Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS)

Kingston, Andrew; Wohland, Pia; Wittenberg, Raphael; Robinson, Louise; Brayne, Carol; Matthews, Fiona E.; Jagger, Carol

Abstract

Background: Little is known about how dependency levels have changed between generational cohorts of older people. We estimated years lived in different care states at age 65 in 1991 and 2011 and new projections of future demand for care. Methods: Two population-based studies of older people in defined geographical areas conducted two decades apart (the Cognitive Function and Ageing Studies) provided prevalence estimates of dependency in four states: high (24-hour care); medium (daily care); low (less than daily); independent. Years in each dependency state were calculated by Sullivan’s method. To project future demand, the proportions in each dependency state (by age group and sex) were applied to the 2014 England population projections. Findings: Between 1991 and 2011 there were significant increases in years lived from age 65 with low (men:1·7 years, 95%CI 1·0-2·4; women:2·4 years, 95%CI 1·8-3·1) and high dependency (men:0·9 years, 95%CI 0·2-1·7; women:1·3 years, 95%CI 0·5-2·1). The majority of men’s extra years of life were independent (36%) or with low dependency (36%) whilst for women the majority were spent with low dependency (58%), only 5% being independent. There were substantial reductions in the proportions with medium and high dependency who lived in care homes, although, if these dependency and care home proportions remain constant in the future, further population ageing will require an extra 71,000 care home places by 2025. Interpretation: On average older men now spend 2.4 years and women 3.0 years with substantial care needs (medium or high dependency), and most will live in the community. These findings have considerable implications for older people’s families who provide the majority of unpaid care, but the findings also supply valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations.

Citation

Kingston, A., Wohland, P., Wittenberg, R., Robinson, L., Brayne, C., Matthews, F. E., & Jagger, C. (2017). Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS). Lancet, 390(10103), 1676-1684. https://doi.org/10.1016/S0140-6736%2817%2931575-1

• Journal Article Type: Article
• Acceptance Date: May 30, 2017
• Online Publication Date: Aug 15, 2017
• Publication Date: Oct 7, 2017
• Deposit Date: Jun 5, 2017
• Publicly Available Date: Aug 15, 2017
• Journal: Lancet
• Print ISSN: 0140-6736
• Electronic ISSN: 1474-547X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 390
• Issue: 10103
• Pages: 1676-1684
• DOI: https://doi.org/10.1016/S0140-6736%2817%2931575-1
• Keywords: Cognitive Function and Ageing Studies, Ageing, Late life dependency, Sullivan’s method, England
• Public URL: https://hull-repository.worktribe.com/output/452013
• Publisher URL: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31575-1/fulltext
• Additional Information: Copyright: © 2017 The Author(s). Published by Elsevier Ltd.