Who is at risk and why?
In the 20th century, one-in-twenty of the UK population being pensioners was widely accepted. In the 21st century it is one-in-five. The Office for National Statistics shows that there are more people over 65 than there are under 16. Older people, some 20% of the population, consume a large portion of some key service, such as 66% of hospital beds.
The main users of health services are people aged 65+. Over 80% of people aged 70+ will suffer from a significant (i.e. in need of treatment) physical illness (Rossman 1979). Further, the prevalence of many conditions increases with age. In the UK, 42% of people aged 65-74 and 48% of those aged 75+ have a limiting longstanding illness. More than two-thirds 71% of people aged 85 and over in the UK have a disability or limiting longstanding illness.
Older people represent 60 per cent of all hospital admissions and at any one time in the UK older people occupy around two-thirds of hospital beds. (Department of Health, 2001). Between 2000 and 2010, the amount of hospital activity for people over 75 has grown by 66 per cent, and on average their stays are around 2.5 times longer than people between the ages of 15 and 59.
About half of people aged 75 and over live alone. Older people are more likely to live in residential and care homes than the general population.
Physical inactivity is a serious and increasing public health problem. The estimated cost of physical inactivity in England is £8 billion annually. Physical activity decreases with age, with seven out of ten men and eight out of ten women aged 75 years and over being inactive. In later life the benefits of an active lifestyle play an important role in helping people to keep mobile, maintain their independence and reduce falls. There is also a relationship between good physical and mental health, as both impact on the other.
Cardiovascular disease (CVD) including heart attack and stroke accounts for one third of all deaths in England and, like many other health concerns, is disproportionately high in older people.
The incidence and prevalence of dementia rises significantly with age and is therefore more prevalent in older people. One in three people aged over 65 will die with some form of dementia (Alzheimer’s Research UK).
In the UK, about one in seven pensioners lives in poverty. About half of these live in severe poverty, with incomes less than half of the median.
Older people are the main users of social care services. National surveys demonstrate that the ratio of incidents of disabilities, incapacities and dependencies grow with age. This is compounded by the expectation that the current economic environment coupled with specific welfare reforms in housing and disability benefits will impact disproportionately on older people.
People with long-term conditions frequently have more than one condition. Around half of the older population will have major health problems and around a quarter will have three or more problems. (British Household Panel Survey, 2001).
There is a greater prevalence of some illnesses among specific groups of people. For example, there are increased rates of hypertension and stroke among African-Caribbean’s and of diabetes among South Asians.