Download - Why should we worry? The Future of Ageing

The International Longevity Centre-UK is an independent, non-partisan think-tank

dedicated to addressing issues of longevity, ageing and population change.

Why should we worry?

And why not.

David Sinclair, International Longevity

Centre – UK @ilcuk @sinclairda



Who are we?

The ILC-UK was established

in 2000 to explore and

address the impact of our

ageing society on public

policy

We have a global reach with

14 Members of the ILC

Global Alliance.



Who do we work with?/Declaration of interests

http://www.housinglin.org.uk/

http://www.dh.gov.uk/health

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http://www.pfizer.co.uk/sites/uk/Pages/default.aspx

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http://www.google.co.uk/url?sa=i&rct=j&q=actuarial+profession&source=images&cd=&cad=rja&docid=SgmFf07sTBHMiM&tbnid=FvxL9CZiwgu4YM:&ved=0CAUQjRw&url=http://www.maths.manchester.ac.uk/undergraduate/careers/cc/company%20profiles.php&ei=N08SUdzRN_GX0QW6yIC4Cg&bvm=bv.41934586,d.d2k&psig=AFQjCNFvZ9NEnjQQaQ0NPMrjBhCP5ZXiEQ&ust=1360240805691645

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Our focus is broad



5 reasons to worry– Oldest old– The cost of ageing– Isolation – Economic crisis– The squeezed middle aged

But opportunities– Prevention (Vaccination nutrition pa)– Housing– Working longer– Health developments and new technology

Why should we worry?



Growth in the number of oldest old



How many centenarians are there?

There are currently 11,800 people in the UK who are currently at least 100 (DWP)

There are fewer than 100 people who are aged more than 110. (DWP)

In 1911 there were just 100 Centenarians living in England & Wales

Growth has been about 7% p/a http://www.flickr.com/photos/un_photo/5832685007/sizes/z/in/

photostream/



Number of people currently alive who can expect to see their 100th birthday, by age in 2010



Life is not easy for the oldest old

Three quarters of the oldest old

suffer from limiting longstanding

illnesses, and one out of three

perceive themselves as being in

poor health. (Tomassini C, 2005)

“almost 50% of men and women

aged 80-84 report severe

limitations in activities” (IFS, 2010)

http://www.flickr.com/photos/pondspider/4170990903/sizes/m/in/photostream/



And many find it difficult to do day to day tasks

Sixty per-cent of over 90s report

difficulties shopping for groceries,

almost a quarter report difficulties

making telephone calls and 35%

report difficulties managing

money. (Sinclair, 2010/ELSA)

http://www.flickr.com/photos/pinkchocolate/3039589789/sizes/

m/in/photostream/



A relatively high proportion live alone

Of those living in private households, four in ten very old men and seven out of ten very old women live alone. One out of five very old people live in communal establishments. (Tomassini C, 2005).

http://www.flickr.com/photos/sbeebe/5154169795/sizes/m/in/photostream/



Most centenarians consult their GP

98% of centenarians

and near

centenarians

consulted a GP and

received prescription

medicine during follow

up. (Roughead,

Kalisch et al, 2010)

http://www.flickr.com/photos/rwjensen/2288339230/sizes/m/in/photostream/



Centenarians do use drugs heavily

A study of 602 centenarians in Italy found that a very high proportion of this age group were users of drugs.

5% no drugs. 13% one drug a day 16% took 2 drugs per day 65% took three drugs a day 5.5% more than 3 drugs a day.



Some evidence of longer hospital stays

Centenarians who had suffered from a hip fracture between 2000 and 2007 compared to a randomly selected control group of 50 hip fracture patients aged between 75 and 85. “the mean stay in acute orthopaedic wards for centenarians was 20.7 days and for the control group was 14.9 days”.

The longer acute hospital stay in the centenarian cohort would amount to a mean extra cost of £ 2511 per patient. (Verma et al)



Depression

“23% of those aged 85 and over

had levels of depressive symptoms

indicative of clinical relevance”

“Almost 13% of men and women

aged 80 and over had high levels

of depressive symptoms in 2008-09

but not in 2002-03” (IFS, 2010)

ELSA

http://www.flickr.com/photos/junglearctic/3002442666/sizes/m/in/

photostream/



Falls

60% of interviewees aged over 90 had had a fall and that of these, 4 in five were unable to get up after at least one fall and almost a third had lain on the ground for an hour or more.

Call alarms were widely available but not used.(Fleming and Brayne, 2008; Cambridge City over 75-Cohor. BMJ)



Poverty is a very real challenge

There is evidence that the

oldest old (aged 85 and over)

are, as a group, at greater

risk of poverty than younger

older people (aged 65-85)

Up to 10% of the oldest old

have total net wealth of

£3,000 or less.



Dementia among centenarians

The prevalence of

dementia-free

survival past 100

years of age varied

between 0 and 50

percent.”

http://www.flickr.com/photos/thousandshipz/4679235/sizes/m/in/photostream/



The oldest old remain the most excluded

Almost 38% of those aged 85 or older faced some kind of social exclusion, an encouraging decline of 10% from the 2002 levels

As people age, they are more likely to become more socially excluded than less

Almost two-fifths (38%) of those aged 85 and older were excluded from two or more domains of exclusion in 2008

http://www.flickr.com/photos/pinkchocolate/3039589789/sizes/

m/in/photostream/



Quality of Life falls with age



Cost of ageing

In the UK: age-related spending is projected to rise from an annual cost of 21.3% to 26.3% of GDP between 2016/17 and 2061/62, a rise of 5% of GDP (equivalent to a rise of around £79bn in today’s money).



Healthcare costs

• In the UK: spending on health care is projected to see the largest

rise of all elements of age-related spending, rising from an annual

cost of 6.8% to 9.1% of GDP between 2016/17 and 2061/62, a rise of

2.3% of GDP (equivalent to a rise of around £36bn in today’s

money).

• In the EU: spending on health care is projected to rise from an

annual cost of 7.1% to 8.3% of GDP between 2010 and 2060, a rise

of 1.1% of GDP.

• Globally: it is difficult to project the costs of health care because of

the lack of data from developing countries. But evidence of growing

numbers with long term conditions.



Spending on health care will see the greatest increase of all age-related spending over the next 50 years

Projected health care spending as a proportion

of GDP



Long term care costs

• In the UK: spending on long term care is projected to rise between 2016/17 and 2061/62 from an annual cost of 1.1% to 2% of GDP, a rise of 0.9% of GDP59 (equivalent to a rise of around £14bn in today’s money).

• EU spending on long term care is projected to rise from an annual cost of 1.8% to 3.4% of GDP between 2010 and 2060



Increasingly living alone - isolation

50 per cent of the

1960s cohort will be

living alone at age 75

compared with 37 per

cent for the 1916-1920

cohort and 41 per cent

of the 1940s cohort

(Evandrou &

Falkingham, 2000).



Many live independently

Substantial numbers of centenarians and nonagenarians continue to live independently in the community, either alone or with family members.

8% of those aged 90 and over were living in privately rented accommodation and 30% in socially rented accommodation. 2009 Understanding Society



Living together is good for us

Those who moved from living alone to living as part of a couple (with no children) exhibited a 68% fall in the odds of becoming multiply excluded between 2002 and 2008 compared to those who stayed living alone;

Those who moved from being resident in a couple household to living alone were over three times more likely to become multiply excluded. For this age group (50+), becoming a widow is one of the most common reasons for starting to live alone.

http://www.flickr.com/photos/anabadili/2963913137/sizes/m/in/

photostream/



Impact of the global economic downturn

EU GDP growth is expected to be 1.4% per year between

2010 and 2060 compared to 2.5% for the 10 years 1997-2006.

More difficult for the state to pay for longevity:

Employment and productivity falling; falling tax intake; more

difficult to meet debt obligations; difficulties in funding public

pension systems

And for the individual: Unemployment, reductions in wages,

or reductions in hours worked, make it more difficult to save

adequately for retirement; Falls in value of pension pots; Price

inflation has been high.



The squeezed middle age

People in their fifties increasingly excluded from society The number of people aged 50 plus

being socially excluded from decent housing, public transport and local amenities has risen sharply

Over one in six people in their fifties (18%) were socially excluded in two of more areas of their life – up from 13 per cent in 2002.



Britons ageing quicker than their parents



Will the baby boomers demand change?

“They have fewer ties to family responsibilities... With their homes paid for their major housing concern is for property taxes and repairs... Being essentially free from obligation, they may spend their income and assets as they wish. Here is a potential market, therefore for those marketers who wish to appeal to it. It is a new market, almost unrecognised which must be developed with care as it depends upon the changing role of older persons in our society and the realisation that they are more free than their predecessors in the past century.”



Will the baby boomers demand change?

“They have fewer ties to family responsibilities... With their homes paid for their major housing concern is for property taxes and repairs... Being essentially free from obligation, they may spend their income and assets as they wish. Here is a potential market, therefore for those marketers who wish to appeal to it. It is a new market, almost unrecognised which must be developed with care as it depends upon the changing role of older persons in our society and the realisation that they are more free than their predecessors in the past century.”

Dodge, 1962



Some Opportunities



Dependency is not inevitable

Dependency is not inevitable

and a ”considerable

proportion of the

centenarians maintain a good

level of auto sufficiency for

the basic performance of the

everyday life”. (Antonini et al,

2008)

http://www.flickr.com/photos/driever/5525684658/sizes/m/in/photostream/



Some of the oldest old become more active



Prevention of ill health

Physical Activity

Smoking and alcohol consumption

Nutrition

Immunisation

A move to prevention is vital



Getting housing right

1. Extra care housing is a

home for life

2. Extra care translates

into fewer falls

3. Extra care is

associated with a lower

uptake of inpatient

hospital beds



And how can we make new housing and communities aspirational?



Working longer – a solution?

The longer that people spend in work, the longer they

have to save for retirement and the shorter their

retirement will be, relative to their working life.

A later average age of exit can also increase the

number of people in work, relative to the number who

are retired, making it easier to fund pensions,

benefits and health and care costs from current

taxes.



We are working longer

Labour market participation at older ages (ages 55 to 64) is expected to increase within the EU from around 50% to around 67% between 2010 and 2060.

The average age of exit is also projected to increase from around 62 to around 64 within the EU and from around 64 to around 65 within the UK between 2010 and 2060.



Technology limited by imagination



Fantastic developments in health

I think there’ll be a cure for cancer one day. That we never thought we’d see…and Alzheimer’s.

I would wish for a pill to cure everything…



From patient/recipient to health consumer

More confident consumers of health with raising expectations rather than patients

More tests available over the counter

Greater access to information about conditions

Expectations to health become more focused on “fix it”, prevent it, cure it?

Growth in health tourism



Developments in genetics



Artificial Intelligence entity

passes A level

Possible technology innovations to 20502010 2020 2030 2040 2050

Artificial Intelligence causes redundancies

Computer controlled hunger suppressant

Emotion control devices

Auto-pilot cars

Holographic TV

Full voice recognition PCs

Thought input mechanisms widespread

Viewers can choose film roles

Global voting on some issues

Tooth regeneration

Listing of individual DNA

Circuits made with bacteria

Bionic Olympics

Active skin makeup

Disposable phones

Digital mirrors

Face recognition doors

Smart bath

Individual pollution credits

Human memory

enhancement

Virtual holidays

Hydrogen fuel stations

Self drive cars

VR windows

Prison countries

Invisibility cloak

Self clean houses

Global ID card

Robocops

Human memory downloads

Nuclear fusion

Humanoid robots beat national football

team

Artificial brain

Brain downloads

Virtual displays

Wave energy =50% in UK



Google knows! Location Based Services



There is lots to worry about

But there are opportunities

What is the role for you?

Summary



Many thanks

David Sinclair

Head of Policy and Research

International Longevity Centre

[email protected]

02073400440

Twitter: @ilcuk and @sinclairda

mailto:[email protected]