Future of an Ageing Population

Social isolation affects 7-17% of older adults, and is becoming more
prevalent 163 . Social isolation is associated with an elevated risk of mortality 164
– there is a 50% reduction in likelihood of mortality for individuals with strong
social relationships 165 . Although loneliness and isolation can cause depression
and poor cardiovascular health, there is relatively little known about the
mechanisms causing this 66 . Social isolation is also associated with higher
rates of emergency admissions, rehospitalisation and earlier entry into care
homes 163 .
Loneliness is not necessarily the result of living alone; those who live with others
can still experience loneliness. Interventions that increase the opportunity for
social interaction with the right people at the right time, and provide support
for older people to feel more confident interacting with communities, are more
likely to impact social isolation 166 . Chapter 7 considers how to reduce social
isolation by improving people’s ability to interact with the world around them.
Other possible interventions include community learning initiatives (see
Chapter 3) and opportunities in care housing and retirement communities
which could also have a role in providing support (see Chapter 4).
The changing health demands of the UK population will affect the provision of
health and care over the next decade. Over the last 20 years, the management
of chronic disease has moved from secondary care to primary and community
care, with older people receiving the majority of their personal care from
family and other unpaid carers 167 . This trend is set to continue. Chronic illness
management is currently based on a single disease paradigm 163 which may lead
to fragmented and ineffective primary care. Individuals with multi-morbidity
(having several chronic health conditions at the same time) require a more
complex care environment, with increased physician and specialist visits,
and are likely to have higher prescription costs and use multiple medications.
Identifying more integrated and person-centred ways of managing people
with multi-morbidity could help services to adapt 168 . There is however a lack
of evidence on the effectiveness of many therapies in patients with multimorbidity.
Training practitioners to provide support to people with complex
conditions could play a role 168 .
Policy Implication
An increasing number of people with long-term disability, chronic
conditions and multiple health conditions will increase the need for care,
and change the nature of the demand. This will put pressure on health and
care systems to adapt to meet these changing demands.
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