This web article is based on the Trend Scenario and the Thematic Foresight Studies. The substantiation for the texts, numbers and figures presented here can be found in these documents, unless indicated otherwise. The Trend Scenario and Thematic Foresight Studies show how our public health situation and health care sector will develop over the next 25 years if we pursue our current course and do not take any additional measures. This approach makes it possible to map out the societal challenges for the future.
The ageing population has a major impact on public health and health care
The percentage of older people in society is increasing. People are also reaching very old age more and more often. As a result, more and more people will suffer from chronic diseases such as arthrosis, neck and back pain, diabetes and dementia. In addition, people are increasingly suffering from multiple diseases at the same time. In 2040, dementia will cause the highest mortality and the highest burden of disease. It is not just medical issues that are increasing, either; social issues are increasing as well. The number of lonely older people is on the rise. Older people live independently more often, and often live alone. These developments will lead to more pressure on formal as well as informal health care. Health care services will face the most pressure in regions where the population is shrinking.
Sharp increase in geriatric diseases
Over the next 25 years, the effects of the ageing population will have an increasing impact. And more and more people are reaching very old age, resulting in a growing number of elderly people. In 2040, we will have 1.7 million more people over 65, and more than 200,000 more people over the age of 90. As a result, more people in the future will suffer from chronic diseases such as arthrosis, neck and back pain, and diabetes. In 2040, for instance, there will be over a million additional people with arthrosis compared to 2015. The number of people suffering from dementia will double from 154,000 in 2015 to 330,000 in 2040. Even though there are other diseases which occur much more frequently, dementia has a huge impact on public health. In 2040, dementia will be the disease that will cause the highest mortality and the highest burden of disease.
Multiple diseases and issues at the same time
There will not only be more people who have a chronic disease, but there will also be more people who have multiple diseases at the same time. We also refer to that as multimorbidity. In addition to chronic diseases, older people often also struggle with issues such as falling, memory problems, visual and hearing impairments, limitations in daily living, incontinence, loneliness and poly-pharmacy (the use of multiple medicines at the same time). The ageing population will also result in more older people being affected by these problems in the future. An accumulation of such problems puts older people in a more vulnerable position.
More loneliness and less control due to the ageing population
The number of lonely people over 75 will increase from over 600,000 in 2015 to over 1.3 million in 2040. That is half of people aged 75 years and older. Loneliness occurs in all age groups, but more often amongst older people. In total, the number of lonely people will increase from 5.2 million in 2015 to almost 5.9 million in 2040. Loneliness will more rapidly increase for people who are single than for those who are cohabiting. Between 2015 and 2040, the number of people over 75 that are living alone will increase by almost 600,000. Compared to younger age groups, older people also more often feel like they do not have sufficient control over their own lives. Between 2015 and 2040, the number of people over 75 that do not experience sufficient control over their own lives will increase by almost 570,000. On average, men feel slightly more in control of their own lives than women.
Increasing pressure on both formal and informal care
The ageing population will increase pressure on health care. In the future, many more people will have some type of disease that requires treatment. Health care demand will also become more complex due to increasing multimorbidity. Pressure will not only increase on formal care, but on informal care as well. That is the result of more and more seniors living independently. The number of single older people will also increase. At the same time, the ratio between people over 85 and people between 50 and 64 – the generation of children that can take care of the people over 85 – will shift from 1 to 10 now down to 1 to 4 in 2040. This means that there will be fewer children who can take care of their parents in future.
The needs of older people are not limited to medical care, but also extend to the field of well-being. More focus on well-being may help older people to retain a good quality of life, in spite of disease and limitations. This not only demands better collaboration between health care professionals, but also between health care professionals, professionals addressing various aspects of well-being, and informal caregivers. In certain areas of the Netherlands where the population is declining, health care and other services will be under pressure because fewer people live there. At the same time, these regions are also seeing the sharpest increase in the ageing population, accompanied by a growing demand for health care and other services.
Impact of the ageing of the population
The number of people aged 65 and over will increase by 55% from 3.1 million in 2015 to 4.8 million in 2040.
The number of people aged 90 and over will increase by 191% from 117,000 in 2015 to 340,000 in 2040.
The number of people aged 65 and over living alone will increase by 88% from 920,000 in 2015 to
1.73 million in 2040.
The number of 50-64 year-olds per person 85+ (informal care givers) will decrease by 60% from 10 in 2015 to 4 in 2040.
The number of people with multiple chronic diseases will increase by 28 % from 4.3 million in 2015 to 5.5 million in 2040.
The number of people with arthrosis will increase by 92% 1.2 million in 2015 to 2.3 million in 2040.
The number of deaths from dementia will increase by 186% from 14,000 in 2015 to 40,000 in 2040.
The number of people with dementia will increase by 114% from 154,000 in 2015 to 330,000 in 2040.
The number of people aged 75 and over feeling lonely will increase by 117% from 600,000 in 2015 to 1.3 million in 2040.
The number of people with urinary incontinence will increase by 49% from 495,000 in 2015 to 740,000 in 2040.
The number of cataract operations among people aged 75 and over will increase by 106% from 62,000 in 2015 to 128,000 in 2040.
The number of people with dementia who need nursing home care will increase by 117% from 76,000 in 2015 to 165,000 in 2040.
The number of first aid visits by people aged 85 and over will increase by 143% from 125,000 in 2015 to 304,000 in 2040.
The expenditures on elderly care will increase by 157% from 17 billion in 2015 to 43 billion in 2040.