Number of 85-year-olds 'to increase by a third by 2020'

The number of 85-year-olds will increase by a third by 2020, putting pressure on health and social services, researchers said today.

Planners must look ahead and address the fact people will be living longer lives but with several diseases, they said.

Experts from the universities of Leicester and Newcastle led a study involving more than 800 85-year-olds and found "potential unmet needs" when it comes to health and social care.

They discovered that while many of the participants felt in good health and were optimistic, a proportion had undiagnosed health problems.

Everyone in the study lived in Newcastle upon Tyne and North Tyneside and were followed via check-ups and analysis of their medical records.

The study found that 12% of the group were suffering moderate or severe mental decline while 21% had incontinence.

A total of 60% had hearing problems and 37% had issues with their sight.

Overall, 58% of the group had high blood pressure, 52% had osteoarthritis and 47% had hardening and narrowing of the arteries while 47% had cataracts.

Women were 10 times more likely than men to have rheumatoid arthritis, eight times more likely to have a diagnosis of hyperthyroidism and six times more likely to have osteoporosis.

They were also more likely to have cataracts, osteoarthritis, a joint replacement, impaired kidney function and anaemia.

Men were significantly more likely to have a diagnosis of heart disease caused by hard or narrowing arteries, and cancer.

A health assessment found a degree of underdiagnosis of health problems among the group, with 25% more people having high blood pressure than were recorded as having it.

Another 13% had undiagnosed heart disease and another 7% had depression that was not recorded.

Undiagnosed Type 1 diabetes or thyroid disease were rare.

Overall, 78% of people rated their health as good, very good or excellent compared with others of the same age.

However, 94% of the group had been in contact with their GP in the previous year.

The authors concluded: "This large cohort of 85-year-olds showed good levels of both self-rated health and functional ability despite significant levels of disease and impairment.

"Hypertension, ischaemic heart disease, atrial fibrillation, depression and dementia may be underdiagnosed.

"For planners of services, on the basis of present demographic trends, we can say that in the UK by 2020 the 85-year-old population will increase by 33%, 10% of whom currently require institutional care, 32% of whom have had an outpatient attendance, and 7% an attendance at an accident and emergency department in the past three months.

"In addition, 61% of older people not in institutional care were living alone, which has implications for the availability of help with activities of daily living and hence to providers of social care.

"The survey findings highlight the potential unmet health and social care needs of this age group."

The research was published online in the British Medical Journal (BMJ).

Andrew Harrop, head of policy at Age Concern and Help the Aged, said: "The fact that people are living longer lives is cause for celebration, but the growth of an older population will also mean significant challenges for policy makers in terms of funding and investing in the sort of services which an ageing society will rely on.

"As this study shows, more funding for research into the diseases associated with ageing - from incontinence to dementia - is needed.

"Finding better ways of preventing, managing and treating these conditions will increase the number of years of good health hand in hand with lifespan.

"The sharp increase in the number of people aged 80 and over predicted over the next years also makes a powerful case for a thorough reform of the creaking care system, which is struggling to satisfy the current needs of our older population."

Dr James Wright, co-ordinating editor of the Cochrane Hypertension Review Group, said in an editorial article that high blood pressure treatment for the over-80s is too aggressive.

Writing in the BMJ, he said a less aggressive regimen may be more appropriate for this age group, based on current evidence.

At present, UK guidelines are for doctors to use a combination of drugs to get people's blood pressure down to 140/90 mmHg.

Ellen Mason, senior cardiac nurse for the British Heart Foundation (BHF), said: "It is important that high blood pressure (hypertension) is treated in people of all ages as it causes an increased risk of stroke and is a risk factor for heart disease.

"More randomised controlled trials are needed to provide further evidence of the most suitable anti-hypertensives and dosage to treat them with."

A Department of Health spokesman said: "The pace of demographic change is exactly why we are proposing a new National Care Service to make the care and support system simpler, fairer and more affordable for everyone who needs it."