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Number of older people with four or more diseases will double by 2035

A greater focus on prevention of disease, and bespoke services for patients with multi-morbidity will be needed

Ingrid Torjesen

Tuesday, 23 January 2018

The number of older people diagnosed with four or more diseases will double between 2015 and 2035, a study* published today in Age and Ageing, the scientific journal of the British Geriatrics Society, predicts. A third of these people will be diagnosed with dementia, depression or a cognitive impairment.

The study, conducted by researchers at Newcastle University's Institute for Ageing, found that over the next 20 years there will be an explosion in the number of people suffering from multiple diseases. As a result, two-thirds of the life expectancy gains, predicted as 3.6 years for men, 2.9 years for women, will be spent with four or more diseases.

Over the next 20 years the largest increase in diagnoses in the older population will be cancer (up by 179.4%) and diabetes (up by 118.1%), whilst arthritis and cancer will see the greatest rise in prevalence. In the population over the age of 85 years all diseases, apart from dementia and depression, will more than double in absolute numbers between 2015 and 2035.

Professor Carol Jagger, Professor of Epidemiology of Ageing at Newcastle University's Institute for Ageing, who led the study, said: "Much of the increase in four or more diseases, which we term complex multi-morbidity, is a result of the growth in the population aged 85 years and over. More worryingly, our model shows that future young-old adults, aged 65 to 74 years, are more likely to have two or three diseases than in the past. This is due to their higher prevalence of obesity and physical inactivity which are risk factors for multiple diseases."

In the UK, healthcare delivery was built, and generally remains centred, on the treatment of single diseases, but the researchers state that a single-disease-focused model of health care is unsuitable for patients with multi-morbidity.

There needs to be a focus on prevention of disease, and a bespoke healthcare service provision for patients with multi-morbidity, the researchers concluded.

Professor Jagger said: "These findings have enormous implications for how we should consider the structure and resources for the NHS in the future. Multi-morbidity increases the likelihood of hospital admission and a longer stay, along with a higher rate of readmission, and these factors will continue to contribute to crises in the NHS."
 *Kingston A, Robinson L, Booth H, et al. Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age and Ageing, 2018: doi:10.1093/ageing/afx201

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