Abstract

Objectives: This study makes projections on long-term care receipt and expenditure among older people living with dementia in England between 2015 and 2040.

Methods: We built a projection model using the macrosimulation approach. Our analyses drew on three sources of data: (1) numbers of older people with dementia projected by the Population Ageing and Care Simulation (PACSim) model; (2) the Cognitive Function & Ageing Study II (CFAS II) which collected information on receipt of long-term care services (including both unpaid care and formal care services) and cognitive functioning in the older population in Cambridgeshire, Newcastle and Nottingham between 2008 and 2011; (3) the Modelling Outcome and Cost Impacts of Interventions of Dementia (MODEM) project cohort which includes 300 people with a clinical diagnosis of dementia and their main carers in Sussex England.

Results: The total number of older people who live with dementia and need to receive long-term care is projected to more than double in 2040. The long-term care expenditure will need to be nearly three times larger by 2040 . The tripling expenditure is due to both demographic pressure in the context of population ageing and expected real rises in wages in the social care sector.

Conclusion: Both the demand for and the expenditure on long-term care services are expected to increase greatly over the coming decades in England. A better integration between health and social care services, effective prevention programmes, and a productive workforce of carers will be essential to promote healthy ageing, improve the quality of life for people with dementia, and address the economic challenges associated with dementia care.