Major changes in population structures and disease patterns over the past decade have resulted in an increased number of individuals aged 65+ who live with disabilities. The aim of this indicator is to assess progress toward ensuring equitable access to quality health care by measuring the percentage of adults aged 65+ who are care-dependent. However, although 26 countries (74%) reported data in 2020, no data related to this indicator have been collected since then. As of 2020, only two countries (El Salvador and Paraguay) had met the regional target of 6.5% for 2025. Trend data for this indicator are not yet available. 

The prevalence and degree of care dependency for adults aged 65 years and older can be assessed at both micro and macro levels, by evaluating individual dependency in select activities or through nationwide surveys including modules for functional ability estimation. However, given the need to improve data collection and monitoring methods, the methodology for this indicator is currently being reviewed by international experts. Efforts are underway—led by PAHO in collaboration with agencies such as the Inter-American Development Bank, collaborating centers, and experts—to standardize surveys and facilitate meaningful comparisons of care administered to individuals aged 65 years and older. 

Several countries (including Argentina, Brazil, Chile, Costa Rica, Dominican Republic, El Salvador, Mexico, Paraguay, and Uruguay) collect data on care dependency in national surveys. Variations among countries in the percentage of adults aged 65 years and older who are care dependent may be attributed to both genuine differences and inconsistencies in data collection tools. Countries characterized by slower demographic transitions are associated with a relatively smaller percentage of individuals aged 65+ dependent on care.

Recommendations 

• Ensure continued improvement of this indicator, as well as related data collection and monitoring methods, to better address regional care requirements for individuals who are 65 years of age and above. 

• Consider the implications of demographic shifts for ongoing health infrastructure assessments, noting projected increases in care-dependent populations.