Objectives to assess the effect of recent stalling of life expectancy and various scenarios for disability progression on projections of social care expenditure between 2018 and 2038, and the likelihood of reaching the Ageing Society Grand Challenge mission of five extra healthy, independent years at birth. Design two linked projections models: the Population Ageing and Care Simulation (PACSim) model and the Care Policy and Evaluation Centre long-term care projections model, updated to include 2018-based population projections. Population PACSim: about 303,589 individuals aged 35 years and over (a 1% random sample of the England population in 2014) created from three nationally representative longitudinal ageing studies. Main outcome measures Total social care expenditure (public and private) for older people, and men and women’s independent life expectancy at age 65 (IndLE65) under five scenarios of changing disability progression and recovery with and without lower life expectancy. Results between 2018 and 2038, total care expenditure was projected to increase by 94.1%–1.25% of GDP; men’s IndLE65 increasing by 14.7% (range 11.3–16.5%), exceeding the 8% equivalent of the increase in five healthy, independent years at birth, although women’s IndLE65 increased by only 4.7% (range 3.2–5.8%). A 10% reduction in disability progression and increase in recovery resulted in the lowest increase in total care expenditure and increases in both men’s and women’s IndLE65 exceeding 8%. Conclusions interventions that slow down disability progression, and improve recovery, could significantly reduce social care expenditure and meet government targets for increases in healthy, independent years.

中文翻译：

---

到 2038 年英格兰老年人口的依赖和相关社会护理支出的预测：不同残疾进展的影响

目标是评估近期预期寿命停滞和残疾进展的各种情景对 2018 年至 2038 年间社会护理支出预测的影响，以及实现老龄化社会大挑战使命的可能性，即出生时额外健康、独立的 5 年。设计两个相关的预测模型：人口老龄化和护理模拟 (PACSim) 模型和护理政策和评估中心长期护理预测模型，更新后包括基于 2018 年的人口预测。人口 PACSim：从三个具有全国代表性的纵向老龄化研究中创建的大约 303,589 名 35 岁及以上的人（2014 年英格兰人口的 1% 随机样本）。主要成果指标 老年人的社会护理总支出（公共和私人），和男性和女性在 65 岁时的独立预期寿命 (IndLE65) 在改变残疾进展和恢复的五种情景下，无论预期寿命是否降低。结果 2018 年至 2038 年间，护理总支出预计将增加 GDP 的 94.1%–1.25%；男性的 IndLE65 增加了 14.7%（范围 11.3-16.5%），超过了出生时五个健康独立年的 8%，尽管女性的 IndLE65 仅增加了 4.7%（范围 3.2-5.8%）。残疾进展减少 10% 和康复增加导致总护理支出增幅最低，男性和女性的 IndLE65 增幅均超过 8%。结论 减缓残疾进展并改善康复的干预措施，