Why should we worry? The Future of Ageing

Why should we worry?
And why not.

David Sinclair, International Longevity
Centre – UK @ilcuk @sinclairda

The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.

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


Our focus is broad


Why should we worry?

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

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/5832
685007/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) http://www.flickr.com/photos/pondspider/4170990
903/sizes/m/in/photostream/

 “almost 50% of men and women
aged 80-84 report severe
limitations in activities” (IFS, 2010)

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% http://www.flickr.com/photos/pinkchocola
te/3039589789/sizes/m/in/photostream/

report difficulties managing
money. (Sinclair, 2010/ELSA)


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

Kalisch et al, 2010)

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
http://www.flickr.com/photos/junglearctic/300
but not in 2002-03” (IFS, 2010) 2442666/sizes/m/in/photostream/

ELSA

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 http://www.flickr.com/photos/pinkchocola
to become more socially excluded te/3039589789/sizes/m/in/photostream/

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


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
(Evandrou &
of the 1940s cohort
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;
http://www.flickr.com/
 Those who moved from being resident in a photos/anabadili/296
3913137/sizes/m/in/p

couple household to living alone were over three hotostream/

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.


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
Dodge,
realisation that they are more free than their
predecessors in the past century.” 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 http://www.flickr.com/photos/driever/5525684658/sizes/
m/in/photostream/
the basic performance of the
everyday life”. (Antonini et al,
2008)

Some of the oldest old become more active


A move to prevention is vital

 Prevention of ill health

 Physical Activity

 Smoking and alcohol consumption

 Nutrition

 Immunisation


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


Possible technology innovations to 2050
2010 2020 2030 2040 2050
Artificial Auto-pilot cars Digital mirrors VR windows
Intelligence entity
Self clean houses
passes A level
Face recognition
Computer controlled doors Individual
pollution credits Nuclear
hunger suppressant Prison countries
Holographic TV fusion
Smart Wave energy
Artificial Intelligence bath Human
=50% in UK
Global ID
causes redundancies memory card
Active skin Invisibility
enhancement
Emotion control makeup cloak
devices Bionic Olympics Brain downloads
Virtual holidays
Full voice Thought input Robocops
recognition PCs mechanisms Hydrogen fuel
Artificial brain
widespread stations
Viewers can choose Human memory
film roles Circuits made downloads
with bacteria Self drive cars
Tooth Humanoid robots beat
regeneration Global voting on Virtual displays national football team
Listing of some issues
Disposable
individual DNA phones


Google knows! Location Based Services


Summary

 There is lots to worry about

 But there are opportunities

 What is the role for you?


Many thanks

David Sinclair
Head of Policy and Research
International Longevity Centre
Davidsinclair@ilcuk.org.uk
02073400440
Twitter: @ilcuk and @sinclairda


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