{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:06:56Z","timestamp":1792278416104,"version":"4.4.0"},"reference-count":89,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":45,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Popul Health Metrics"],"DOI":"10.1186\/s12963-026-00477-2","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:43:47Z","timestamp":1777304627000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating long-term care needs in data-scarce settings: a diagnostic model with evidence from MENA"],"prefix":"10.1186","volume":"24","author":[{"given":"Mohamed","family":"Ismail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka D.","family":"Kanth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Hussein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"477_CR1","unstructured":"DESA U. World population ageing 2019: Highlights. Technical report, New York: United Nations 2019."},{"key":"477_CR2","unstructured":"WHO: Ageing and health (fact sheet). Technical report, Geneva: World Health Organization 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/ageing-and-health"},{"key":"477_CR3","unstructured":"Tuwaijri A, SM, M, B, S, S. Aging and health: Policy considerations for long-term care. Technical report, Aging and Health: Policy Considerations for Long-term Care 2024."},{"issue":"Suppl 1","key":"477_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-020-00216-1","volume":"18","author":"DC Malta","year":"2020","unstructured":"Malta DC, Duncan BB, Schmidt MI, Teixeira R, Ribeiro ALP, Felisbino-Mendes MS, et al. Trends in mortality due to non-communicable diseases in the Brazilian adult population: national and subnational estimates and projections for 2030. Popul Health Metrics. 2020;18(Suppl 1):16.","journal-title":"Popul Health Metrics"},{"key":"477_CR5","unstructured":"D, W. Long-term care assessment toolkit: Application to the Republic of Korea. Technical report, Long-term Care Assessment Toolkit: Application to the Republic of Korea 2022."},{"issue":"1","key":"477_CR6","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12963-016-0092-2","volume":"14","author":"B Cao","year":"2016","unstructured":"Cao B. Future healthy life expectancy among older adults in the US: a forecast based on cohort smoking and obesity history. Popul Health Metrics. 2016;14(1):23.","journal-title":"Popul Health Metrics"},{"key":"477_CR7","doi-asserted-by":"publisher","DOI":"10.1596\/42141","volume-title":"Unlocking the power of healthy longevity: Demographic change, non-communicable diseases, and human capital","author":"W Bank","year":"2024","unstructured":"Bank W. Unlocking the power of healthy longevity: Demographic change, non-communicable diseases, and human capital. Technical report, Unlocking the Power of Healthy Longevity: Demographic Change, Non-communicable Diseases, and Human Capital; 2024."},{"key":"477_CR8","unstructured":"Wittenberg R, Hu B, Hancock R. Projections of demand and expenditure on adult social care 2015 to 2040. Technical Report PSSRU Discussion Paper 2944, London School of Economics and Political Science (LSE), Personal Social Services Research Unit 2018. Accessed: 2025-08-26. https:\/\/www.pssru.ac.uk\/pub\/DP2944.pdf"},{"key":"477_CR9","unstructured":"European\u00a0Commission D-GfE, Affairs F. Long-term care: need, use and expenditure in the EU-27. European Economy Economic Papers 469, European Commission, Brussels 2012. https:\/\/ec.europa.eu\/economy_finance\/publications\/economic_paper\/2012\/pdf\/ecp469_en.pdf"},{"issue":"2","key":"477_CR10","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1017\/S0021932020000218","volume":"53","author":"S Metwally","year":"2021","unstructured":"Metwally S. Disability-free life expectancy at old ages in Egypt. J Biosoc Sci. 2021;53(2):290\u2013304. https:\/\/doi.org\/10.1017\/S0021932020000218. (Epub 2020 May 6).","journal-title":"J Biosoc Sci"},{"key":"477_CR11","unstructured":"Koettl-Brodmann J, Tamayo G, S, Morgandi M, Zeid R. Global megatrends and human development in the MENA region: Preparing for demographic, climate and technological change. washington, d.c.: World bank group. Technical report, Global Megatrends and Human Development in the MENA Region: Preparing for Demographic, Climate and Technological Change 2025."},{"key":"477_CR12","doi-asserted-by":"crossref","unstructured":"Morgandi M, Koettl-Brodmann J, Gentilini U, Duran D, Caillaud F, Saadah M, F. Embracing and shaping change: Human development for a Middle East and North Africa in transition. washington, d.c.: World bank group. Technical report, Embracing and Shaping Change: Human Development for a Middle East and North Africa in Transition 2025.","DOI":"10.1596\/43714"},{"issue":"1","key":"477_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-023-00308-8","volume":"21","author":"P Kowal","year":"2023","unstructured":"Kowal P, Corso B, Anindya K, Andrade FC, Giang TL, Guitierrez MTC, et al. Prevalence of unmet health care need in older adults in 83 countries: measuring progressing towards universal health coverage in the context of global population ageing. Popul Health Metrics. 2023;21(1):15.","journal-title":"Popul Health Metrics"},{"key":"477_CR14","unstructured":"EMRO W. Review of long-term care systems in the eastern mediterranean region. Technical report, Cairo: WHO Regional Office for the Eastern Mediterranean 2024."},{"key":"477_CR15","unstructured":"ESCWA: Disability in the arab region 2022: Strengthening social and economic inclusion. Technical report, Beirut: United Nations Economic and Social Commission for Western Asia 2022."},{"key":"477_CR16","unstructured":"Arias D, Bolongaita SA, Chan B, Feil CS, YN, R, Schack MV, Sumer S, Wahnschafft SL. Addressing noncommunicable diseases in europe and central asia: Regional report. Technical report, Addressing Noncommunicable Diseases in Europe and Central Asia: Regional Report 2022."},{"issue":"1","key":"477_CR17","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7762-5","volume":"19","author":"P Maresova","year":"2019","unstructured":"Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, et al. Consequences of chronic diseases and other limitations associated with old age \u2013 a scoping review. BMC Public Health. 2019;19(1):1431. https:\/\/doi.org\/10.1186\/s12889-019-7762-5.","journal-title":"BMC Public Health"},{"key":"477_CR18","unstructured":"Freire GN, Mora ME, Orellana SD. Disability inclusion in Latin America and the Caribbean: A path to sustainable development. Technical report, Disability Inclusion in Latin America and the Caribbean: A Path To Sustainable Development 2021."},{"key":"477_CR19","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S119327","author":"J Dolejs","year":"2017","unstructured":"Dolejs J, Mare\u0161ov\u00e1 P. Onset of mortality increase with age and age trajectories of mortality from all diseases in the four Nordic countries. Clin Interv Aging. 2017. https:\/\/doi.org\/10.2147\/CIA.S119327.","journal-title":"Clin Interv Aging"},{"key":"477_CR20","doi-asserted-by":"crossref","unstructured":"Tinios P, Valvis Z. Defining long-term care need levels for older adults: towards a standardized European classification. DOI: 10 2023.","DOI":"10.1080\/08959420.2022.2110810"},{"key":"477_CR21","unstructured":"Wittenberg R, Comas-Herrera A, King D, Malley J, Pickard L, Darton R. Future demand for long-term care, 2002 to 2041: Projections of demand for long-term care for older people in england. Technical Report PSSRU Discussion Paper 2330, Personal Social Services Research Unit, London School of Economics 2006. https:\/\/www.pssru.ac.uk\/pub\/dp2330.pdf"},{"key":"477_CR22","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s12889-015-1574-z","volume":"15","author":"RTC Yokota","year":"2015","unstructured":"Yokota RTC, Berger N, Nusselder WJ, Robine J-M, Tafforeau J, Deboosere P, et al. Contribution of chronic diseases to the disability burden in a population 15 years and older, belgium, 1997\u20132008. BMC Public Health. 2015;15:229. https:\/\/doi.org\/10.1186\/s12889-015-1574-z.","journal-title":"BMC Public Health"},{"key":"477_CR23","unstructured":"United Nations Economic and Social Commission for Western Asia (UN-ESCWA): Disability in the arab region 2022: Strengthening social and economic inclusion. Technical report, United Nations Economic and Social Commission for Western Asia (UN-ESCWA), Beirut 2022. Accessed 2025-10-23. https:\/\/www.unescwa.org\/publications\/disability-arab-region-2022"},{"key":"477_CR24","unstructured":"Planning and Statistics Authority (Qatar): Disability characteristics, census 2010. Technical report, Planning and Statistics Authority (Qatar) (2010). Includes breakdowns of population with and without disabilities by age, sex, type and degree of difficulty; tables accessible via PSA website. https:\/\/www.psa.gov.qa\/en\/statistics1\/StatisticsSite\/Census\/census2010\/results\/pages\/disabilitycharacteristics.aspx"},{"key":"477_CR25","unstructured":"General Authority for Statistics, Saudi Arabia: Disability survey 2017. Technical report, General Authority for Statistics 2017. Includes detailed tables by age, sex, nationality, degree of disability; based on household survey data. https:\/\/www.stats.gov.sa\/sites\/default\/files\/disability_survey_2017_en.pdf"},{"key":"477_CR26","unstructured":"Hussein S, Ismail M, Rosenberg M, Nababan H, Ismail O, Elfeky S. Evidence gaps on unmet health and social care needs in the WHO eastern mediterranean region: Research report. Evidence gaps on unmet health and social care needs in the WHO Eastern Mediterranean Region: Research report 2025."},{"key":"477_CR27","unstructured":"Office of Disease Prevention and Health Promotion (ODPHP), U.S. Department of Health and Human Services: Social Determinants of Health and Older Adults. https:\/\/health.gov\/our-work\/national-health-initiatives\/healthy-aging\/social-determinants-health-and-older-adults. Accessed: 2025-08-26 2025."},{"key":"477_CR28","doi-asserted-by":"publisher","first-page":"335","DOI":"10.3389\/fpubh.2017.00335","volume":"5","author":"E Jaul","year":"2017","unstructured":"Jaul E, Barron J. Age-related diseases and clinical and public health implications for the 85 years old and over population. Front Public Health. 2017;5:335.","journal-title":"Front Public Health"},{"issue":"4","key":"477_CR29","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/S0143-6228(00)00015-1","volume":"20","author":"K Field","year":"2000","unstructured":"Field K. Measuring the need for primary health care: an index of relative disadvantage. Appl Geogr. 2000;20(4):305\u201332.","journal-title":"Appl Geogr"},{"issue":"1","key":"477_CR30","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/S2666-7568(23)00217-9","volume":"5","author":"J Filler","year":"2024","unstructured":"Filler J, Georgakis MK, Dichgans M. Risk factors for cognitive impairment and dementia after stroke: a systematic review and meta-analysis. Lancet Healthy Longev. 2024;5(1):31\u201344.","journal-title":"Lancet Healthy Longev"},{"issue":"5","key":"477_CR31","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1093\/geront\/42.5.603","volume":"42","author":"EA Borrayo","year":"2002","unstructured":"Borrayo EA, Salmon JR, Polivka L, Dunlop BD. Utilization across the continuum of long-term care services. Gerontologist. 2002;42(5):603\u201312.","journal-title":"Gerontologist"},{"key":"477_CR32","unstructured":"Gregg EW, Menke A. Diabetes and disability. In: Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, Gregg EW, Knowler WC, Barrett-Connor E, Becker DJ, Brancati FL, Boyko EJ, Herman WH, Howard BV, Narayan KMV, Rewers M, Fradkin JE (eds.) Diabetes in America, 3rd edn., p. . National Institute of Diabetes and Digestive and Kidney Diseases (US), Bethesda, MD 2018. Chap. 34. PMID: 33651544. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK567985\/"},{"issue":"1","key":"477_CR33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v076.i01","volume":"76","author":"B Carpenter","year":"2017","unstructured":"Carpenter B, Gelman A, Hoffman MD, Lee D, Goodrich B, Betancourt M, et al. Stan: A probabilistic programming language. J Stat Softw. 2017;76(1):1\u201332. https:\/\/doi.org\/10.18637\/jss.v076.i01.","journal-title":"J Stat Softw"},{"key":"477_CR34","unstructured":"R Core Team: R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria 2024. R Foundation for Statistical Computing. https:\/\/www.R-project.org\/"},{"key":"477_CR35","volume-title":"Python 3 Reference Manual","author":"G Van Rossum","year":"2009","unstructured":"Van Rossum G, Drake FL. Python 3 Reference Manual. Scotts Valley, CA: CreateSpace; 2009."},{"key":"477_CR36","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1017\/S0013091500034428","volume":"44","author":"AG McKendrick","year":"1926","unstructured":"McKendrick AG. Applications of mathematics to medical problems. Proc Edinb Math Soc. 1926;44:98\u2013130.","journal-title":"Proc Edinb Math Soc"},{"key":"477_CR37","first-page":"382","volume-title":"The Kinetics of Cellular Proliferation","author":"H Foerster","year":"1959","unstructured":"Foerster H. Some remarks on changing populations. In: Stohlman F, editor. The Kinetics of Cellular Proliferation. New York: Grune & Stratton; 1959. p. 382\u2013407."},{"issue":"4","key":"477_CR38","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1093\/ije\/dyt088","volume":"42","author":"A B\u00f6rsch-Supan","year":"2013","unstructured":"B\u00f6rsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, et al. Data resource profile: the survey of health, ageing and retirement in Europe (SHARE). Int J Epidemiol. 2013;42(4):992\u20131001. https:\/\/doi.org\/10.1093\/ije\/dyt088.","journal-title":"Int J Epidemiol"},{"issue":"1","key":"477_CR39","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2307\/3349592","volume":"55","author":"EM Gruenberg","year":"1977","unstructured":"Gruenberg EM. The failures of success. Milbank Mem Fund Q Health Soc. 1977;55(1):3\u201324. https:\/\/doi.org\/10.2307\/3349592.","journal-title":"Milbank Mem Fund Q Health Soc"},{"issue":"3","key":"477_CR40","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1056\/NEJM198007173030304","volume":"303","author":"JF Fries","year":"1980","unstructured":"Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980;303(3):130\u20135. https:\/\/doi.org\/10.1056\/NEJM198007173030304.","journal-title":"N Engl J Med"},{"issue":"2","key":"477_CR41","doi-asserted-by":"publisher","first-page":"183","DOI":"10.2307\/3349767","volume":"60","author":"KG Manton","year":"1982","unstructured":"Manton KG. Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q Health Soc. 1982;60(2):183\u2013244. https:\/\/doi.org\/10.2307\/3349767.","journal-title":"Milbank Mem Fund Q Health Soc"},{"issue":"1","key":"477_CR42","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05171-3","volume":"23","author":"AM Metwally","year":"2023","unstructured":"Metwally AM, Aboulghate A, Elshaarawy GA, Abdallah AM, Abdel Raouf ER, El-Din EMS, et al. Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study. BMC Psychiatry. 2023;23(1):689. https:\/\/doi.org\/10.1186\/s12888-023-05171-3.","journal-title":"BMC Psychiatry"},{"key":"477_CR43","unstructured":"Department of Statistics (DoS), Jordan: The reality of disability (\u201cfunctional difficulties\u201d) in Jordan, based on the data of the general population and housing census 2015. Technical report, Department of Statistics, Jordan 2021. Analytical report based on 2015 population census; accessed via DOS website. https:\/\/dosweb.dos.gov.jo\/DataBank\/Analytical_Reports\/Disability_2021.pdf"},{"key":"477_CR44","unstructured":"Handicap International (Humanity & Inclusion): Disability & social protection in Jordan. Technical report, Handicap International (Humanity & Inclusion) 2023. Briefing Paper; explores disability-inclusive social protection coverage in Jordan. https:\/\/www.hi.org\/sn_uploads\/document\/Briefing-Paper_Jordan-Disability-Social-Protection_September-2023_Final-Version.pdf"},{"key":"477_CR45","unstructured":"International Labour Organization (ILO): Living with disabilities in Lebanon: A snapshot assessment of basic needs, social protection, and employment. Technical report, International Labour Organization 2023. Uses 2019 data from national surveys to assess the situation of persons with disabilities in Lebanon. https:\/\/www.ilo.org\/publications\/living-disabilities-lebanon"},{"key":"477_CR46","unstructured":"El\u00a0Ouazzani\u00a0Touahami Z. Moroccan experience on disability statistics. Technical report, High Commission for Planning, Kingdom of Morocco 2015. Presentation at the 15th Washington Group Meeting, Copenhagen, on national and survey disability statistics in Morocco. https:\/\/www.washingtongroup-disability.com\/fileadmin\/uploads\/wg\/Documents\/Events\/15\/wg15_session_8_4_touahami.pdf"},{"key":"477_CR47","unstructured":"Rohwerder B. Disability in North Africa. Technical report, Institute of Development Studies, K4D Helpdesk 2018. Rapid desk-based overview of inclusion and experiences of people with disabilities across Algeria, Egypt, Libya, Morocco, and Tunisia. https:\/\/assets.publishing.service.gov.uk\/media\/5b2378d340f0b634cb3dd823\/Disability_in_North_Africa.pdf"},{"key":"477_CR48","unstructured":"Office for National Statistics: Disability by age, sex and deprivation, england and wales: Census 2021. Technical report, Office for National Statistics 2023. Statistical bulletin providing disability prevalence by age, sex and area deprivation from the 2021 Census. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/disability\/articles\/disabilitybyagesexanddeprivationenglandandwales\/census2021"},{"key":"477_CR49","unstructured":"United Nations Economic and Social Commission for Western Asia (UN-ESCWA): Building forward better for older persons in the arab region. Population and Development Report\u00a09, United Nations Economic and Social Commission for Western Asia, Beirut 2022. https:\/\/www.unescwa.org\/publications\/population-development-report-9"},{"key":"477_CR50","volume-title":"Global Burden of Disease Study 2024 (GBD 2024) Results","author":"Institute for Health Metrics and Evaluation (IHME)","year":"2025","unstructured":"Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease Study 2024 (GBD 2024) Results. Seattle, United States: IHME; 2025."},{"key":"477_CR51","volume-title":"National Population Projections: 2024 Update","author":"U.S. Census Bureau","year":"2024","unstructured":"U.S. Census Bureau. National Population Projections: 2024 Update. Washington, D.C.: U.S. Department of Commerce; 2024."},{"issue":"1","key":"477_CR52","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s11205-017-1832-9","volume":"141","author":"S Greco","year":"2019","unstructured":"Greco S, Ishizaka A, Tasiou M, Torrisi G. On the methodological framework of composite indices: a review of the issues of weighting, aggregation, and robustness. Soc Indic Res. 2019;141(1):61\u201394.","journal-title":"Soc Indic Res"},{"key":"477_CR53","doi-asserted-by":"crossref","unstructured":"Banks J, French E, McCauley J. Long-term care in England. NBER Working Paper 31826, National Bureau of Economic Research 2023. https:\/\/www.nber.org\/system\/files\/working_papers\/w31826\/w31826.pdf","DOI":"10.3386\/w31826"},{"key":"477_CR54","unstructured":"NHS Digital: Health survey for england, 2021 part 2: Social care for older adults. Technical report, NHS Digital 2023. Official statistics on need for and receipt of help with ADLs and IADLs among adults aged 65 and over. https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/health-survey-for-england\/2021-part-2\/social-care"},{"issue":"1","key":"477_CR55","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1319-4","volume":"19","author":"A Cwirlej-Sozanska","year":"2019","unstructured":"Cwirlej-Sozanska A, Wisniowska-Szurlej A, Wilmowska-Pietruszynska A, Sozanski B. Determinants of ADL and IADL disability in older adults in southeastern Poland. BMC Geriatr. 2019;19(1):297. https:\/\/doi.org\/10.1186\/s12877-019-1319-4.","journal-title":"BMC Geriatr"},{"key":"477_CR56","unstructured":"World Health Organization: Long-Term Care in the Eastern Mediterranean Region: Review of Current Evidence. WHO Regional Office for the Eastern Mediterranean. Accessed 2025 2025."},{"issue":"1","key":"477_CR57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12062-016-9163-3","volume":"10","author":"S Hussein","year":"2017","unstructured":"Hussein S, Ismail M. Ageing and elderly care in the arab region: policy challenges and opportunities. Ageing Int. 2017;10(1):1\u201314. https:\/\/doi.org\/10.1007\/s12062-016-9163-3.","journal-title":"Ageing Int"},{"key":"477_CR58","unstructured":"Hussein S, Ismail M, Pallares-Miralles M. Ageing and Long-Term Care in the Middle East: Towards Inclusive Development Strategies. Under review 2025."},{"issue":"4","key":"477_CR59","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1080\/08959420.2019.1589873","volume":"31","author":"M Ismail","year":"2019","unstructured":"Ismail M, Hussein S. Population aging and long-term care policies in the gulf region: a case study of Oman. J Aging Soc Policy. 2019;31(4):338\u201357. https:\/\/doi.org\/10.1080\/08959420.2019.1589873.","journal-title":"J Aging Soc Policy"},{"issue":"9967","key":"477_CR60","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/S0140-6736(14)61347-7","volume":"385","author":"M Prince","year":"2015","unstructured":"Prince M, Wu F, Guo Y, Gutierrez Robledo LM, O\u2019Donnell M, Sullivan R, et al. The burden of disease in older people and implications for health policy and practice. Lancet. 2015;385(9967):549\u201362. https:\/\/doi.org\/10.1016\/S0140-6736(14)61347-7.","journal-title":"Lancet"},{"issue":"1","key":"477_CR61","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1186\/s12877-019-1331-3","volume":"19","author":"JH Fong","year":"2019","unstructured":"Fong JH. Disability incidence and functional decline among older adults with major chronic diseases. BMC Geriatr. 2019;19(1):323. https:\/\/doi.org\/10.1186\/s12877-019-1331-3.","journal-title":"BMC Geriatr"},{"key":"477_CR62","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-05364-8","volume":"15","author":"O Algahtani","year":"2025","unstructured":"Algahtani O, Almazah MMA, Alshormani F. Artificial neural network-driven approaches to improved forecasting of disability care expenditures in an aging Kingdom of Saudi Arabia population. Sci Rep. 2025;15:20538. https:\/\/doi.org\/10.1038\/s41598-025-05364-8.","journal-title":"Sci Rep"},{"key":"477_CR63","unstructured":"Badreldin HA, Al-Jedai A, Alghnam S, Nakshabandi Z, Alharbi M, Alzahrani A, AlKnawy B. Sustainability and Resilience in the Saudi Arabian Health System. Unpublished report \/ forthcoming 2025."},{"issue":"1","key":"477_CR64","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1186\/s12913-021-06183-z","volume":"21","author":"S Abdulrhim","year":"2021","unstructured":"Abdulrhim S, et al. Collaborative care model for diabetes in primary care settings in Qatar: A multiple time series study. BMC Health Serv Res. 2021;21(1):689. https:\/\/doi.org\/10.1186\/s12913-021-06183-z.","journal-title":"BMC Health Serv Res"},{"key":"477_CR65","unstructured":"Weill Cornell Medicine-Qatar: Diabetes: A global challenge. https:\/\/qatar-weill.cornell.edu\/media-center\/news\/story\/diabetes-a-global-challenge. Accessed 2025-08-19 2024."},{"issue":"1","key":"477_CR66","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1186\/s12877-024-0243-0","volume":"24","author":"N Sallahi","year":"2024","unstructured":"Sallahi N, et al. Real-world clinical validation of the Qatar pre-diabetes risk score (prisq). BMC Geriatr. 2024;24(1):448. https:\/\/doi.org\/10.1186\/s12877-024-0243-0.","journal-title":"BMC Geriatr"},{"issue":"1","key":"477_CR67","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1093\/geronb\/gbr133","volume":"67","author":"KS Chan","year":"2012","unstructured":"Chan KS, Kasper JD, Brandt J, Pezzin LE. Measurement equivalence in ADL and IADL difficulty across international surveys of aging: findings from the HRS, SHARE, and ELSA. J Gerontol B Psychol Sci Soc Sci. 2012;67(1):121\u201332. https:\/\/doi.org\/10.1093\/geronb\/gbr133.","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"2","key":"477_CR68","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1093\/ije\/dyu067","volume":"43","author":"A Sonnega","year":"2014","unstructured":"Sonnega A, Faul JD, Ofstedal MB, Langa KM, Phillips JW, Weir DR. Cohort profile: The Health and Retirement Study (HRS). Int J Epidemiol. 2014;43(2):576\u201385. https:\/\/doi.org\/10.1093\/ije\/dyu067.","journal-title":"Int J Epidemiol"},{"issue":"13","key":"477_CR69","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18136962","volume":"18","author":"JE Prynn","year":"2021","unstructured":"Prynn JE, Polack S, Mactaggart I, Banks LM, Hameed S, Dionicio C, et al. Disability among older people: analysis of data from disability surveys in six low- and middle-income countries. Int J Environ Res Public Health. 2021;18(13):6962. https:\/\/doi.org\/10.3390\/ijerph18136962.","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"477_CR70","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02782-y","volume":"22","author":"S Chauhan","year":"2022","unstructured":"Chauhan S, Kumar S, Bharti R, Patel R. Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatr. 2022;22(1):64. https:\/\/doi.org\/10.1186\/s12877-022-02782-y.","journal-title":"BMC Geriatr"},{"issue":"3","key":"477_CR71","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-093566","volume":"15","author":"TT Nguyen","year":"2025","unstructured":"Nguyen TT, Giang LT, Bui TD, Nguyen NT. Prevalence of functional disability and associated factors among older people in Vietnam: a secondary data analysis. BMJ Open. 2025;15(3):093566. https:\/\/doi.org\/10.1136\/bmjopen-2024-093566.","journal-title":"BMJ Open"},{"issue":"20","key":"477_CR72","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17207387","volume":"17","author":"D Portela","year":"2020","unstructured":"Portela D, Almada M, Mid\u00e3o L, Costa E. Instrumental activities of daily living (IADL) limitations in Europe: an assessment of SHARE data. Int J Environ Res Public Health. 2020;17(20):7387. https:\/\/doi.org\/10.3390\/ijerph17207387.","journal-title":"Int J Environ Res Public Health"},{"key":"477_CR73","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2022.1605155","volume":"67","author":"VC Nguyen","year":"2022","unstructured":"Nguyen VC, Moon S, Oh E, Hong G-R. Factors associated with functional limitations in daily living among older adults in Korea: a cross-sectional study. Int J Public Health. 2022;67:1605155. https:\/\/doi.org\/10.3389\/ijph.2022.1605155.","journal-title":"Int J Public Health"},{"key":"477_CR74","doi-asserted-by":"publisher","unstructured":"Colombo F, Llena-Nozal A, Mercier J, Tjadens, F. Help Wanted? Providing and Paying for Long-Term Care. OECD Health Policy Studies. OECD Publishing, Paris 2011. https:\/\/doi.org\/10.1787\/9789264097759-en .","DOI":"10.1787\/9789264097759-en"},{"issue":"2","key":"477_CR75","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1177\/10497315211051629","volume":"32","author":"CT Fatoye","year":"2022","unstructured":"Fatoye CT, Gebrye T, Fatoye F. The effectiveness of personalisation on health outcomes of older people: a systematic review. Res Soc Work Pract. 2022;32(2):146\u201354.","journal-title":"Res Soc Work Pract"},{"issue":"8","key":"477_CR76","doi-asserted-by":"publisher","first-page":"462","DOI":"10.15171\/ijhpm.2019.22","volume":"8","author":"N Ikegami","year":"2019","unstructured":"Ikegami N. Financing long-term care: lessons from Japan. Int J Health Policy Manag. 2019;8(8):462\u20136. https:\/\/doi.org\/10.15171\/ijhpm.2019.22.","journal-title":"Int J Health Policy Manag"},{"issue":"3","key":"477_CR77","doi-asserted-by":"publisher","first-page":"174","DOI":"10.4235\/agmr.20.0037","volume":"24","author":"M Yamada","year":"2020","unstructured":"Yamada M, Arai H. Long-term care system in Japan. Annals of Geriatric Medicine and Research. 2020;24(3):174\u201380.","journal-title":"Annals of Geriatric Medicine and Research"},{"issue":"4","key":"477_CR78","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1111\/j.1467-7660.2011.01716.x","volume":"42","author":"I Peng","year":"2011","unstructured":"Peng I. The good, the bad and the confusing: the political economy of social care in South Korea. Dev Chang. 2011;42(4):905\u201323. https:\/\/doi.org\/10.1111\/j.1467-7660.2011.01716.x.","journal-title":"Dev Chang"},{"issue":"1","key":"477_CR79","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.healthpol.2020.11.003","volume":"125","author":"H Kim","year":"2021","unstructured":"Kim H, Kwon S. A decade of public long-term care insurance in South Korea: policy lessons for aging countries. Health Policy. 2021;125(1):22\u20136.","journal-title":"Health Policy"},{"key":"477_CR80","doi-asserted-by":"publisher","first-page":"97","DOI":"10.4337\/9781800378421.00018","volume-title":"Handbook on Social Protection and Social Development in the Global South","author":"A Barrientos","year":"2023","unstructured":"Barrientos A. Social protection in Latin America. In: Handbook on Social Protection and Social Development in the Global South. Cheltenham: Edward Elgar Publishing; 2023. p. 97\u2013111."},{"issue":"1","key":"477_CR81","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40744-020-00252-1","volume":"8","author":"H Almoallim","year":"2021","unstructured":"Almoallim H, Al Saleh J, Badsha H, Ahmed HM, Habjoka S, Menassa JA, et al. A review of the prevalence and unmet needs in the management of rheumatoid arthritis in Africa and the Middle East. Rheumatol Ther. 2021;8(1):1\u201316.","journal-title":"Rheumatol Ther"},{"issue":"14","key":"477_CR82","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12144675","volume":"12","author":"O Mahmoud","year":"2023","unstructured":"Mahmoud O, Yosipovitch G, Attia E. Burden of disease and unmet needs in the diagnosis and management of atopic dermatitis in the Arabic population of the Middle East. J Clin Med. 2023;12(14):4675.","journal-title":"J Clin Med"},{"issue":"1","key":"477_CR83","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1186\/s12913-024-10787-6","volume":"24","author":"M Alattas","year":"2024","unstructured":"Alattas M, Gordon S, Sabin LL, El-Jardali F, Wirtz VJ. Equity and unmet need of non-communicable diseases services in Saudi Arabia using a national household survey (2019). BMC Health Serv Res. 2024;24(1):346.","journal-title":"BMC Health Serv Res"},{"key":"477_CR84","first-page":"23","volume-title":"Reforms in Long-Term Care Policies in Europe: Investigating Institutional Change and Social Impacts","author":"F Carrera","year":"2012","unstructured":"Carrera F, Pavolini E, Ranci C, Sabbatini A. Long-term care systems in comparative perspective: Care needs, informal and formal coverage, and social impacts in European countries. In: Ranci C, Pavolini E, editors. Reforms in Long-Term Care Policies in Europe: Investigating Institutional Change and Social Impacts. New York: Springer; 2012. p. 23\u201352."},{"issue":"3","key":"477_CR85","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1017\/S0047279417000903","volume":"47","author":"T Burchardt","year":"2018","unstructured":"Burchardt T, Jones E, Obolenskaya P. Formal and informal long-term care in the community: interlocking or incoherent systems? J Soc Policy. 2018;47(3):479\u2013503.","journal-title":"J Soc Policy"},{"key":"477_CR86","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104536","volume":"153","author":"J Wang","year":"2021","unstructured":"Wang J, Fu Y, Lou V, Tan SY, Chui E. A systematic review of factors influencing attitudes towards and intention to use the long-distance caregiving technologies for older adults. Int J Med Inform. 2021;153:104536.","journal-title":"Int J Med Inform"},{"issue":"4","key":"477_CR87","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s13167-019-00188-9","volume":"10","author":"M Barrett","year":"2019","unstructured":"Barrett M, Boyne J, Brandts J, Brunner-La Rocca HP, De Maesschalck L, De Wit K, et al. Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care. EPMA J. 2019;10(4):445\u201364.","journal-title":"EPMA J"},{"issue":"1","key":"477_CR88","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40520-025-03021-8","volume":"37","author":"V Gianfredi","year":"2025","unstructured":"Gianfredi V, Nucci D, Pennisi F, Maggi S, Veronese N, Soysal P. Aging, longevity, and healthy aging: the public health approach. Aging Clin Exp Res. 2025;37(1):1\u201312.","journal-title":"Aging Clin Exp Res"},{"issue":"6","key":"477_CR89","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2025.103971","volume":"35","author":"F Battista","year":"2025","unstructured":"Battista F, Duregon F, Vecchiato M, Ermolao A, Neunhaeuserer D. Sedentary lifestyle and physical inactivity: a mutual interplay with early and overt frailty. Nutr Metab Cardiovasc Dis. 2025;35(6):103971.","journal-title":"Nutr Metab Cardiovasc Dis"}],"container-title":["Population Health Metrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12963-026-00477-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12963-026-00477-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12963-026-00477-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:32:51Z","timestamp":1781137971000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12963-026-00477-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":89,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["477"],"URL":"https:\/\/doi.org\/10.1186\/s12963-026-00477-2","relation":{},"ISSN":["1478-7954"],"issn-type":[{"value":"1478-7954","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"31 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42"}}