Gains and Losses in Life Expectancy with Care Needs from the Elimination of Diseases in Japan

Background: Evaluating the impact of diseases on expected years of life with care needs is important in older populations. We examined gains or losses in expected years with care needs at age 65 years in Japan.Methods: We used Japanese national health statistics data, including care needs, based on long-term care insurance. The number of expected years with and without care needs at age 65 years, after the elimination of five selected diseases in 2010, 2013, and 2016 were calculated using a proposed method.Results: Expected years without care needs at age 65 years increased from 17.15 years in 2010 to 17.82 years in 2016 for men and from 20.24 to 20.74 years for women; expected years with care needs were between 1.70 and 1.73 years for men and between 3.59 and 3.66 years for women. Elimination of malignant neoplasms and heart diseases led to gains in expected years with and without care needs. Elimination of cerebrovascular diseases, arthropathies, and dementia showed gains in expected years without care needs and losses in expected years with care needs. Gains and losses from elimination of dementia expanded each year but those from elimination of other diseases compressed.Conclusions: Our results suggest that the prevention of dementia, cerebrovascular diseases, and arthropathies lead to more expected years without care needs and fewer expected years with care needs. The impact of dementia might increase and that of other diseases might decrease each year.