Is Ageing Changing? Health, healthy life and cognition across generations.

Economic and social planning is essential for the efficient operation of health and welfare services in modern economies. Improving the quality of public services requires the availability of high quality data and trend information. This is not just about knowing the age and sex structure of the population. To plan services efficiently policy makers in central government, local government, the National Health service, and in private and voluntary organisations need to have access to good forecasts of the levels of health and ill health within different sub-groups in the older population, the level of social support available and trends in general health status, mental and physical disability and long term survival of older people. Information about dementia is particularly important in the planning of health and social services because of the devastating impact it can have on the individual and their families due to an individual?s increased physical, psychological, emotional and social dependency on others. The proposed study will enhance the quality of data upon which planning decisions are made and of our understanding of trend in health and ill health within different social and geographical groups, particularly in the presence of increased life expectancy. The applicants will wish to engage directly with policy makers in different forums and with service consumers and their representatives or advocates to ensure that the scientific interpretation of the data is widely understood by the public. We will do this through discussion with groups of stakeholders and consumers and through involvement and other stakeholders in the management of the study.

Cognitive ageing and dementia are major consequences with ageing of our population. They present challenges to national and local policy makers and service providers in planning and providing for the social protection needs of the older population. However the projection of future needs is dependent on contemporary information and understanding of the assumptions about health status and risk factors in the total older population, including those in institutions: healthy active life expectancy, social support networks and demands for formals service, particularly variations between different social groups and generational and geographical cohorts. The proposed study builds on the design and infrastructure of the successful MRC Cognitive Function and Ageing Study (CFAS). New cohorts, including people in institutions, in three of the original CFAS centres (n=7,500) will be recruited. CFAS with its robust well tested methods is the only study in the UK with the ability to examine these issues rigorously. None of the existing sister studies in Europe is conducting similar cohort studies so this new study will have not only national but international significance. The study will provide important baseline information on older people aged 65-84 in 2007/9 who will reach the age of greatest frailty in the 2020s when the peak in numbers of 85 and over is expected. This will be the first definitive study to provide reliable data on whether there is reduced morbidity and frailty in the presence of extended life expectancy (compression of morbidity) in the UK and Europe. This study also can examine whether trajectories of change over time are the same or different across generations, testing the policy implications of any such changes.