An aging population — Some demographic and health trends

Abstract

This article reports information on the demographic changes that have occurred in England and Wales in this century, with particular emphasis on aspects related to the elderly. What is known about the major diseases killing the elderly and trends in these diseases is also reported. Projections of the elderly population over the next 40 years and attempts to identify the possible degree of handicap in these elderly are discussed. Since the beginning of the century the population of England and Wales has grown from about 32.5 million to over 49 million. Age-specific mortality trends throughout the century indicate that there has been an appreciable decline at younger ages, but less of a decrease with advancing age in males. The fluctuation in the birth rate, different trends in the age-specific mortality, and differences between mortality for the sexes has resulted in a change in the age structure of the population. The main cause of death in the age range 60-84 years for both males and females is ischaemic heart disease--responsible for 1/3 of all deaths in males and 1/4 of all deaths in females. As with mortality, the statistics for hospital in-patient care show a marked rise with advancing age. About 8% of the male and 11% of the female population aged 75 years and over were receiving care from health and welfare service facilities day by day during 1981. In the oldest age group of 90 years and over, there are at present about 25 males for every 100 females; by 2023 this is projected to increase to about 35 males for every 100 females. What is not clear from the basic projection is whether the improvement in mortality is associated with an increasing number of healthy survivors, or an increasing number of survivors who have a chronic disease.