population aging; health expectancy projections; disability projections; dementia projections; need for assistance with care; care gap; long-term care expenditures projections; old-age dependency ratio; support ratio
Abstract :
[en] This chapter reviews recent projections related to the aging of populations, developments in health expectancy and disability, and associated trends in need for and provision of long-term care, focusing on the developments in Europe but mentioning worldwide trends where possible. First, I present demographic trends in changing age structure of populations, expected costs of those changes, and discuss how innovative measures such as the ‘real elderly dependency ratio’ could offer a more balanced view on those trends. Second, projections of healthy life expectancy and time spent with morbidity and disability are presented. Then possible limitations of those projections are discussed, especially regarding recent evidence on changing incidence of dementia, and the possible further reductions in incidence if unfavorable lifestyle and health behaviours were reduced. After that, I will delineate demographic trends in need for assistance with care, and their implications for both formal and informal long-term care provision and costs. Specifically, a ‘care gap’ both in the provision of formal and informal care has been foreseen for several countries. Lastly, I discuss some trends and phenomena in long-term care provision which may influence the trends in long-term care needs and provision. In particular, estimated care gaps could become less threatening if the trend of migration of trained and untrained caregivers to provide live-in and institutional care in understaffed countries will continue, and if technological innovations will reduce care needs by enabling persons with disabilities to carry out activities of daily living autonomously.
Research center :
- Integrative Research Unit: Social and Individual Development (INSIDE) > PEARL Institute for Research on Socio-Economic Inequality (IRSEI)
Disciplines :
Sociology & social sciences Public health, health care sciences & services Human geography & demography
Author, co-author :
LEIST, Anja ; University of Luxembourg > Faculty of Language and Literature, Humanities, Arts and Education (FLSHASE) > Integrative Research Unit: Social and Individual Development (INSIDE)
External co-authors :
no
Language :
English
Title :
Population aging, demographic trends and consequences for long-term care
FNR9522302 - A Research Programme On Social Inequality Within The National, European And International Context, 2011 (01/06/2012-31/12/2018) - Louis Chauvel
Applebaum, R., Bardo, A., & Robbins, E. (2013). International approaches to longterm services and supports. Generations, 37(1), 59–65.
Biessels, G. J. (2014). Capitalising on modifiable risk factors for Alzheimer’s disease. The Lancet Neurology, 13(8), 752–753.
Bloom, D. E., Chatterji, S., Kowal, P., Lloyd-Sherlock, P., McKee, M., Rechel, B., … Smith, J. P. (2015). Macroeconomic implications of population ageing and selected policy responses. The Lancet, 385(9968), 649–657.
Carretero, S., Stewart, J., & Centeno, C. (2015). Information and communication technologies for informal carers and paid assistants: Benefits from micro-, meso-, and macro-levels. European Journal of Ageing, 12(2), 163–173. doi:10.1007/s10433-015-0333-4
Chatterji, S., Byles, J., Cutler, D., Seeman, T., & Verdes, E. (2015). Health, functioning, and disability in older adults—present status and future implications. The Lancet, 385(9967), 563–575.
Cherlin, A. J. (2010). Demographic trends in the United States: A review of research in the 2000s. Journal of Marriage and Family, 72, 403–419. doi:10.1111/j.1741-3737.2010.00710.x
Chou, Y.-C., Kröger, T., & Pu, C.-y. (2015). Models of long-term care use among older people with disabilities in Taiwan: institutional care, community care, live-in migrant care and family care. European Journal of Ageing, 12(2), 95–104.
De La Maisonneuve, C., & Martins, J. O. (2013). Public spending on health and long-term care: A new set of projections. OECD Economic Policy Papers, No. 06. Retrieved from http://www.oecd.org/eco/growth/Health%20FINAL.pdf
Erol, R., Brooker, D., & Peel, E. (2015). Women and dementia: A global research review. Alzheimer’s Disease International. Retrieved from https://www.alz.co.uk/women-and-dementia
Eurocarers (2016). InformCare—The EU information hub on informal care. Retrieved August 1, 2016, from http://eurocarers.org/InformCare
European Commission. (2015). The 2015 ageing report. Economic and budgetary projections for the 28 EU Member States (2013–2060). Luxembourg: Publications Office of the European Union.
Eurostat. (2015). Europe in figures—Eurostat yearbook. Retrieved from http://ec.europa.eu/eurostat/statistics-explained/index.php/Europe_in_figures_-_Eurostat_yearbook
Freedman, V. A., Spillman, B. C., Andreski, P. M., Cornman, J. C., Crimmins, E. M., Kramarow, E., … Schoeni, R. F. (2013). Trends in late-life activity limitations in the United States: an update from five national surveys. Demography, 50(2), 661–671.
Harrison, N. (2015). Caredroids in health care. The Lancet, 386(9990), 235–236.
Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology, 80(19), 1778–1783.
Jeune, B., Eriksen, M. L., Andersen-Ranberg, K., & Brønnum-Hansen, H. (2015). Improvement in health expectancy at ages 50 and 65 in Denmark during the period 2004–2011. Scandinavian Journal of Public Health, 43(3), 254–259.
Kaye, H. S., Harrington, C., & LaPlante, M. P. (2010). Long-term care: Who gets it, who provides it, who pays, and how much? Health Affairs, 29(1), 11–21.
Kinsella, K., & He, W. (2009). An aging world: 2008. International Population Reports, P95/09-1. Washington, DC: U.S. Census Bureau.
Leist, A. K. (2013). Social media use of older adults: a mini-review. Gerontology, 59(4), 378–384. doi:10.1159/000346818
Matthews, F. E., Stephan, B. C. M., Robinson, L., Jagger, C., Barnes, L. E., Arthur, A., … Ageing Studies, C. (2016). A two decade dementia incidence comparison from the Cognitive Function and Ageing Studies I and II. Nature Communications, 7. doi:10.1038/ncomms11398
Meijer, C., Bakx, P., Doorslaer, E., & Koopmanschap, M. (2015). Explaining declining rates of institutional LTC use in the Netherlands: A decomposition approach. Health Economics, 24(S1), 18–31.
Muramatsu, N., & Akiyama, H. (2011). Japan: super-aging society preparing for the future. The Gerontologist, 51(4), 425–432.
National Center for Health Statistics. (2016). Quarterly provisional estimates for selected causes of death: United States, 2014–Quarter 4, 2015. National Vital Statistics System, Vital Statistics Rapid Release Program.
Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K., & Brayne, C. (2014). Potential for primary prevention of Alzheimer’s disease: an analysis of populationbased data. The Lancet Neurology, 13(8), 788–794.
Organization for Economic Cooperation and Development [OECD]. (2013). Health at a glance: OECD indicators. OECD Publishing.
Olshansky, S. J. (2016). Articulating the case for the longevity dividend. Cold Spring Harb Perspect Med, 6(2). doi:10.1101/cshperspect.a025940
Pickard, L. (2015). A growing care gap? The supply of unpaid care for older people by their adult children in England to 2032. Ageing and Society, 35(01), 96–123.
Pinquart, M., Sörensen, S., & Song, Y. (2018). Older persons’ care-related preferences: Cultural and cross-cultural influences. In T. Boll, D. Ferring, & J. Valsiner (Eds.), Cultures of care in aging (pp. 123–147). Charlotte, NC: Information Age Publishing.
Prince, M., Guerchet, M., & Prina, M. (2013). World Alzheimer report 2013: Journey of caring: an analysis of long-term care for dementia. London, England: Alzheimer’s Disease International.
Prince, M., Wimo, A., Guerchet, M., Ali, G.-C., Wu, Y.-T., Prina, M., & Alzheimer’s Disease International. (2015). World Alzheimer Report 2015. The global impact of dementia, an analysis of prevalence, incidence, cost and trends. London, England: Alzheimer’s Disease International.
Rechel, B., Grundy, E., Robine, J.-M., Cylus, J., Mackenbach, J. P., Knai, C., & McKee, M. (2013). Ageing in the European union. The Lancet, 381(9874), 1312–1322.
Robinson, H., MacDonald, B., Kerse, N., & Broadbent, E. (2013). The psychosocial effects of a companion robot: A randomized controlled trial. Journal of the American Medical Directors Association, 14(9), 661–667.
Sanderson, W. C., & Scherbov, S. (2013). The characteristics approach to the measurement of population aging. Population and Development Review, 39(4), 673–685.
Sanderson, W. C., & Scherbov, S. (2015). Faster increases in human life expectancy could lead to slower population aging. PloS one, 10(4), e0121922.
Satizabal, C. L., Beiser, A. S., Chouraki, V., Chêne, G., Dufouil, C., & Seshadri, S. (2016). Incidence of dementia over three decades in the Framingham Heart Study. New England Journal of Medicine, 374(6), 523–532. doi: doi:10.1056/NEJMoa1504327
Schulz, R., Wahl, H.-W., Matthews, J. T., Dabbs, A. D. V., Beach, S. R., & Czaja, S. J. (2014). Advancing the aging and technology agenda in gerontology. The Gerontologist, 55(5). doi:10.1093/geront/gnu071
Spencer, S., Martin, S., Bourgeault, I. L., & O’Shea, E. (2010). The role of migrant care workers in ageing societies: Report on research findings in the United Kingdom, Ireland, Canada and the United States. IOM Migration Research Series, No. 41. Retrieved from http://publications.iom.int/system/files/pdf/mrs41.pdf
Spijker, J. (2015). Alternative indicators of population ageing: An inventory. Vienna, Austria: Vienna Institute of Demography Working Papers.
Spijker, J., & MacInnes, J. (2013). Population ageing: the timebomb that isn’t? BMJ, 347, f6598.
Thomas, K. S., & Applebaum, R. (2015). Long-term services and supports (LTSS): A growing challenge for an aging America. Public Policy & Aging Report, 25(2), 56–62.
Timonen, V., & Rostgaard, T. (2018). Turning the ‘problem’ into the solution: Hopes, trends and contradictions in home care policies for ageing populations. In T. Boll, D. Ferring & J. Valsiner (Eds.), Cultures of care in aging (pp. 39–55). Charlotte, NC: Information Age Publishing.
Tsukada, N. (2013). The foreign long-term worker challenge in Japan. Generations, 37(1), 66–69.
Uhlenberg, P. (2013). Demography is not destiny: The challenges and opportunities of global population aging. Generations, 37(1), 12–18.
Werblow, A., Felder, S., & Zweifel, P. (2007). Population ageing and health care expenditure: a school of ‘red herrings’? Health Economics, 16(10), 1109–1126.
World Health Organization. (2015). World report on ageing and health. Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/ageing/events/world-report-2015-launch/en/
Zhan, H. J. (2013). Population aging and long-term care in China. Generations, 37(1), 53–58.
