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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; Green, E.; Woods, B.; Harrison, S.; Barnes, L. E.; Gao, L.; Barnes, R.; Arthur, A.; Baldwin, C.; Brayne, C.; Comas-Herrera, A.; Dening, T.; Forster, G.; Ince, P. G.; McKeith, I. G.; Parry, B.; Pickett, J.; Stephan, B. C.M.; Wharton, S.; Weller, R.


Andrew Kingston

Pia Wohland

Raphael Wittenberg

Louise Robinson

Carol Brayne

Fiona E. Matthews

Carol Jagger

E. Green

B. Woods

S. Harrison

L. E. Barnes

L. Gao

A. Arthur

C. Baldwin

C. Brayne

A. Comas-Herrera

T. Dening

G. Forster

P. G. Ince

I. G. McKeith

B. Parry

J. Pickett

B. C.M. Stephan

S. Wharton

R. Weller


E Green

L Gao

R Barnes

A Arthur

C Baldwin

L E Barnes

C Brayne

A Comas-Herrera

T Dening

G Forster

S Harrison

P G Ince

C Jagger

F E Matthews

I G McKeith

B Parry

J Pickett

L Robinson

B C M Stephan

S Wharton

R Wittenberg

B Woods

R Weller


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.

Journal Article Type Article
Publication Date Oct 7, 2017
Journal Lancet
Print ISSN 0140-6736
Electronic ISSN 1474-547X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 390
Issue 10103
Pages 1676-1684
APA6 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. doi:10.1016/S0140-6736(17)31575-1
Keywords Cognitive Function and Ageing Studies, Ageing, Late life dependency, Sullivan’s method, England
Publisher URL
Additional Information Copyright: © 2017 The Author(s). Published by Elsevier Ltd.


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Copyright Statement
© The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY 4.0 license.

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