ILC-UK Future of Ageing Conference

The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
The Future of Ageing
ILC-UK 2015 Conference

With thanks to the following for their
sponsorship of this conference:
And to the following for providing inserts for delegate
packs:

How long will we live?
Steven Baxter
Partner, Hymans Robertson LLP

Hymans Robertson LLP is authorised and regulated by the Financial Conduct
Authority
How long will we live?
The future of ageing
Steven Baxter
24 November 2015

7
0
10
20
30
40
50
60
70
80
90
1840 1860 1880 1900 1920 1940 1960 1980 2000
Life expectancy from birth
(period life exectancy, 1840-2013)
Women Men
Rising life expectancy
Infectious diseases Circulatory disease
Source: ONS & Human Mortality Database (www.mortality.org)

8
Premature deaths (largely) eradicated?
Deaths relate to England & Wales civilian population Source: Human Mortality Database (www.mortality.org)
150 years
ago
Now
0 10 20 30 40 50 60 70 80 90 100
0 10 20 30 40 50 60 70 80 90 100
Age at death
Age at death

9
A changing population profile
1965 2015 2065?
Source: ONS 2104-based principal population projections (2015 & 2063); Human Mortality Database (1965)

10
The future of longevity
Today’s big killers
15%
7%
7%
13%
9%
8%
Source: ONS

11
The future of longevity
‘Accelerants’ and ‘decelerants’
Slowing longevity Increasing longevity

12
The future of ‘observed’ life expectancy

13

14

15
83.5
86.0

16
How long will we live? (on average, assuming reach age 65)
65 today
55 today
45 today
86.6
87.8
88.9
89.3
90.4
91.5

17
How long will you live?
Mr
Average
4 years6 years
Health Wealth Lifestyle
Source: Club Vita

18
Encouraging realism
People underestimate how
long they might live for by
between 5 and 8 years
1 in 10 people will live 10 years longer than the average
Source: Hymans Robertson & Club Vita
Survey of 1,000 people aged 50-65.

19
Planning for retirement
Transition Certainty Care
Drawdown Annuities
Fuller Working
Lifetimes
State Pension
Long Term
Care
Part time working
Paying off debt
Equity
release?
Retirement savings House?

The future of ageing – yours and
mine!
The Lord Filkin CBE
Chair, Centre for Ageing Better

The Future of Ageing – Yours
and Mine!
Longer lives – how can all of us benefit?
ILC Future of Ageing Conference
24 November 2015
Geoff Filkin

Ready for Ageing?
24
We have not all understood that:
We will live much longer
Later life can be a time of happiness
It requires big shifts in our attitudes and how we plan and prepare
What we do before we are older affects our later life
Society has not recognised the opportunity:
See it as a crisis not a great gift
We under-estimate the asset of older people
And the potential for more collective action
Government has so far:
Not gripped the significance or benefits
Seen it mainly as a fiscal threat
Been short term, siloed and reactive
Not set out the changes we all must make

25
Living longer – the greatest gift of our lives:
Life expectancy has risen greatly and is still rising
Men live 7 years longer than 30 years ago
50% of girls born in 2011 will live to 97 or more
A later life can be a very good one
In ten years there will be many more older people:
19% more people 65+; 40% more people 85+
A profound, certain and persistent change
Affects society, the economy and every one of us.
The Opportunity

What people want for a better later life should set our
societal goals
26
What makes a better later life?
Good enough health and financial security
Sustain our identity and independence
To live in a home and neighbourhood good for later life
To have relationships, meaning and purpose
But many are missing out
Inequalities in life and healthy life expectancy and frailty
11 million people are not saving enough into a pension
Only 3% of homes are mobility accessible
Striking differences in people’s well-being

Who may be at risk in the future?
27
People at risk of a poorer later life in future include those:
without decent employment pensions
unable to save sufficiently
who cannot sustain employability
have not adopted healthy life-styles
have premature chronic long term conditions
are unable to get the care and support they need
are socially isolated
How can we reduce these risks for better later lives?

What can we do ourselves?
28
What we do before we are old greatly influences later well-being:
Planning and preparation
Keeping in employment
Saving enough
Keeping active, nutrition, weight, smoking, alcohol
Our relationships and meaning in our lives
Resilience to face major life changes
Change is not easy; how do we support it?

Three Policy Risks for Better Later Lives
29
1. Our voluntary pension’s savings system
High housing costs, downwards pressure on wages and denial mean many will
not save enough. Future older people are at risk
2. NHS demand, funding and re-modelling
We have a National Illness System, hospital centric, it fails to join up; and
demand is rising fast. The current system will fail today’s older people.
3. Social care - a crisis now, where will we be in 5 years?
These significant risks need to be addressed

Care for Ageing
30
The current system is in crisis and need is growing
Social care needs have increased, public funding has reduced
The social care market is shrinking; serious concerns about care quality,
workforce skills and supply
Many more people will be frail or have long term conditions:
People aged 85+ in England: - 17% more by 2020 - and 40% more by 2025
We need commitment to transform social care:
To build the workforce numbers and skills
To produce more domiciliary care and care homes
To help those who cannot pay for themselves
To support carers and families better
To build community responses to support informal care

Health for Ageing
31
The NHS Five Year Forward View defined three key changes:
• Prevention
• Service re-configuration and innovation
• Funding to support change
Are they happening?
Wanless Report 2002
• Vital to engage people in living healthier lives for a sustainable NHS.
• Vital too for better later lives
Thirteen years after Wanless little has been done to address this
What action is needed?
• Preventing illness and expanding community action to provide support for others
are both essential
• Funding for service change and prevention, not to prop up the old system
• The funding has to be raised in ways fair to all generations

32
Realising the benefits of longer lives should be our collective goal
Individuals
We need information and advice of what works
We need help to make changes in our attitudes and behaviours
We must prepare and plan for a later life
We need older people themselves to have a stronger voice
And be much better at listening to them
An Agenda for Ageing Better

Better later lives cannot be achieved just by the state
33
Communities
Community action, particularly to support the frail and ill
Volunteering by many willing older people
Private sector
Better products and services
Realise the growth opportunities from the “silver society”
Voluntary sector
Work more together; consider future older people as well as today’s
Academia
Research that is likely to be useful. Innovations that generate useful evidence.
Funders, academics, older people, policymakers and practitioners jointly explore
where evidence and research is needed.

Government Leadership is crucial
34
Affirm the benefits of longer lives
Give leadership to the agenda for change
Transform health and care systems for an ageing society
Address housing supply failures for old and young
Maximise the benefits of the silver economy, longer working, GDP growth
How can we all work to realise better longer lives?

Annex – Centre for Ageing Better
35
A What Works Centre, promoted by Government, endowed by BIG, independent of both,
funded for ten years.
We start with the person; driven by evidence; focused on change, independent, open and
collaborative.
We will use evidence and our voice and to help make change, working with older people and
organisations to improve later life.
Next week we will publish:
- Our review of what makes for a good later life, and who is experiencing it
- How we will work to help everyone prepare better and ensure fewer people miss out
- Our initial programme areas and how everyone can get involved
We look forward to exploring how we may work together to help people enjoy their longer lives.

Contact
Centre for Ageing Better
33 Greycoat Street
London SW1P 2QF
020 3829 0113
ageing-better.org.uk
Registered Company Number: 8838490 & Charity Registration Number: 1160741 36
Thank you
Geoff Filkin
Geoff.filkin@agebetter.org.uk
020 3829 0113

The economics of ageing
The Rt. Hon the Lord Willetts
Executive Chair, Resolution Foundation

The Pinch
How the baby boomers
took their children’s future –
and why they should
give it back
David Willetts
November 2015
@resfoundation
38

Britain has gone through baby boom and bust
39
Definitions of
generations
vary
But the period
of births/year
topping
800,000 (or
even 1m) post-
war was clearly
exceptional

A greater demographic strain is set to emerge,
though the UK remains better placed than others
40

We pay in and take out at different parts of our lives
42
…

But baby booms can break the contract
43
• “Giving goods to an older person is
figuratively giving goods to yourself when
old.”
(Paul Samuelson, 1958)
• Balancing the budget across the economic
cycle with stable public spending
commitments benefits the baby boom

As a result, some generations have received much
more from the welfare state than they put in
44
…
Source: J Hills, ‘Distribution and redistribution’,
Inequality and the state, 2004.

And the burden on younger generations appears to
have grown over time
Source: T Papworth and A Corlett, ‘Intergenerational
fairness: What is it? Does it matter?’ 2014.
The difference
between the
1997 and 2008
calculations
may suggest
that changes
over the
intervening
decade have
turned even
those who
were previously
expected to be
in surplus into a
burden on
future
generations

Pensioner benefits have been protected (and then
some) while others’ benefits have been cut
46
The pension
triple lock
already costs
£6bn pa more
than a straight
earnings link

This may be reflected in the generational divide in
views on the welfare state
47
Older
generations,
including the
baby boomers,
have a much
more positive
outlook on the
creation of the
welfare state
than
Generations X
andY

Employment of older workers has reached a record
high and of under 25s a record low
49
Much of the fall
for the young is
a positive
trend, with
education
continuing for
longer

Recent cohorts are earning significantly less than
they might have expected
Successive
cohorts tend to
earn more than
their
predecessors –
but that hasn’t
applied for those
currently in their
20s
Members of the
1988 cohort are
earning around
£50pw less on
average than
those who
entered the
workplace 10
years earlier

And the DB pension scheme deficits of yesterday’s
workers are weighing on the wages of today’s
51
Taking the period
since 1983, a 23ppt
gap has opened up
between
productivity and
median pay
The distribution of
pay accounts for
around 70% of this
‘wedge’
Means wage
disappointment
since 2002 is only a
little over half due
to productivity
stagnation

Only 26 per cent of the liabilities of defined benefit
relate to currently employed workers
52Source: PPF / The Pensions Regulator
Work by Brian Bell shows
that a significant share of
the ‘non-wage
compensation’ of employees
actually relates to employer
pension contributions
designed to plug the gap in
closed DB schemes
While many of those
classified as deferred may
still be in employment in
other firms, the potential
burden on wages is not
spread evenly across
employers and industries

Younger people are more likely to report having
financial difficulties
53
Source: Understanding Society

But important to remember that not all older people
are better off
Though the
proportion of
pensioners in
poverty has
fallen, 16%
find
themselves in
poverty after
housing costs
Persistent
poverty is also
highest
among the
over 65s
54
Source: Households Below Average Income

Property and pension wealth form the majority of
older households’ wealth
56
Today’s less
generous
pension
schemes raise
questions
around
whether this
will continue
to be the
pattern with
younger
cohorts
Source: Wealth and Assets Survey, 2010-12

The time required to save for a deposit has grown
from 3 years in 1983 to 24 years today
57
Number of years required for low to middle income households to save typical first time buyer deposit:
UK 1983 -2017
Source: RF analysis of CML, OBR, BoE, Halifax
House Price Index

Though opposition to house-building has softened in
recent years
58
Source: British Social Attitudes Survey 2014

Why do the boomers own so much?
• Inflation came at the right time to wipe out their debts
• Improvements in life expectancy at the right time too
• Pension regulation has helped possessors
• Who gained the most from the bank bail out and who
pays for it?
59

The Inter-generational contract –
What governments do, by Edmund Burke
“Society is indeed a contract. Subordinate contracts for objects of
mere occasional interest may be dissolved at pleasure – but the
state ought not to be considered as nothing better than a
partnership agreement in a trade of pepper and coffee... It is to be
looked on with other reverence; because it is not a partnership in
things subservient only to the gross animal existence of a
temporary and perishable nature. It is a partnership in all science; a
partnership in all art; a partnership in every virtue, and in all
perfection. As the ends of such a partnership cannot be obtained in
many generations, it becomes a partnership not only between
those who are living, but between those who are living, those who
are dead, and those who are to be born.”
60

The Pinch
How the baby boomers
took their children’s future –
and why they should
give it back
David Willetts
November 2015
@resfoundation
61

The future of retirement income
Paul Johnson
Director, Institute for Fiscal Studies

© Institute for Fiscal Studies
The future of retirement income
Paul Johnson

Introduction
• People living longer and incomes in retirement rising
– Incomes higher than non-pensioners on average
– Next decade likely to see continued rise in pensioner incomes
• Longer term future looks less certain
– Lower state pensions
– Collapse of private sector DB schemes
– Falling home ownership
• Retirement age will be key
• We have got ourselves into a difficult place on private pensions

Good news
• Life expectancy has been rising
– Unexpectedly

Good news
– Unexpectedly
• Incomes in retirement have been rising fast
– And much more than for working age population

The remarkable catch-up in pensioner incomes
60%
65%
70%
75%
80%
85%
90%
95%
100%
105%
110%
chart shows median after housing costs incomes of pensioner households as %
of overall median (HBAI income definitions)

Income by age 1978-80 to 2012-13
60%
80%
100%
120%
140%
Percentageofoverallmedianincome
(measuredAHC)
Age
1978–80 2007–08 2012–13
Median income by age compared to overall median income (measured AHC)
Source: Figure 3.7b of Living Standards, Poverty and Inequality: 2014
http://www.ifs.org.uk/publications/7274
Notes: Household income is equivalised and measured after housing costs are deducted

Poverty rates by age
0%
5%
10%
15%
20%
25%
30%
35%
40%
1978-80
Source: Figure 6.3a of Living Standards, Poverty and Inequality: 2013

Poverty rates by age
0%
5%
10%
15%
20%
25%
30%
35%
40%
1978-80 2011-12
Source: Figure 6.3a of Living Standards, Poverty and Inequality: 2013

Pensioners doing better before the recession
-2.0%
-1.0%
0.0%
1.0%
2.0%
3.0%
4.0%
0s 10s 20s 30s 40s 50s 60s 70s
2001-02 to 2007-08
Annual real income change by age

...and after
-2.0%
-1.0%
0.0%
1.0%
2.0%
3.0%
4.0%
0s 10s 20s 30s 40s 50s 60s 70s
2001-02 to 2007-08
2007-08 to 2013-14
Annual real income change by age

Good news
– Unexpectedly
• Reflecting rising state and private pensions
– And also later retirement and increased earnings

Male employment rates slumped but have been
rising for some time
0
10
20
30
40
50
60
70
80
90
100
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
Employmentrate
65-69 (LFS)

0
10
20
30
40
50
60
70
80
90
100
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
Employmentrate
60-64 (LFS)
65-69 (LFS)

0
10
20
30
40
50
60
70
80
90
100
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
Employmentrate
50-54 (LFS)
55-59 (LFS)
60-64 (LFS)
65-69 (LFS)
Chandler and Tetlow (2014) http://www.ifs.org.uk/uploads/publications/comms/R98.pdf

Good news
– Unexpectedly
• Reflecting rising state and private pensions
– And also later retirement and increased earnings
• And our projections suggest continued improvements over the
next decade
– http://www.ifs.org.uk/publications/7251

Equivalised family income projections:
65+ population
£0
£10,000
£20,000
£30,000
£40,000
£50,000
£60,000
2010 2012 2014 2016 2018 2020 2022
Realfamilyincome
(£pa,2014–15prices)
Median 10th percentile 90th percentile
Source: Figure 5.1, Emmerson, Heald and Hood (2014)

But are we doing too well?
• One way of thinking about that is to ask how well off people are
in retirement relative to during their working life
• Traditionally looked at how much of gross final earnings are
replaced by pensions
– This was the basis for much of the Pension Commission’s work
• But is this a good measure?
– Should be interested in net, not gross incomes
– Why just consider pensions and not other wealth?
– And aren’t we interested in incomes compared to average over a
working life, not just final earnings?

Replacement of average lifetime earnings
• For couple households born in the 1940s we define:
50-20ageearningsrealdequivaliseAverage
65ageatincomerealEstimated
ratetReplacemen 
Consider several
definitions of income
Taking into account
household size
Adjusting for inflation;
considering average
purchasing power
Source: Table 6.2, Crawford & O’Dea (2014): Retirement sorted? The adequacy and optimality of
wealth among the near-retired?

Percentage of couple
with:
Total
pension
income
<=67% replacement 20%
ratetReplacemen 
wealth among the near-retired?

Percentage of couple
with:
Total
pension
income
... plus
annuitised non-
housing wealth
<=67% replacement 20% 10%
ratetReplacemen 
wealth among the near-retired? http://www.ifs.org.uk/publications/7358

Comparing ‘optimal’ and actual (private) wealth

For the current generation of pensioners
• A remarkable triumph
– Despite longer lives and earlier retirement incomes are higher than
they were during working life for most
• Down to a combination of
– Increasing state pensions
– More generous means tested benefits
– Occupational pensions
– House prices

What about the future?
• For the next decade at least things still look quite positive
• Further ahead things may look less rosy
– Earnings have fallen and savings rates were lower

Incomes are dipping
100
200
300
400
500
600
700
800
20 25 30 35 40 45 50 55 60 65 70
Realhouseholdincome
(£perweek,2011-12prices)
Age
1940s 1950s 1960s 1970s
Source : Authors’ calculations using FES/EFS/LCF, various years

As are savings rates
-80
-60
-40
-20
0
20
40
60
20 25 30 35 40 45 50 55 60 65 70
Realhouseholdsaving
(£perweek,2011-12prices)
Age
1940s 1950s 1960s 1970s
Source : Authors’ calculations using FES/EFS/LCF, various years

– We can model incomes really quite well that far ahead given what
we know about pensions, health, working patterns etc
• The state pension is becoming less generous for many
– The single tier is worth less than basic pension plus SERPS/S2P

• The single tier is worth less than basic pension plus SERPS/S2P
– Home ownership rates are declining

Recent cohorts are also less likely to own a
home
0%
10%
20%
30%
40%
50%
60%
70%
80%
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
Homeownershiprate(%)
Age
Born 1963–67 Born 1973–77 Born 1983–87

• The single tier is worth less than basic pension plus SERPS/S2P
– Home ownership rates are declining
• The collapse in DB scheme membership outside the public
sector is huge
– A double whammy on earnings

Declining private sector DB coverage
0
1
2
3
4
5
6
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Millions
Close
d
© Institute for Fiscal Studies Source: Occupational Pension Scheme Survey.
Active members of private sector defined benefit schemes

Pension costs have played a big role in average
wages rising less quickly than productivity
http://www.resolutionfoundation.org/wp-content/uploads/2015/09/Productivity-briefing.pdf

To recap...
• The current generation at and near retirement are doing very well
• To some extent at the expense of younger generations
– Who can expect lower retirement incomes
• What about policy?

The recent history of state pensions
• SERPS was introduced in 1978
• Governments have spent the whole period since un-introducing it
– A long and tortuous path given the complexities around contracting
out
• Any link between contributions and entitlement has effectively
ended
• The single tier is the logical final step
– Very close to a flat rate “citizens’ pension” based on history of
residence
– Note that it reduces expected future generosity for almost everyone

Remaining policy issues
• Pension age
– Rising over coming decades
– We know that increasing female SPA is increasing employment
• http://www.ifs.org.uk/publications/7323
– Commitment to raise with life expectancy so people live a third of
adult life (over 20) in retirement

Remaining policy issues
• Pension age
– Rising over coming decades
– We know that increasing female SPA is increasing employment
• http://www.ifs.org.uk/publications/7323
– Commitment to raise with life expectancy so people live a third of
adult life (over 20) in retirement
• Level and indexation
– Triple lock adds more than 1% of GDP to costs by 2060 relative to
earnings indexation
– Introduces an element of pure randomness into pension level
– Makes no sense as a policy

Effects of triple lock and pension age on
spending

Recent history of private pensions
• Regulation and demise of private sector DB schemes
– This looks irreversible
• Spread of DC
• Introduction of auto-enrolment
– Successful so far (but minimum default contributions very low)
• Ending of compulsory annuitisation
– Effects unknown
• Chaotic changes to tax treatment
– And continual change to tax treatment of other forms of savings

Policy priorities for private pensions
• Risk sharing
– No risk sharing in DC schemes
– None now in retirement without annuitisation
– This CANNOT be optimal
• In my view the overwhelming priority must be to find some way of
achieving more risk sharing
– Defined ambition?
• Also to limit the windfall to those with accrued rights
– Move from RPI to CPI indexation
– (note this was easily the biggest change to public service pensions)
• http://www.ifs.org.uk/budgets/gb2012/12chap5.pdf

The formula effect
[http://www.ifs.org.uk/publications/7513]

Policy conclusions
• State pensions
– Stick with single tier but move away from contributory fiction and
make dependent on, say, 30 years residence
– Get rid of triple lock: link to earnings, raising in line with prices when
they rise more but claw back later
– Raise pension age at least in line with longevity
• Private pensions
– Focus on finding a way to reintroduce some risk sharing
– Consider reducing DB benefits by enforcing CPI indexation
– Move to rational, stable EET tax system
– Over time increase employee auto enrolment contribution rates

The future of ageing research
Professor Jane Elliott
CEO, The Economic and Social Research
Council

The Future of ageing research: the known knowns
and the known unknowns
Professor Jane Elliott CEO of ESRC (@JaneElliott66)

Structure
▶ The Third age and the Fourth Age
▶ What we know about ageing
– Importance of early life
– Trajectories in later life
– Predicting dementia
▶ Issues & Dilemmas in research on ageing
▶ Mapping the future
– European roadmap
– Foresight project

Laslett (1989) A new map of life
• There is a principle which I believe we should
adopt as we contemplate the facts of growing old.
We have to conduct our lives as far as possible,
not simply in remembrance of our former, but in
the presence of our future, selves.’(Laslett 1989,
p22) A Fresh Map of Life: The emergence of the
third age. Weidenfeld and Nicolson: London.
• The concept of planning (life plans and
strategies) is central to the notion of the third age

Laslett’s characterisation of the life
course
▶ First age: dependence, socialization; immaturity and
education
▶ Second age: independence, maturity & responsibility,
earning and saving
▶ Third age: personal achievement, fulfilment; ‘apogee’ of
personal life
▶ Fourth age; dependence, decrepitude and death.
Leisure is distinct from idleness, concept of rest should be
dissociated from that of retirement; importance of activism
rather than disengagement

Longitudinal studies with data on
ageing
▶ English Longitudinal Study of Ageing
▶ MRC National Study of Health and Development
(1946 cohort)
▶ 1958 British Birth Cohort Study
▶ Whitehall II study
▶ Hertfordshire Cohort Study
▶ Understanding Society
▶ Potential for the use of linked administrative and
health data (and imaginative secondary analysis)

(International) consortia of
longitudinal studies
▶ HALCyon (NDA funded) Healthy Ageing across
the lifecourse (led by Diana Kuh)
▶ NIH-funded Integrative Analysis of Longitudinal
Studies on Aging and Dementia (IALSA)
research network (led by Scott Hofer)
▶ Family of studies based on the Health and
Retirement Study NIH-funded; including ELSA,
KLOSA, TILDA, CHARLS, SHARE
(http://hrsonline.isr.umich.edu/index.php?p=sister
s)

Findings from HALCyon
▶ Childhood cognitive ability and other aspects of
early experience are associated with adult
cognitive capability and wellbeing.
▶ There is robust evidence that those in better
socioeconomic circumstances in childhood as
well as adulthood have better capability at older
ages.
▶ Growth in early life is associated with later life
capability, most likely through its influence on the
maximum level of function achieved at maturity.

CLOSER: bringing longitudinal
evidence together
▶ Childhood socioeconomic circumstances are
associated with physical capability in adulthood,
even when controlling for other mediating
factors.
▶ In middle age, the gap between men and
women’s physical capability increases
dramatically.
▶ People enter later life with greater
socioeconomic inequalities in physical
functioning – studies have shown that the gap

0.5
0.55
0.6
0.65
0.7
0.75
0.8
0.85
0.9
0.95
Wave 1
(2002)
Wave 2
(2004)
Wave 3
(2006)
Wave 4
(2008)
Wave 5
(2010)
Wave 6
(2012)
m
/
s
Walking speed (age 70-74 in wave 1)
Men
Women
0
10
20
30
40
50
60
70
Wave 1
(2002)
Wave 2
(2004)
Wave 3
(2006)
Wave 4
(2008)
Wave 5
(2010)
Wave 6
(2012)
Sedentary or low physical activity
(%)
(age 70-74 in wave 1)
Men
Women
Trajectories in later life: results from the
English Longitudinal Study of Ageing (1)

0
1
2
3
4
5
6
7
8
9
10
Wave 1
(2002)
Wave 2
(2004)
Wave 3
(2006)
Wave 4
(2008)
Wave 5
(2010)
Wave 6
(2012)
Numberofitemsrecalled
Item recall (age 70-74 in wave 1)
Men
Women
0
2
4
6
8
10
12
14
50-54 55-59 60-64 65-69 70-74 75-80 80+
Item recall (Wave 6)
Men
Women
Trajectories & cross sectional comparisons in later
life: results from the English Longitudinal Study of
Ageing (1)

Figure 5. Male life expectancy at age 65 for expanded NS-
SEC classes including the unclassified and England and
Wales, 1982-86 to 2007-11(Source ONS population
projections October 2015)
(http://www.ons.gov.uk/ons/dcp171778_420190.pdf)

Figure 12. Female life expectancy at age 65 for expanded
NS-SEC classes including the unclassified and England
and Wales, 1982-86 to 2007-11 (Source ONS population
projections October 2015)

Inequalities in healthy life
expectancy
▶ Clear evidence of large inequalities in health and well-
being in later life, which relate to dimensions of socio-
economic position, ethnicity, gender and area
▶ the wealth differences in levels of frailty are stark. The
trajectory of frailty for an individual in the richest tertile at
age 80+ years is comparable to that for a 70–74 year old
in the poorest tertile
▶ Similarly, in the age group 61–70, 34% of White English
people report fair or bad health, compared with 63–69%
of Indian, Pakistani and Caribbean people and 86% of
Bangladeshi people.
▶ Source: Addressing inequalities in healthy life expectancy, James Y. Nazroo University of Manchester April
2015
▶ https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/455811/gs-15-20-future-ageing-

Source: Marshall, A., Nazroo, J., Tampubolon, G. and Vanhoutte, B. (2015) Cohort differences in the levels
and trajectories of frailty among older people in England. Journal of Epidemiology and Community Health
69, 316–321.

Predicting dementia (CFAS study)
▶ Female sex and particularly increasing age were more strongly associated
with dementia
▶ More years of education were associated with lower-levels of dementia.
▶ Poor self-perceived health increased the risk for incident dementia
▶ Alcohol and smoking (never, past and current) were neither strongly
protective nor predictive.
▶ Stroke was strongly related to incident dementia as was Parkinson’s disease
▶ Exposure to general anaesthesia (GA) was inversely associated with
dementia development with a trend with increasing GA exposure.
The association of increasing age with the development of dementia is
several magnitudes greater than the other factors in the study (OR of
25.6). Ageing of populations is likely to result in an increase in the number of
people dying with dementia even in the presence of preventative programmes.
Source: MRC Cognitive Function and Ageing Study, Agustin G. Yip, Carol Brayne, and Fiona E. Matthews. Risk factors for incident
dementia in England and Wale: The Medical Research Council Cognitive Function and Ageing Study. A population-based nested
case-control study.

Issues & dilemmas in research on
ageing
▶ Need for prospective longitudinal research to understand
how early life factors influence later life experiences
▶ Need for detailed longitudinal data on later life
trajectories of decline
▶ but…each cohort is likely to have distinct experiences
▶ Given the heterogeneity of experiences of ageing, desire
to understand ‘Healthy’ or ‘Successful’ ageing,
▶ but…how to encourage a focus on success without
implying individuals are ‘to blame’
▶ Longitudinal research can lead to a focus on the
individual – need to understand the broader context of

The future of ageing research in
Europe: a roadmap
▶ FUTURAGE two-year project funded by the
European Commission (completed 2011)
▶ Priorities
– Healthy Ageing for more life in years
– Maintaining and regaining mental capacity
– Inclusion and participation in the community and in the
labour market
– Ageing well at home and in community environments
– Unequal ageing and age related inequalities
– Bio-gerontology: from mechanisms to interventions
– Source: http://futurage.group.shef.ac.uk/

Foresight project on the Future of
Ageing
▶ Independent evidence review due to report
March 2016 (led by Prof Sarah Harper)
▶ Government office for Science with collaboration
from Research councils to understand gaps in
knowledge
▶ Basis for a range of policies and actions to:
– maintain wellbeing throughout life, for all individuals regardless of
their generation
– improve quality of life for older people and enable them to
participate more fully in society
– ensure everyone can access the tools and facilities to help them
live a long and healthy life

Foresight project on Ageing
▶ Independent evidence reviews including:
– Future of ageing: inequalities in healthy life
expectancy
– Future of ageing: emotional and personal
resilience
– Future of ageing: relationships between the
generations
– Future of ageing: effect of technology on support
networks
– Future of ageing: health and care infrastructure
– Future of ageing: workplace infrastructure

Conclusions & further evidence
needed
▶ Frailty & Causes of the loss of function in later
life
▶ Unequal Ageing
▶ Comparative research & global ageing
▶ Ageing and prevention – what works and why?
▶ Multidisciplinary work important
▶ Contexts of ageing and not just individual
perspective
▶ Understanding trajectories of ageing and

Ageing research funding by Research Councils
Long history of funding ageing research in the Research Councils
Approximately £200m spend on ageing research in current CSR plus large
underpinning ageing-related portfolio
• Vast majority in response-mode by individual Councils
• Strategic initiatives including in partnerships
• Relatively small proportion in joint Council programmes – NDA and LLHW
ERA/SAGE

Ageing research: New Dynamics of Ageing
New Dynamics of Ageing – interdisciplinary programme (£20M over 10
years) Examples of projects funded through NDA:
Ageing and Biology (http://www.newdynamics.group.shef.ac.uk/stress-
and-immunity.html)
Fiction and the cultural mediation of ageing
(http://www.newdynamics.group.shef.ac.uk/ageing-and-fiction.html)
Dynamics of cardiovascular ageing
(http://www.newdynamics.group.shef.ac.uk/assets/files/NDA%20Findings
%2019v.pdf)
HALCYON (Healthy Ageing Across the Lifecourse)
http://www.newdynamics.group.shef.ac.uk/assets/files/NDA%20Findings
_33.pdf

Ageing research: LLHW
Since 2008 LLHW has committed £51m, funded 54 awards and 60 PhD
and post docs. Examples of projects funded through LLHW:
• Inequalities in later life frailty and wellbeing: an interdisciplinary approach to
causality (Nazroo)
• The menopausal transition and healthy ageing and wellbeing (Lawlor)
• Engaging with Older People to Develop and Deliver Interventions for the self
management of Chronic Pain (Smith)
• Uncertain Futures: Managing Late-Career Transitions and Extended Working
Life (Vickerstaff)
• Extending Working Lives in the National Health Service: Opportunities,
Challenges and Prospects (Nolan)
• Mobility, Mood and Place: a user-centred approach to design of built
environments to make mobility easy, enjoyable and meaningful for older
people (Ward Thompson)
• Over-Hear: assessing functionality of hearing aids in complex listening
environments (McAlpine/Brimijoin)
• http://www.mrc.ac.uk/research/initiatives/lifelong-health-wellbeing/research-
activities/

Ageing research: non-LLHW
CIMA:
The Centre for
Integrated
research in
Musculoskeletal
Ageing
MODEM:
Modelling
outcome and
cost impacts of
interventions
for dementia
Social
Connections
and Wellbeing
in older adults
Dementia and
imagination:
connecting
communities
and developing
well-being
through socially
engaged visual
arts practice
MARQUE:
Managing
Agitation and
Raising Quality
of Life in
dementia
Centre for
Musculoskeletal
Health and Work
The health and
wellbeing of
grandparents
caring for
grandchildren
Pensions,
health and
wellbeing of
older people in
developing
countries

What next?
• Two big and successful cross council ageing programmes but we have also
funded a lot more besides through other routes.
• An outcome of the success of our large programmes is that ageing research
becomes embedded in our wider portfolio.
• Opportunities continue to exist for ageing research funding:
 Responsive mode – CCFA and remit (remit@esrc.ac.uk)
 Other existing schemes – SDAI, Large Grants, Future Research Leaders,
Transformative
 Calls in specific areas
• Age and Ageing is relevant to many areas e.g. Mental Health

Future Opportunities
The Future of Ageing Research:
Post REF 2014

Ready for ageing – where next?
Professor Sir Mark Walport
Government Chief Scientific Adviser and
Head of the Government Office for Science

The Government Office for Science
Sir Mark Walport
Chief Scientific Adviser to HM Government
The future of an ageing population
International Longevity Centre - UK
Sir Mark Walport
Chief Scientific Adviser to HM Government

135
• Wellbeing, health, security &
resilience
• Knowledge translated to economic
advantage
• The right science for emergencies
• Underpinning policy with evidence
• Advocacy and leadership for
science
The Future of an Ageing Population – 24 November 2015
Government’s Chief Scientific Adviser

136
• Response to ‘Ready
for Ageing?’ report
• Expert-led and
evidence-based
• Collaborative across
Whitehall and
underpinned by
public engagement
• Identify policy
challenges and
opportunities across
the ageing population
‘Evidence Safari’ at a workshop with policy-makers
Future of an Ageing Population
Foresight project

137
• 1854 cholera outbreak
in Soho
• Dominant theory that
cholera caused by ‘bad
air’
• John Snow traced
outbreak to one pump
on Broad Street
• Established the link
between contaminated
water and cholera© Justinc
1854 Broad Street cholera outbreak

138
Increased life expectancy is the result
of many such scientific successes

139
Housing Health and care
Education and work Technology
Project focuses on four inter-
connected areas

140
Growth in households in England to 2037. Source: DCLG
Households
in 2010:
21,919,022
Households
in 2010:
5,892,194
Households
in 2010:
844,097
• Increased number of
single occupier
homes
• Increased demand for
specialised housing
• More demand for
homes that can be
adapted through the
life course
• Potential rise in cost of
inadequate housing
to the NHS (currently
£1.4bn in England
across all age groups)
The number of older households is
expected to increase

141
Older people in the future are less
likely to be home owners
Homeownershiprate(%)
Home ownership rates by birth year and age. Source: Family
expenditure survey and family resources survey
• More older private
renters
• Due to low interest
rates and historic rent
increases - private
renters spend twice
as much (30%) of
income on housing
than mortgage payers
• Fewer people will
have homes to use as
assets in retirement

142
• Places of healthcare –
reducing NHS pressure
and maintaining
independent living
• Workplaces – older
people more likely to work
at home, technology (i.e.
teleworking services) can
facilitate this
Smart home technology has
great potential

143
1. Housing stock appropriate for
older people
2. Supporting choice – ‘rightsized’,
specialised or adapted housing
3. Design neighbourhoods for
wellbeing, services, community
through the life course
Policy challenges

144
• ‘Oldest old’ (80+) to
double as a proportion
of the population by
2040
• Increased multi-
morbidity
• Healthcare may
increasingly need to
focus on prevention and
management of disease
‘Oldest old’ (80+ years) as a percentage of the entre population. Source: Foresight
Changing health and care
demands

145
• Transfer of chronic disease
management from secondary to primary
care
• Projections suggest 400,000 more older
people receiving unpaid care by 2031
• Unpaid carers face difficulties in the
workplace and are more likely to
experience stress and poor health
Changes to the demand and
nature of care

146
Robotics – including
therapeutic robots
Bio-medical –
including stem cells,
nano-technology and
3D printing of body
parts
Wearables – including
health monitors and
sleep enhancement© Aaron Biggs
Medical technology has great
potential

147
1. Configuration of health
and care services for
increasing prevalence of
chronic diseases
2. Homes to enable
wellbeing and care to
reduce pressures on the
NHS
3. Support unpaid carers to
maintain quality of life
and balance employment
and care
Policy challenges

148
• Proportion of workers aged
50+ to increase from 25% to
31% between 2005 and 2020
• 58% of people regard
workplace ageism as
widespread
• Physical challenges, e.g.
eyesight
• Increasing responsibilities as
carers
Older workers face particular
challenges

149
• Increased UK demand for health and
tech skills
• Changes in jobs and skills demand as
technology advances
• Training through the lifecourse will be
key to responding to these changes
• Workers age 50+ are less likely to
receive training
The demand for skills will
change

150
1. Adapting workplaces –
and the role of
employers
2. Supporting flexible
working practices to
extend working lives
3. Awareness and
appetite for investing in
training for older
workers
Policy challenges

151
Broadband performance, May 2013. Source: Ofcom Projected proportion aged 65 and over, 2037. Source: ONS
Technology has great potential to
improve the lives of older people
but access is an ongoing challenge

152
• Attitudes – older people less likely to agree with the
statement ‘new technologies are very useful’ (Ofcom 2015)
• Accessibility – challenges include fonts and layouts on web-
based application and cumbersome wearable technology
• Cost – recent studies question the current cost effectiveness
of telecare and telemedicine
Other barriers to technology
uptake include:

153
1. Access and uptake of
technology – across the
population
2. Innovative business
models aimed at
deploying technology for
older people
Policy challenges

154
… and this exposes
future challenges for
government and for
science
Our response to these
‘multi-dimensional’
issues is crucial…
Important to recognise that the
challenges and opportunities are
‘multi-dimensional’ – e.g. public health

155
• Understand how different factors
throughout the life course come together
• Work across departments in government
• Develop the case for long-term
interventions
• Respond to regional and local differences
To ensure the UK fully benefits from
the ageing population, we must…

Every effort has been made to trace copyright holders and to obtain their permission for the use of copyright material. We
apologise for any errors or omissions in the included attributions and would be grateful if notified of any corrections that
should be incorporated in future versions of this slide set. We can be contacted through go-science@bis.gsi.gov.uk .
@UKScienceChief
@foresightgovuk
www.gov.uk/go-science

The future of financial services
in an ageing society
Jim Boyd
Director of Corporate Affairs, Partnership

The Future of Financial
Services in an Ageing
Population
November 15
Jim Boyd
Director of Corporate Affairs

Agenda
• What does an ageing population need?
• What does financial services do?
• What needs to change?
• Will it happen?

What does an ageing population need?

• Easy to slip into working out what an elderly population needs from our industry in a
lazy way
• All of that is true but it misses some of the broader policy agenda, some of which we
need to support
What does an ageing population need?

What does financial services do in these areas?

• Lets do it broadly chronologically
• Reducing Future Dependency
• Helping Forward Planning
• Helping People Stay in Work
• Decumulation / Managing Uncertain Longevity
What does financial services do?

0%
5%
10%
15%
20%
25%
30%
Up to 5 years 6 - 10 years 11 - 15 years 16 - 20 years 21 - 25 years 26 - 30 years 31 - 35 years Over 35
years
Estimate
**Source: Projected lifespans are derived from the ONS 2012-based principal projection for the UK population
Actual projected life
span**
How long do people expect to live?
*Source: Partnership survey (2014)
Bit of a gap!

• Access to Liquidity from Property Assets
• Insure the Cost of Care
• IHT Planning
What does financial services do?

• Perception is probably the biggest thing
• Then it needs to solve the impediments to doing what customers need
• Finally we need to engage people before its too late
• Regulation needs to change
• This becomes a bigger issue as populations age
What needs to change?

• Its time for a proper public debate about the balance between regulation and
affordability
What needs to change?

• Hard to say how much and when!
• Most people I meet in insurance care about their customers and want to do the right
thing
• The framework we operate in is complex and inflexible and that makes it hard
• Catalyst may come from outside industries coming into industry
• I do worry a lot that industry is too stuck in legacy and short term results
• And politicians time horizons too short term to support the required investment
Will it happen?

Thank you 171
November 15 Footer
Partnership is a trading style of the Partnership Group of Companies, which includes: Partnership Assurance Group plc (registered in England and Wales No. 08419490),
Partnership Life Assurance Company Limited (registered in England and Wales No. 05465261), and Partnership Home Loans Limited (registered in England and Wales
No. 05108846).
Partnership Life Assurance Company Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential
Regulation Authority. Partnership Home Loans Limited is authorised and regulated by the Financial Conduct Authority.
The registered office for these companies is 5th Floor, 110 Bishopsgate, London, EC2N 4AY.

The future challenges and
opportunities of health in an
ageing society
Professor Ian Philp CBE
Deputy Medical Director for Older
People’s Care, Heart of England NHS
Foundation Trust

Challenges and Opportunities for Health in an
Ageing Society
Professor Ian Philp CBE
ILC-UK, London
November 2015

Priorities in Health and Care
Older People:
Their families:
Advocacy:
Policy:
Providers of care:
independence and well-being
respect for dignity
opportunity/relief of suffering
financial sustainability
meeting quality standards

Preventive care
EASYCareHealth:
25 Years,
44 Countries,
80 Publications

EASYCare Assessment
1
• Seeing, hearing, communicating
2
• Looking after yourself
3
• Getting around
4
• Your safety
5
• Accommodation and finance
6
• Staying healthy
7
• Your mental health and well-being

Top Four Concerns
Loneliness Finance
Memory
Pain

What Could be Achieved
From welfare and care…
…to empowerment and capability
www.easycarehealth.org.uk

ILC-UK Future of Ageing Conference

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