Intended for healthcare professionals


Innovation to prevent dependency in old age

BMJ 2000; 320 doi: (Published 19 February 2000) Cite this as: BMJ 2000;320:460

Technological innovations may reduce the cost burden of an ageing population

  1. David Metz, director (
  1. AgeNet, Wolfson Institute of Preventive Medicine, St Bartholomew's and the Royal London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ

    The Royal Commission on Long Term Care1 has been criticised for missing the opportunity for creative thinking about what older people in the future will really want.2 The commission also missed an opportunity to flag up the full potential for reducing the cost of long term care through innovation that will prevent dependency.

    The royal commission estimated that expenditure on long term care services would increase (at constant prices) from £11bn ($17.6bn) in 1995 to £20bn in 2020 and to £45bn in 2050, reflecting principally the growth in numbers of older people. These cost projections are sensitive to assumptions about the unit costs of care, the numbers of older people, the availability of informal care, and the health of older people. The base case assumes no change in age specific disability rates over time. However, if disability fell by 1% per year the costs would be reduced to £28bn in 2050, all else being equal.3 So there is a big pay off —for individuals, their families, and society—if we could reduce the scale of disability in old age through research led innovation.

    Until recently research on age associated conditions has been a …

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