015 Apr 22.


Objective: To examine rates of institutionalization of Chinese older adults aged 65+ and the impact of changes in health status on the likelihood of institutionalization.

Method: Using data from the 2002, 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), admission rates for each 3-year interval between waves were calculated. Logistic regression models were used to assess the changes of five health status variables as risk factors.

Results: Between the first (2002-2005) and third (2008-2011) intervals, the institutionalization rate increased from 0.5% to 0.8%. Risk of institutionalization increased 70% for respondents with declining ability to perform activities of daily living, 53% for those with declining cognitive function, and 44% for those with increasing number of chronic diseases.

Discussion: Development of policies and programs to improve older adults' health status is essential to delay institutionalization. Quality of workforce is also critical in meeting the care needs.

Keywords: activities of daily living; cognitive function; health status changes; institutionalization; long-term care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • China
  • Chronic Disease
  • Cognition Disorders
  • Female
  • Follow-Up Studies
  • Health Status*
  • Health Surveys
  • Humans
  • Institutionalization / statistics & numerical data*
  • Longitudinal Studies
  • Male
  • Risk Factors