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Forecasting the care needs of the older population in England over the next 20 years: estimates from the Population Ageing and Care Simulation (PACSim) modelling study

Between 2015 and 2035 in England, both the prevalence of and numbers of people with dependency will fall for young-old adults (65–74 years). For very old adults (≥85 years), numbers with low dependency will increase by 148·0% (range from ten simulations 140·0–152·0) and with high dependency will almost double (increase of 91·8%, range 87·3–94·1) although prevalence will change little. Older adults with medium or high dependency and dementia will be more likely to have at least two other concurrent conditions (increasing from 58·8% in 2015 to 81·2% in 2035). Men aged 65 years will see a compression of dependency with 4·2 years (range 3·9–4·2) of independence gained compared with life expectancy gains of 3·5 years (3·1–4·1). Women aged 65 years will experience an expansion of mainly low dependency, with 3·0 years (3·0–3·6) gained in life expectancy compared with 1·4 years (1·2–1·4) with low dependency and 0·7 years (0·6–0·8) with high dependency.


In the next 20 years, the English population aged 65 years or over will see increases in the number of individuals who are independent but also in those with complex care needs. This increase is due to more individuals reaching 85 years or older who have higher levels of dependency, dementia, and comorbidity. Health and social care services must adapt to the complex care needs of an increasing older population