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

Kingston, Andrew, Robinson, Louise, Booth, Heather, Knapp, Martin, Jagger, Carol, MODEM project, , Adelaja, Bayo, Avendano, Mauricio, Bamford, Sally-Marie, Banerjee, Sube, Berwald, Sharne, Bowling, Ann, Burgon, Clare, Bustard, Elizabeth, Comas-Herrera, Adelina, Dangoor, Margaret, Dixon, Josie, Farina, Nicolas, Greengross, Sally, Grundy, Emily, Hu, Bo, King, Derek, Lombard, Daniel, Lorenz, Klara, McDaid, David, Park, A-La, Pikhartova, Jitka, Rehill, Amritpal and Wittenberg, Raphael (2018) Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age and Ageing, 47 (3). pp. 374-380. ISSN 0002-0729

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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).

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.

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.

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.

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.

Item Type: Article
Keywords: Adult;Age Distribution;Aged;Aged, 80 and over;Aging;Computer Simulation;Disease Susceptibility;England;Forecasting;Health Services Needs and Demand;Health Services for the Aged;Health Status;Humans;Life Expectancy;Mental Health;Models, Theoretical;Multimorbidity;Prevalence;Risk Assessment;Risk Factors;Time Factors
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 30 Jan 2020 11:39
Last Modified: 30 Jan 2020 11:45

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