Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary

Eur J Health Econ. 2019 Jun;20(Suppl 1):17-30. doi: 10.1007/s10198-019-01059-w. Epub 2019 May 20.

Abstract

Background: We aimed to investigate individuals' subjective expectations regarding health and happiness alongside their provisions on life circumstances for older ages.

Methods: A cross-sectional online survey was performed involving a representative sample (N = 1000; mean age 50.9, SD = 15.4; female 54.5%) in Hungary. Subjective expectations on health status (EQ-5D-3L/-5L, GALI, WHO-5), happiness (0-10 VAS), employment status, care time, and forms of care for ages 60, 70, 80, and 90 were surveyed.

Results: Current mean EQ-5D-5L was 0.869 (SD = 0.164) and happiness was 6.7 (SD = 2.4). Subjective life expectancy was 80.9 (SD = 11.1), and median expected retirement age was 65. Mean expected EQ-5D-5L for ages 60/70/80/90 was 0.761/0.684/0.554/0.402, and no activity limitations (GALI) were expected by 64%/40%/18%/14%, respectively. Expected happiness score was 6.8/6.7/6.2/5.7, and a decrease in mental well-being (WHO-5) was provisioned. A substantial increase in drug expenses and care time was anticipated, but only 52% thought to have extra income besides pension. The great majority expected to be helped by the family (77%/72%/53%/40%) if needed. Educational level, GALI, and longevity expectations were significant predictors of EQ-5D-5L expectations using a standard 5% significance level of decision. Current happiness was major determinant of expected future happiness.

Conclusions: Individuals expect a significant deterioration of health with age but only a moderate decrease in happiness. Overestimation of future activity limitations suggests a gap between statistical and subjective healthy life expectancy. The majority expects to rely on informal care in the elderly. Raise in retirement age is underestimated. Our results can be used as inputs for economic modelling of labor force participation and ageing.

Keywords: Ageing; EQ-5D-5L; Employment; Happiness; Informal care; Subjective expectations.

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Aging / psychology*
  • Cross-Sectional Studies
  • Fees, Pharmaceutical
  • Female
  • Happiness*
  • Health Expenditures
  • Health Status*
  • Humans
  • Hungary
  • Life Expectancy
  • Male
  • Mental Health*
  • Middle Aged
  • Quality of Life*
  • Socioeconomic Factors
  • Young Adult