Institute of Health & Society and Newcastle University Institute for Ageing, Newcastle University.
School of Demography, ANU College of Arts and Social Sciences, Australian National University.
Age Ageing. 2018 May 1;47(3):374-380. doi: 10.1093/ageing/afx201.
models projecting future disease burden have focussed on one or two diseases. Little is known on how risk factors of younger cohorts will play out in the future burden of multi-morbidity (two or more concurrent long-term conditions).
a dynamic microsimulation model, the Population Ageing and Care Simulation (PACSim) model, simulates the characteristics (sociodemographic factors, health behaviours, chronic diseases and geriatric conditions) of individuals over the period 2014-2040.
about 303,589 individuals aged 35 years and over (a 1% random sample of the 2014 England population) created from Understanding Society, the English Longitudinal Study of Ageing, and the Cognitive Function and Ageing Study II.
the prevalence of, numbers with, and years lived with, chronic diseases, geriatric conditions and multi-morbidity.
between 2015 and 2035, multi-morbidity prevalence is estimated to increase, the proportion with 4+ diseases almost doubling (2015:9.8%; 2035:17.0%) and two-thirds of those with 4+ diseases will have mental ill-health (dementia, depression, cognitive impairment no dementia). Multi-morbidity prevalence in incoming cohorts aged 65-74 years will rise (2015:45.7%; 2035:52.8%). Life expectancy gains (men 3.6 years, women: 2.9 years) will be spent mostly with 4+ diseases (men: 2.4 years, 65.9%; women: 2.5 years, 85.2%), resulting from increased prevalence of rather than longer survival with multi-morbidity.
our findings indicate that over the next 20 years there will be an expansion of morbidity, particularly complex multi-morbidity (4+ diseases). We advocate for a new focus on prevention of, and appropriate and efficient service provision for those with, complex multi-morbidity.
预测未来疾病负担的模型主要集中在一种或两种疾病上。对于年轻人群的风险因素将如何影响未来多种疾病（两种或多种同时存在的长期疾病）的负担，人们知之甚少。
一种动态微观模拟模型，即人口老龄化和护理模拟（PACSim）模型，模拟了 2014 年至 2040 年期间个人的特征（社会人口因素、健康行为、慢性疾病和老年病）。
约 303589 名年龄在 35 岁及以上的个体（从理解社会、英国老龄化纵向研究和认知功能与衰老研究 II 中抽取的 2014 年英格兰人口的 1%随机样本）。
慢性疾病、老年病和多种疾病的患病率、患病人数和患病年限。
在 2015 年至 2035 年期间，预计多种疾病的患病率将会增加，患有 4 种及以上疾病的比例几乎翻了一番（2015 年：9.8%；2035 年：17.0%），其中三分之二的人患有精神健康问题（痴呆、抑郁、认知障碍但无痴呆）。65-74 岁新入队列的多种疾病患病率将会上升（2015 年：45.7%；2035 年：52.8%）。预期寿命的增加（男性 3.6 年，女性 2.9 年）主要归因于患有 4 种及以上疾病的时间（男性：2.4 年，占 65.9%；女性：2.5 年，占 85.2%），这是由于多种疾病的患病率增加，而不是生存时间延长所致。
我们的研究结果表明，在未来 20 年里，疾病负担将扩大，特别是复杂的多种疾病（4 种及以上疾病）。我们主张将新的重点放在预防和为患有复杂多种疾病的人群提供适当和高效的服务上。
