research on ageing –what the evidence tells us...• the life span is not fixed and is slowly...
TRANSCRIPT
Research on Ageing – What the
Evidence Tells Us
Professor James Goodwin PhD
Head of Research
Age UK
London
Overview
What is the extent of population ageing ?
What are the challenges of an ageing population ?
What does the research tell us?
Q1: What is the extent of
population ageing ?
“ “I’ve turned 60 and I can barely believe nearly a third of my life is over ”
Woody Allen
Demographic predictions
The changing age profile of society – 85+
–One in five of the population is a
pensioner and one in three is aged 50
or over
–By 2025, every fifth person in the UK
will be aged 65 or over
–The fastest growing segment of the
UK population is the oldest old; 1.5m
today, 3.0m by 2030
–These trends will lead to a
restructuring of society; the 100 year
life-span and the 4 generation family
0
1,000
2,000
3,000
4,000
5,000
6,000
1961 1971 1981 1991 2001 2011 2021 2031 2041 2051 2061
Population of the UK aged 85 or over 1961 - 2061
Source: Office for National Statistics population projections
people, thousands
YOUNG CHILDREN AND OLDER PEOPLE PROJECTED INCREASE IN GLOBAL POPULATION
AS A PERCENTAGE OF GLOBAL POPULATION BETWEEN 2005 and 2030, BY AGE
Ageing - International
“The number of centenarians in Japan increased
almost one-hundredfold from 154 in 1963 to
more than 13,000 at the beginning of this century
and is projected to increase to almost 1,000,000
by 2050”
Ageing Horizons, 3,1 (2005)
Ageing - International
Population Ageing – The Evidence
• Survival is increasing to the oldest ages
• The life span is not fixed and is slowly increasing
• Ageing occurs across the lifespan
• Ageing is malleable
• It is perfectly possible to live most of life in good health
• Demographic change is going to re-structure society (the
100 year life-span)
Summary
Q2 What are the challenges of
population ageing ?
Things are awful
Principle of Miserabilism
Things will get worse
• Health: exponential relationship between age and
prevalence of chronic ill health
• Economics: dependency ratio soon to reach unity
• Social problems: increasing isolation and loneliness
• Care: insufficient resources for a growing problem
Theoretical Gloom
• Type 1 Panic ‘We can’t afford to make or keep
old people healthy’
• Type 2 Panic ‘We can’t afford healthy old
people’
Panic in Government
Q3: What does the research tell us?
Finance and Economics
OBR projections – ageing no cause for
concern
OBR projections – ageing no cause of
concern
Universal benefits – the crucial small
beer
Total Public Expenditure (TME)…
This is how much is spent on Winter Fuel Payments, Concessionary Bus Fares, and free TV Licences together…
Universal benefits – the crucial small beer
0.58%
Total Public Expenditure (TME)…
This is how much is spent on Winter Fuel Payments, Concessionary Bus Fares, and free TV Licences together…
11.2
6.6
6.2
4.8
4.7
4.4
4.0
3.8
3.7
3.7
3.5
2.4
1.9
1.9
-0.5
3.2
-5 0 5 10 15
Greece
Spain
Netherlands
Germ any
Finland
Ireland
Portugal
Austria
France
Belgium
Denm ark
Sweden
Luxem bourg
Italy
UK
EU
Forecast change in public pension spending 2000–2040 (%)
Health
Effect of age on health
The prevalence of disability, including limiting long standing illness, clearly rises with age
Age range Individuals without
disability (approx)
Individuals with
disability (approx)
0-15 95% 5%
16-24 95% 5%
25-34 90% 10%
35-44 90% 10%
45-54 85% 15%
55-59 75% 25%
60-64 70% 30%
65-74 60% 40%
75-84 45% 55%
85+ 30% 70%
Multiple health problems• ‘Multi-morbidity’ is common. Most older people have more than one
condition. In Scotland, 2012:
• The majority of over-65s have 2 or more conditions
• The majority of over-75s have 3 or more conditions
• More people have 2 or more conditions than only have 1
The health-span gap
• Healthy life expectancy is increasing but at a slower rate than life expectancy.
• There is evidence that compression of morbidity is taking place, i.e. delay of onset of age-related illness to the end of life – but progress is slower than expected.
• So we face a health-span gap in which more older people will live for more years with more age-related health problems.
• There are significant health inequalities among older people in the UK, and age discrimination in the provision of health services.
Dementia – An Illustration of the Risks
� You are obese (BMI>30) the risk of dementia post 65 is doubled
� You are hyper-cholesterolemic (>5 mmol/l) the risk…is doubled
� You are hypertensive (BP>140/90) the risk …is doubled
If you have all 3 conditions (ca.1 million people in the UK) then
you are six times at risk
If you are in mid-life (45-55) and….
Dementia - the Cost
UK: £23 billion annually 1
Globally: $604 billion annually (1%GDP) 2
Projected to rise by 85% by 2030 3
1. Alzheimers Research Trust 2010
2. World Alzheimers Report 2010
3. World Alzheimers Report 2010
Social Care
The social care funding crisis: looking forward
Note: no data between 2016-17 and 2024-25 – the two data points are linked by a straight line
Projections of net expenditure on older people’s social care between 2011 and 2026
Numbers of clients fall while population
increases
Total number of clients aged
65 and over receiving services
during the period
Total Estimated
Population 65+
(England)%
2007-08 1,220,660 8,156,466 14.97%
2008-09 1,215,575 8,288,300 14.67%
2009-10 1,147,695 8,426,200 13.62%
2010-11 1,064,475 8,585,000 12.40%
2011-12 989,905 9,076,900 10.91%
Poor integrationToo much care is still provided in hospitals and care homes, and treatment services
continue to receive higher priority than prevention.
Current models of care appear to be outdated at a time when society and technologies
are evolving rapidly and are changing the way patients interact with service providers.
But it can work: Torbay Care Trust
• Reduction in the daily average number of occupied beds from 750 in 1998/9 to 502
in 2009/10
• Emergency bed use aged 65+ lowest in region, negligible delayed transfers of care.
There is a need for innovation in the sector – AUK can innovate and the care / health
interface
• SIB crucial – particularly additional learning / other projects?
• Evidence of effectiveness is crucial
Summary
Ageing is not the burden on society that many
claim but society will have to change
• emphasis on prevention, early diagnosis and
early access to health care
• changed models of provision, negative
attitude to ageing improved
• better integrated care pathways
• different models of social care and payment
Research can make it better!
