Major demographic changes and evolving disease patterns over the past decade have increased the number of individuals aged 65 years and older who depend on care. This indicator measures progress toward reducing care dependence among older adults. 

For this indicator, there were not enough data to support an assessment. Although monitoring of care dependence remains limited in the Region, progress is evident in countries that have established strategic frameworks and national commitments for long-term care, such as Brazil, Chile, Costa Rica, Mexico, and Uruguay. Some countries, including Brazil, Mexico, and Uruguay, are implementing surveys and programs that enable estimation of care dependence in older people. These data sources generally follow approaches inspired by the Washington Group methodology, assessing difficulties in performing activities of daily living (ADLs) and instrumental ADLs (IADLs). 

In addition, Costa Rica and Uruguay use dependency assessment scales to measure levels of dependence and determine the services received by people with care dependence. These advances provide a foundation for monitoring the proportion of adults aged 65 years and older who are care-dependent, and support the development of evidence-informed long-term care policies in the Region. 

An important barrier to integrating this measure into national surveys is the lack of a standardized definition of care dependence, including levels of severity and support needs. In addition, difficulties in performing activities may sometimes be mitigated through adaptations or assistive devices and therefore do not necessarily indicate care dependence. 

Given the growing demand for long-term care, driven largely by population aging, it is crucial to monitor functioning and dependence in order to expand services, programs, and actions that support individuals with care needs— and their caregivers, who are predominantly women. During the 2020–2025 period, PAHO continued to provide technical cooperation in these areas, which are prioritized under the Policy on Long-Term Care approved by Member States at the 61st Directing Council.