Disability, dementia and the future costs of long-term care

Increasingly sophisticated efforts to project future long-term care (LTC) expenditure highlight that this is very sensitive to assumptions made about future rates of disability and dementia. This article reviews different ways of formulating such assumptions and gives examples of their impact on future LTC expenditure projections in England. Using disability scenarios from an epidemiological model (based on assumptions about chronic diseases and their outcomes and expected treatments), suggests that assuming constant prevalence of disability may be optimistic . The projections indicate that investing in cost effective public health and management of chronic conditions measures that moderate disability or slow down the progression of dementia may produce good returns in terms of reducing the future costs of LTC.