Older Adults Seeking Publicly Funded Long-Term Care in a Super-ageing Society: Trends in Functional Impairments and Multimorbidity Burden Based on InterRAI-Home Care Data From 2001 to 2019 in Hong Kong

BackgroundUnderstanding changes in long-term care (LTC) applicants' needs informs service planning.ObjectiveTo examine trends in functional impairment and multimorbidity among Hong Kong's publicly funded LTC applicants during 2001-2019.MethodsWe analyzed interRAI assessments from 315,556 applicants aged ≥60. Hierarchical mixed-effects models estimated trends in physical and cognitive impairment, loneliness, and multimorbidity, adjusting for age, birth cohort, and sociodemographic factors. Subgroup analyses examined differences by age, disease, and living status.ResultsCognitive impairment and multimorbidity increased, physical impairment plateaued, and loneliness declined. Stroke was associated with greater physical and cognitive impairment, and cataract with greater loneliness. Applicants aged ≥85 had more functional impairments but less multimorbidity.ConclusionsApplicants' functional and health needs became more complex and varied over time, differing by age, living arrangements, and disease profiles. These findings support integrated, tailored strategies to address changing health and social needs of older adults applying for publicly funded LTC services.