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If the pace of increase in life expectancy in developed countries over the past
two centuries continues through the 21st century, most babies born since 2000
in France, Germany, Italy, the UK, the USA, Canada, Japan, and other countries
with long life expectancies will celebrate their 100th birthdays. Although trends
differ between countries, populations of nearly all such countries are ageing as
a result of low fertility, low immigration, and long lives.

https://jamanetwork.com/journals/jamaneurology/article-abstract/775488

IN LONGITUDINAL, population-based studies of persons 65 years and older, advancing age

is associated with more rapid cognitive decline1,2 and with increased prevalence and incidence
of Alzheimer disease.3-9 It is likely that some of the cognitive decline observed in aged
populations reflects Alzheimer disease. Unfortunately, few longitudinal, population-based
studies include clinical evaluation for dementia and Alzheimer disease.

Knowledge of the relations among cognitive function, age, and Alzheimer disease comes
mainly from studies of persons who are evaluated in clinical settings,10-15 but these studies are
subject to bias for several reasons. First, a minority of all persons with Alzheimer disease
come to medical attention.16 Therefore, clinical settings are unlikely to represent the full
spectrum of Alzheimer disease in the general population

https://kclpure.kcl.ac.uk/ws/portalfiles/portal/35828472/
P326_AS_Dementia_Report_WEB2.pdf

This report estimates that in 2013 there were 815,827 people with dementia in the UK (Table
4.1), of whom 773,502 are aged 65 years or over.

If the prevalence of dementia remains the same, the number of people with dementia in the
UK is forecast to increase to 1,142,677 by 2025 and 2,092,945 by 2051, an increase of 40%
over the next 12 years and of 157% over the next 38 years. This growth would be driven by
population ageing alone. Life expectancy for older people is increasing, as mortality declines,
even for the oldest old. Older people are most at risk for dementia. Hence the largest
increases in the number of people with dementia would occur in the oldest age groups (Figure
4.2). Numbers of men and women with dementia in the UK are projected to increase at a
similar rate

https://www.sciencedirect.com/science/article/pii/S2173580817301232
The prevalence of Alzheimer's disease in Europe was estimated at 5.05% (95% CI,
4.73-5.39). The prevalence in men was 3.31% (95% CI, 2.85-3.80) and in women,
7.13% (95% CI, 6.56-7.72), and increased with age.
The incidence of Alzheimer's disease in Europe was 11.08 per 1000 person-years
(95% CI, 10.30-11.89). Broken down by sex, it was 7.02 per 1000 person-years (95%
CI, 6.06-8.05) in men and 13.25 per 1000 person-years (95% CI, 12.05-14.51) in
women; again these rates increased with age.

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2702.2010.03549.x

The brain processes that underpin memory and cognition may be compromised by
loneliness, which could increase a person's susceptibility to the harmful consequences of
age-related neuropathology by lowering neural reserve.

https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.1421

Mental health services and residential home staff need to be aware that many
needs remain unmet and much can be done to improve the quality of life of the
residents with dementia.
Unmet needs were associated with psychological problems, such as anxiety and
depression, but not with severity of dementia or level of dependency.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-3156.1993.tb00683.x

In addition, more attention needs to be given to ensure that staff input results in
outcomes for service users.

https://www.sciencedirect.com/science/article/abs/pii/S0168851005000679

Availability of informal carers is potentially a big problem, but the extent of the
problem is very sensitive to the assumptions made concerning health improvements
and care-giving patterns.

The subject of long-term care (LTC) is receiving increasing attention both in the
research community and by various countries’ governments due to the belief that an
ageing population will greatly swell the demand for long-term care services and
create huge public expense.

https://www.cambridge.org/core/journals/international-psychogeriatrics/article/healthcare-
utilization-and-monetary-costs-associated-with-agitation-in-uk-care-home-residents-with-
advanced-dementia-a-prospective-cohort-study/
436A3EFCDCD6502CF62C93D6CE8F1A2D

After adjustment, health and social care costs, and costs of providing
informal care varied significantly by level of agitation as death
approached, from £23,000 over a 1-year period with no agitation
symptoms (CMAI agitation score 0–10) to £45,000 at the most severe
level (CMAI agitation score >100). On average, agitation accounted for
30% of health and social care costs. Informal care costs were
substantial, constituting 29% of total costs.

With the increasing prevalence of dementia, costs of care will impact

on healthcare and social services systems, as well as informal carers.
Agitation is a key driver of these costs in people with advanced
dementia presenting complex challenges for symptom management,
service planners, and providers.

https://www.cambridge.org/core/journals/ageing-and-society/article/abs/care-
relationships-quality-of-care-and-migrant-workers-caring-for-older-people/
15D03FC88A5FDAA208289203119FDDA6

Migrant care workers make a substantial contribution to older adult

care in Ireland and the United Kingdom (UK)

https://onlinelibrary.wiley.com/doi/abs/10.1111/hsc.12684

The UK's departure from the European Union (Brexit) is likely to result in greater
immigration and employment restrictions on European Union/European
Economic Area (EU/EEA) nationals within the United Kingdom. EU/EEA citizens
constitute a significant proportion of the current social care workforce. Research
evaluating the impact of Brexit on social care has highlighted potentially severe
future workforce shortfalls,

https://link.springer.com/article/10.1007/s12134-021-00807-3

With a growing and increasingly diverse ageing population, it is likely that the UK
home care sector will continue to need migrant care workers to fill gaps in the
workforce. The end of free movement of EEA workers and the new post-Brexit
immigration system will create new risks and challenges that will be unfolding in
the context of the COVID-19 pandemic.

COMPETITION? HOWEVER, Combined with the introduction of a more restrictive

immigration system, this could create incentives for the emergence of an
unregulated and informal ‘grey’ market of care in people’s homes.