International Psychogeriatrics

Research Article

Future costs of dementia-related long-term care: exploring future scenarios

Adelina Comas-Herreraa1 c1, Sara Northeya2, Raphael Wittenberga1, Martin Knappa1a2, Sarmishtha Bhattacharyyaa3 and Alistair Burnsa4

a1 Personal Social Services Research Unit, London School of Economics and Political Science, London, U.K.

a2 Department of Psychology, University of Surrey, Guildford, Surrey, U.K.

a3 Centre for the Economics of Mental Health, King's College London Institute of Psychiatry, London, U.K.

a4 Memory Clinic and Early Onset Dementia Penn Hospital, Wolverhampton, U.K.

a5 Department of Psychiatry, School of Medicine, The University of Manchester, Manchester U.K.


Background: This study explores how the views of a panel of experts on dementia would affect projected long-term care expenditure for older people with dementia in England in the year 2031.

Methods: A Delphi-style approach was used to gather the views of experts. The projections were carried out using a macro-simulation model of future demand and associated expenditure for long-term care by older people with dementia.

Results: The panel chose statements that suggested a small reduction in the prevalence of dementia over the next fifty years, a freeze in the numbers of people in care homes, and an increase in the qualifications and pay of care assistants who look after older people with dementia. Projections of expenditure on long-term care that seek to capture the views of the panel suggest that future expenditure on long-term care for this group will rise from 0.6% of GDP in 2002 to between 0.82% and 0.96% of GDP in 2031. This range is lower than the projected expenditure of 0.99% of GDP in 2031 obtained under a range of base case assumptions.

Conclusions: This paper attempts to bridge the gap between qualitative forecasting methods and quantitative future expenditure modelling and has raised a number of important methodological issues. Incorporating the panel's views into projections of future expenditure in long-term care for people with dementia would result in projected expenditure growing more slowly than it would otherwise.

(Received June 22 2009)

(Revised August 27 2009)

(Revised December 22 2009)

(Accepted December 23 2009)

(Online publication April 08 2010)


c1 Correspondence should be addressed to: Adelina Comas-Herrera, Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, U.K. Phone: +44 (0)2079557306; Fax: +44 (0) 2070556131. Email: