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Projections of dependency and associated social care expenditure for the older population in England to 2038: Effect of varying disability progression

Lookup NU author(s): Dr Andrew KingstonORCiD, Emerita Professor Carol Jagger



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


© 2022 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. Objectives: to assess the effect of recent stalling of life expectancy and various scenarios for disability progression on projections of social care expenditure between 2018 and 2038, and the likelihood of reaching the Ageing Society Grand Challenge mission of five extra healthy, independent years at birth. Design: two linked projections models: the Population Ageing and Care Simulation (PACSim) model and the Care Policy and Evaluation Centre long-term care projections model, updated to include 2018-based population projections. Population: PACSim: about 303,589 individuals aged 35 years and over (a 1% random sample of the England population in 2014) created from three nationally representative longitudinal ageing studies. Main outcome measures: Total social care expenditure (public and private) for older people, and men and women's independent life expectancy at age 65 (IndLE65) under five scenarios of changing disability progression and recovery with and without lower life expectancy. Results: between 2018 and 2038, total care expenditure was projected to increase by 94.1%-1.25% of GDP; men's IndLE65 increasing by 14.7% (range 11.3-16.5%), exceeding the 8% equivalent of the increase in five healthy, independent years at birth, although women's IndLE65 increased by only 4.7% (range 3.2-5.8%). A 10% reduction in disability progression and increase in recovery resulted in the lowest increase in total care expenditure and increases in both men's and women's IndLE65 exceeding 8%. Conclusions: interventions that slow down disability progression, and improve recovery, could significantly reduce social care expenditure and meet government targets for increases in healthy, independent years.

Publication metadata

Author(s): Kingston A, Wittenberg R, Hu B, Jagger C

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2022

Volume: 51

Issue: 7

Online publication date: 23/07/2022

Acceptance date: 20/04/2022

Date deposited: 02/09/2022

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press


DOI: 10.1093/ageing/afac158

PubMed id: 35871421


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Funder referenceFunder name
PR-PRU-1217-21502National Institute for Health Research (NIHR)