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. 2018 May 1;47(3):374-380.
doi: 10.1093/ageing/afx201.

Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model

Andrew Kingston  1 , Louise Robinson  1 , Heather Booth  2 , Martin Knapp  3 , Carol Jagger  1 ; MODEM project
Affiliations

Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model

Andrew Kingston et al. Age Ageing. .

Abstract

Background: models projecting future disease burden have focussed on one or two diseases. Little is known on how risk factors of younger cohorts will play out in the future burden of multi-morbidity (two or more concurrent long-term conditions).

Design: a dynamic microsimulation model, the Population Ageing and Care Simulation (PACSim) model, simulates the characteristics (sociodemographic factors, health behaviours, chronic diseases and geriatric conditions) of individuals over the period 2014-2040.

Population: about 303,589 individuals aged 35 years and over (a 1% random sample of the 2014 England population) created from Understanding Society, the English Longitudinal Study of Ageing, and the Cognitive Function and Ageing Study II.

Main outcome measures: the prevalence of, numbers with, and years lived with, chronic diseases, geriatric conditions and multi-morbidity.

Results: between 2015 and 2035, multi-morbidity prevalence is estimated to increase, the proportion with 4+ diseases almost doubling (2015:9.8%; 2035:17.0%) and two-thirds of those with 4+ diseases will have mental ill-health (dementia, depression, cognitive impairment no dementia). Multi-morbidity prevalence in incoming cohorts aged 65-74 years will rise (2015:45.7%; 2035:52.8%). Life expectancy gains (men 3.6 years, women: 2.9 years) will be spent mostly with 4+ diseases (men: 2.4 years, 65.9%; women: 2.5 years, 85.2%), resulting from increased prevalence of rather than longer survival with multi-morbidity.

Conclusions: our findings indicate that over the next 20 years there will be an expansion of morbidity, particularly complex multi-morbidity (4+ diseases). We advocate for a new focus on prevention of, and appropriate and efficient service provision for those with, complex multi-morbidity.

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Figures

Figure 1.
Figure 1.
Years gained between 2015 and 2035 in life expectancy at age 65 and years lived from age 65 with multi-morbidity (diseases only), by sex
See this image and copyright information in PMC

References

    1. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012; 380(9836):37–43. - PubMed
    1. Salive ME. Multimorbidity in older adults. Epidemiol Rev 2013; 35: 75–83. - PubMed
    1. Office for National Statistics. National Population Projections: 2014-based Statistical Bulletin 2015http://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigratio... (16 December 2015, date last accessed).
    1. Collerton J, Davies K, Jagger C et al. . Health and disease in 85 year olds: baseline findings from the Newcastle 85+cohort study. Br Med J 2009; 339. - PMC - PubMed
    1. Marengoni A, Angleman S, Melis R et al. . Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10(4):430–9. - PubMed

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