Seniors Now Spend More Years with Caregivers

Newcastle University (United Kingdom), the University of Cambridge (United Kingdom), and other institutions conducted a population-based study in order to estimate the years lived in different dependency states at age 65 years and to project future demand for care. To do so, they compared between two cognitive function and ageing studies of adults 65 years and older permanently registered with general practices in Cambridgeshire, Newcastle, and Nottingham. The studies were held two decades apart (one in 1991 and the other in 2011).

The studies provided lists of individuals to be contacted for baseline interviews, including sex, socio-demographic data, cognitive status, urinary incontinence, and self-reported ability to complete daily living activities. The studies provided prevalence estimates of dependency in four care states: high dependency (24 hour care), medium dependency (daily care), low dependency (less than daily), and independent. To project future demands, the proportions of each dependency state were applied to the 2014 England population projections.

The results revealed that between 1991 and 2011, the majority of men's extra years of life were spent independent (36.3%) or with low dependency (36.3%), whereas for women the majority were spent with low dependency (58.0%), and only 4.8% were independent. For both men and women, there were significant increases in years lived from age 65 years with low and high dependency, with the number of years spent with substantial care needs averaging three years for women and 2.4 years for men aged over 65.

The authors estimated that if rates of dependency remain constant, there will be an additional 190,000 older people with medium dependency, and 163,000 with high dependency by 2025, compared to 2015. While approximately half of these people will live in the community, at current rates of provision, an extra 71,215 care home spaces will be needed. Additionally, the study projects an increase of 885,000 people with low dependency, reaching 4.44 million by 2025. The study was published on August 15, 2017, in The Lancet.

“The past 20 years have seen continued gains in life expectancy, but not all of these years have been healthy years. Our study suggests that older people today are spending more of their remaining life with care needs,” said senior author Professor Carol Jagger, PhD, of Newcastle University. “Though most of the extra years are spent with low dependency, including help with activities such as washing, shopping, or doing household tasks, older men and women are spending around one year more requiring 24-hour care.”

Between 1991 and 2011, life expectancy increased for both men (from 77.9 to 82.6) and women (from 81.5 to 85.6), and the fastest growing section of the population is those aged 85 years and older. The proportion of years that an adult aged 65 could expect to live independently declined from 73.6% to 63.5% for men, and from 58% to 47.3% for women.

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