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Oldest Old in the United Kingdom March 2013 This factsheet is the most up-to-date source of publicly available, general information on people in very later life in the UK. Wherever possible, figures for the whole UK are quoted. For ease of reading and unless otherwise stated, the term “oldest old” is used here for people aged 85 and over. If you have any queries or comments, please contact [email protected] Table of Contents Overview .............................................................................................................................. 3 UK Population .................................................................................................................. 3 Population projections ...................................................................................................... 3 Within the older population ............................................................................................... 3 Age discrimination ............................................................................................................ 3 Legal marital status .......................................................................................................... 3 Ethnicity............................................................................................................................ 4 Household dynamics ........................................................................................................ 4 Health and Wellbeing ........................................................................................................... 4 Life expectancy ................................................................................................................ 4 Life style ........................................................................................................................... 4 Physical activity ................................................................................................................ 5 Illnesses ........................................................................................................................... 5 National Health Service .................................................................................................... 6 Nutrition ............................................................................................................................ 6 Malnutrition....................................................................................................................... 6 Smoking ........................................................................................................................... 6 Sleep ................................................................................................................................ 7 Pain .................................................................................................................................. 7 Falls.................................................................................................................................. 7 Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) ......... 8 Dental and oral health ...................................................................................................... 8 Mental health .................................................................................................................... 8 Memory and cognitive decline .......................................................................................... 9 Dementia .......................................................................................................................... 9 Perceptions of health........................................................................................................ 9 Quality of life .................................................................................................................... 9 Dying .............................................................................................................................. 11 Home care...................................................................................................................... 11 Residential care ............................................................................................................. 11 Older people as carers ................................................................................................... 12 Housing and homelessness ........................................................................................... 12 Money Matters ................................................................................................................... 12 Pensions ........................................................................................................................ 12 Savings .......................................................................................................................... 12 Income and wealth ......................................................................................................... 12 Oldest Old fact sheet - last updated 8 March 2013 2 Spending ........................................................................................................................ 13 Fuel poverty ................................................................................................................... 13 Travel and Lifestyle ............................................................................................................ 13 Transport and accessibility ............................................................................................. 13 Community and citizenship ............................................................................................ 14 Leisure and time use ...................................................................................................... 14 Digital inclusion .............................................................................................................. 14 Social participation ......................................................................................................... 14 Volunteering ................................................................................................................... 14 Crime.............................................................................................................................. 15 Work and Learning ............................................................................................................ 15 Employment ................................................................................................................... 15 Learning ......................................................................................................................... 15 References ........................................................................................................................ 15 Oldest Old fact sheet - last updated 8 March 2013 3 Overview UK Population Over 1.4 million people are aged 85 or over 1 66% of these are women (about 977,000)2 The numbers of centenarians as nearly quadrupled since 1981, from 2,600 to 12,000 in 2009.3 Population projections The number of people aged 85+ in the UK is predicted to double in the next 20 years and nearly treble in the next 304 Nearly one in five people currently in the UK will live to see their 100th birthday (see section on life expectancy below)5 However, according to the National Statistician, the UK’s population is ageing more slowly than other comparable counties6 Within the older population Over 2 million people over 75 live alone; 1.5 million of these are women.7 62% of widows (women only) are aged 75 and over 8 Black and minority ethnic (BME) groups make up over 16% of the population of England, but only 1.8% of people in England aged 85 and over 9 Government estimates that between 5 and 7% of the UK population are lesbian, gay or bisexual. On this basis, we estimate there are between 74,000 and 103,600 LGB people aged 85 and over in the UK 10 Age discrimination 97% of annual travel insurance policies impose an upper age limit for new customers 11 In a study of patients at a stroke until between 2004 and 2006, only 4 per cent of patients age 75 and above were given an MRI scan, compared to 26 per cent of those under 75 12 Legal marital status According to the Understanding Society survey, in the UK amongst those aged 85 and over 63.2 per cent are either widowed or a surviving civil partner. In the younger-old population (aged 65 to 84), 23 per cent are either widowed or a surviving civil partner.13 Only 26.8 per cent of the aged 85+ UK population are married or civil partnered compared to 61.7 per cent of the population aged between 65 and 84.14 6.6 per cent of those aged 85+ are single, never married or civil partnered and a further 3.4 per cent are divorced (including dissolved civil partnerships) or separated.15 Disaggregated by sex, 74.9 per cent of women aged 85+ are widowed compared to 47 per cent of men. Amongst men aged 85 and over, 45.3 per cent compared to 13.5 per cent of women are married or civil partnered.16 Oldest Old fact sheet - last updated 8 March 2013 4 Ethnicity The segment of the population who are White at ages 85+ is 97.2 per cent, higher than the 92.9 per cent amongst those aged 65 to 84.17 The percentage of those of Asian ethnicity falls from 3.6 per cent amongst the aged 65 to 84 to 1 per cent of the oldest old.18 1.7 per cent of those aged 85+ are Black compared to the group aged 65 to 84 where 2.9 per cent are Black.19 Household dynamics Almost three quarters (74.8 per cent) of people at oldest old ages live on their own compared to 37 per cent of those aged 65 to 84.20 One in 10 aged 85 and over live with their biological adult children. At youngest old ages the prevalence is slightly lower with 8.8 per cent living with their biological adult children however the difference between the two age groups is not statistically significant at the 95 per cent confidence level.21 Almost a quarter (24.4 per cent) of people at oldest old ages live with their spouse and this is higher at 60.6 per cent of those aged 65 to 84.22 Prevalence of cohabitation at older ages is low relative to younger people; 2.5 per cent of those aged 65 to 84 live with a cohabitee compared to only 0.8 per cent of those at oldest old ages.23 Health and Wellbeing Life expectancy UK life expectancy estimates at the age of 65 are 85.6 for women and 83 for men.24 UK life expectancy estimates at the age of 85 are 92.0 for women and 91.2 for men.25 A baby born in 2011 is almost eight times more likely to reach 100 than one born in 1931. 26 A baby girl born in 2011 has a one in three chance of living to 100 and a baby boy has a one in four chance 27 People aged 80 in 2011 have a 7.7% chance of living to 100 (6.2% for men, 9.2% for women). 28 The chances of living to 100 drop every year until people are age 84 (7.2% chance); after this the odds rise continuously, especially rapidly after age 95 (19.7%, rising to 67.6% at age 99).29 Of the 500,000 people who die in England each year, two-thirds are older than 75 and onethird are over 85 years old. According to projections, by 2030, 86% of deaths will be among people aged over 65 and those over 85 will account for 44% of deaths.30 Life style A considerable number of people in later life are vitamin D deficient, with rates rising to over 22% in women aged 85 and over.31 Vitamin D is made by the skin when it is exposed to sufficient sunshine, but this is more difficult in the UK’s northern latitudes and in ageing skin. Vitamin D is involved in bone health, and also plays a role in some cancers, heart disease, type 2 diabetes, stroke and dementia32 33. Vitamin D deficiency has also been linked to increased mortality34. In parallel with the rising prevalence of obesity in later life, there has been a dramatic increase in the percentage of older people being diagnosed with Type 2 diabetes. In people aged 75+, this has risen from around 8% in 1994 to nearly 20% in 2009 for men and from around 5% to almost 13% in women in those years. In addition, once diagnosed under half those aged 55 to 84 years received the full recommended annual care processes as set out by the National Institute of Clinical Excellence. 35 Oldest Old fact sheet - last updated 8 March 2013 5 Physical activity Research does not support the belief that people can be ‘too old’ for exercise to benefit them. In fact, studies show that strength exercises can reduce the rate of osteoarthritis progression, and flexibility exercises help older people recover from falls;36 even among the very old, exercise can delay or prevent the onset of diabetes, colon cancer, heart disease, and stroke.37 Lower levels of physical activity in older people have been associated with having a higher body mass index, lower physical function, and with taking fewer journeys away from the home each week.38 In the ‘90+ Study’ in the US, researchers found that doing ½ hour of daily ‘active’ activity reduced the risk of mortality by 15-35% (compared with people doing none)39, and cuts risk of cardiovascular disease by 20-40%40. In one study, older people who kept to a walking regimen had fewer functional limitations due to health, better functional performance, stronger self-efficacy expectations (belief about the ability to perform specific health behaviours) and fewer falls. Adherence was affected by beliefs about exercise and its benefits, experience with exercise, goals, personality, and unpleasant sensations due to exercise.41 However, people aged 75-plus are much less likely to report taking the minimum levels of physical activity necessary to achieve health benefits.42 In English adults aged 65-74, 19% say they meet this minimum level, and only 7% of 75+ men and 4% of women do.43 In people aged 85+, around 70% say they have mobility difficulties (cannot walk a quarter of a mile without difficulties or without aids).44 Studies show that the common barriers the oldest old say prevents them from exercising are: health problems, lack of help from healthcare professionals, being ‘too tired’, lack of transportation, and ‘bad weather.45 Self-efficacy expectations (belief about the ability to perform specific health behaviours) can be one of the strongest influences on health behaviours in the oldest old.46 One study found that interventions that targeted specific diseases in patients made them more active. The presence of chronic illness, common to older adults, may cause patients to be more responsive. 47 For promoting health behaviours, behavioural interventions, face-to-face delivery and targeting individuals were more effective than cognitive interventions, telephone/post and targeting communities.48 Having social support may also increase amounts of exercise.49 Illnesses In a study of people aged 85+, women had significantly higher disease counts (medians: women 5, men 4) and disability scores (medians: women 4, men 2) than men, but were less likely to have attended outpatient clinics in the previous three months (women 29%, men 37%)50 Women were 10 times more likely than men to have rheumatoid arthritis, eight times more likely to have a diagnosis of hyperthyroidism, three times more likely to have a diagnosis of hypothyroidism, and six times more likely to have osteoporosis. Women also had a significantly higher prevalence of cataract, osteoarthritis, joint replacement, renal impairment, and anaemia. Men were significantly more likely to have a diagnosis of atherosclerotic disease and cancer.51 About 40 per cent of the oldest old are estimated to have a ‘severe disability’.52 However, in a recent UK study, researchers found that a high proportion (41%) of respondents aged 85 and above were ‘independent’, particularly men. Of the remainder, 39% required help, but not on a daily basis, 12% required regular daily help and 8% required care 24 hours a day.53 The Newcastle 85+ study found severe or profound urinary incontinence in 21.3%, hearing impairment in 59.6%, and visual impairment in 37.2%.54 Oldest Old fact sheet - last updated 8 March 2013 6 ELSA participants aged 85+ were also significantly more likely to self-reported eyesight as worse than the younger ages (though still averaging close to ‘fair’), and more had cataract surgery, and worse hearing (though they still thought it was close to ‘very good’), though 59% admitting finding it hard to follow conversations in noisy environments.55 Around 70% of people aged 80+ have at least 1 ‘long term condition’ (LTC, not currently curable, as classified by the Department of Health); over 30% have 2 or more LTCs.56 The most prevalent types of LTC (as classified by the Department of Health) in those aged 80+ are musculoskeletal (37%), coronary heart disease (15%), and hypertension (14%).57 Prevalence of long-standing illness or disability increases from 59 per cent amongst the youngest old to 70.4 per cent at oldest ages.58 National Health Service Overall, the oldest old have the highest usage of acute hospital services and it is estimated that they account for around 45 per cent of NHS spending.59 For cancer, people aged 85+ are more likely to be admitted to hospital as an emergency, where they are diagnosed at a later stage of disease when survival rates are lower60 61 62. Older people are also reported to be relatively under-investigated and receive less aggressive treatment63; this could be due to age discrimination, a combination of clinical appropriateness (i.e. the patient is too frail to withstand radical, but potentially curative procedures) and/or patient preferences for less aggressive management64. The number of emergency readmission for people aged 75+ in English hospitals in 2009/10 was 188,138, a rise of 88% since 1999/2000 65 9 per cent of people aged 75 and over in England find it very difficult to get to their doctor’s surgery 66 Nearly one in five (19%) find it very difficult to get to their local hospital 67 64% of older people think health and care staff don’t always treat older people with respect for their dignity 68 Nutrition Choice may not be possible if the person does not do the shopping or cooking for themselves; families/carers are an important target for nutrition messages for these people. Eating a large number of fruits and vegetables might not be possible because appetite is usually lessened, so concentrating on high-quality nutrient-dense foods is better.69 Malnutrition All figures using accepted BAPEN/NICE/WHO definitions “under 20 BMI, loss of appetite and/or unexplained weight loss”. The risk of having malnutrition on admission to hospital is 33% for people aged 80+ (40% for those 90+), compared to 22% in people under age 60.70 Malnutrition of people aged 85+ entering care homes was 52% (41% for all ages).71 Every ten minutes, someone with malnutrition dies in hospital (all ages).72 Also: o Malnourished patients stay an average of 5-10 days longer in hospital. o Only just over half of older patients describe their hospital food as good o 37% of adult inpatients said they did not get enough help to eat meals and o 42% said there were not always enough nurses on duty to care for them73 Smoking 4.7 per cent of the oldest old smoke whilst 11.5 per cent of those aged 65 to 84 do so.74 Oldest Old fact sheet - last updated 8 March 2013 7 Sleep Our analysis of ELSAa data shows: o Rating sleep quality overall: surprisingly the 85+ group rated theirs at a bit higher than ‘very good’, slightly higher (but still statistically significant) than all of the other age groups.75 o People aged 85+ were significantly less likely to report that felt their sleep was restless during past week, at 30% versus 37% for 50 – 64 year olds.76 Pain Our analysis of ELSAb data shows: o Whether often troubled with pain: 41% said yes, which was similar to younger age groups77 o Severity of pain most of the time: the mean came to 0.93 which was close to ‘moderate’, similar to other age groups, except significantly higher than people aged 50 – 64 (0.85).78 o Only 29% of the 85+ group said they were currently receiving treatment.79 Falls Our analysis of ELSAc data shows: People aged 85+ were significantly more likely to have fallen in the last year than younger old (41% versus 24%).80 But they only reported falling twice last year on average, versus three times for people 50-6481 Only 35% of 85+ said a fall had injured them seriously enough to need medical treatment 82 When asked whether the doctor or nurse tried to understand causes of their fall, only 40% of those who sought medical treatment said yes83 Asked whether the doctor or nurse tested balance or strength after a fall, only 21% said yes84 Fall: whether doctor or nurse recommended additional tests: only 7% said yes85 Fortunately, having a fractured hip in the last two years was not common – only 2% said they had, though this was significantly more than younger groups86 Hip fractures are the most expensive osteoporosis fracture with estimated costs per patient £25,424 (2000 figure).87 The latter figure is now routinely updated to £28,000 by some falls teams to reflect increased costs over the past 12 years. a ELSA: English Longitudinal Study on Ageing; most of the participants live in the community, and are not representative of those in residential care. b ELSA: English Longitudinal Study on Ageing; most of the participants live in the community, and are not representative of those in residential care. c ELSA: English Longitudinal Study on Ageing; most of the participants live in the community, and are not representative of those in residential care. Oldest Old fact sheet - last updated 8 March 2013 8 Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) Our analysis of ELSA Wave 4 data shows: The 85+ group reported significantly more difficulty with all of the ADLs and IADLs than younger-old groups. These are listed here with the mean for the 85+ group along with the 50 – 64 group for comparison: difficulty dressing, including putting on shoes and socks (29% vs 10%); walking across a room (15% vs 2%); bathing or showering (35% vs 6%); eating, such as cutting up food (9% vs 2%); getting in and out of bed (12% vs 5%); using the toilet, including getting up or down (11% vs 2%); using map to figure out how to get around strange places (22% vs 3%).88 However, note that the averages are still usually less than one third, and most are much less. The IADLS were difficulty with: recognising when in physical danger (11% of 85+ vs 0.7% for 50 – 64); preparing a hot meal (23% vs 3%); shopping for groceries (37% vs 6%); making telephone calls (13% vs 1%); communication (speech, hearing or eyesight) (16% vs 2%); taking medications (13% vs 1%); doing work around the house or garden (45% vs 10%); and managing money, such as bills and expenses (20% vs 2%).89 In all, 32% of the 85+ said they had none of listed difficulties, whereas 80% of the 50 – 64 group had no difficulties with ADLs or IADLs. The 85+ group significantly more likely to say they had help with mobility, an adl, or an iadl at 67% (versus 37% of the 65 – 74 year olds and 50% of 75 – 84 year olds).90 In the Newcastle 85+ study, a median of 3 (interquartile range 1-8) activities of daily living were undertaken with difficulty. 91 Dental and oral health Over half (53%) of people aged 85+ have at least some of their natural teeth (England, Wales, and NI).92 26% of people aged 85+ have 21 or more of their natural teeth (England, Wales, and NI).93 In 1978, the proportion of those aged 75+ without any natural teeth was 78%. This has been dropping steadily, and as of 2009 was only 33% (England).94 Mental health While depression is thought to affect 22% of men and 28% of women aged 65+95, only 5% of men and 11% of women aged 85+ have been diagnosed.96 From ELSA data, 26% of women aged 80–84 and 23% of those aged 85 and over had levels of depressive symptoms indicative of clinical relevance.97 The Royal College of Psychiatrists estimates that 85% of older people with depression receive no help at all from the NHS98 Another study estimates that depression affects 40% of older people in care homes, most of whom are over the age of 80.99 Worse general health can be associated with depression among older adults100, and other risk factors include not living close to friends and family, poor satisfaction with accommodation, and poor satisfaction with finances101 In Canada, men over the age of 85 have – on average – higher suicide rates (29 per 100,000) than all other age groups. And although older women have lower suicide rates than older men, their suicide attempt rate is higher.102 Oldest Old fact sheet - last updated 8 March 2013 9 Memory and cognitive decline In ELSA participants, self-rated memory for people 85+ was ‘good’, significantly different only from the 50 – 64 group who said ‘very good’.103 Perception of memory compared to two years ago: the 85+ group was only slightly lower than other groups except ages 50 – 64, but all fell around ‘same as before’.104 Moderate or severe cognitive impairment was present in only 11.7% of Newcastle 85+ study participants.105 Dementia Dementia is one of the main causes of disability in later life, ahead of some cancers, cardiovascular disease and stroke.106 It affects 1 person in 6 over 80 and one in three over 95107 Up to 25% of all hospital beds are occupied with older patients with dementia and they stay in hospital for longer than others with similar conditions108 There are several types of dementia. The most common are Alzheimer’s disease (62% of all cases of dementia) and vascular dementia (27%)109 Several studies give evidence that Cognitive Stimulation Therapy (CST) benefits cognition and quality of life for people with dementia, regardless of whether they are on medication for the disease or not. CST seems to be most beneficial for women and people older than 80 years.110 Perceptions of health Self-reported general health: people aged 85+ In ELSA Wave 4 rated themselves significantly lower on average than those aged 50 – 74, but still nearly ‘very good’ (2.8 out of 4 versus 3.3 for those aged 50 – 64)111 Similarly, overall, 77.6% of Newcastle 85+ participants rated their health compared with others of the same age as good, very good, or excellent.112 Quality of life The great majority of older people, even the oldest old, say they are fairly or very happy, with less than 10% reporting being unhappy. These responses did not change much with advancing age.113 The dominant strategy for rating one’s quality of life (according to one study) is ‘Downward Contrast ’. This is focusing on those around you who are worse off. It was significantly associated with a higher perceived quality of life.114 Among other statistically significant findings, it was found that positive orientation, optimistic orientation, and the use of Contrast rather than Identification comparisons associated with a better reported quality of life. In the UK and US, researchers observed a U-shaped relationship between age and levels of life satisfaction for individuals aged between 16 and approximately 70. It declines somewhat after this, but not to the lowest levels (which are seen in 45 – 54 year olds in the UK – see graph from ONS below)115 Oldest Old fact sheet - last updated 8 March 2013 10 Aggregate life satisfaction scores by age group from Happiness release ONS, 2012 One study showed that just over half of the oldest old experienced a substantial decrease in quality of life over the period between 2002–03 and 2008–09; however, 10% had a substantial increase in scores, and 36% stayed about the same.116 Our analysis of ELSA Wave 4 data showed: 19% of respondents aged 85+ said they felt depressed much of the time during past week, versus 14% of those aged 50 – 74117 Whether felt everything they did during past week was an effort: people 85+ were twice as likely to report this as 50 - 64 age group, at 37% versus 18%118 Whether could not get going much of the time during past week: 85+ significantly higher ‘yes’ than other ages at 32%, versus 18%, 18%, and 25%.119 Whether was happy much of the time during past week: quite high for all age groups: 88% for 85+, 89% - 91% for people in 50 – 84 groups.120 Whether enjoyed life much of the time during past week: all of these were also high: 87% for 85+, compared to 90% - 92% for the 50 -84 groups.121 Whether felt sad much of the time during past week: Similar for all ages: 23% for 85+, and 19% - 24% for the younger old groups.122 How old respondent feels they are (in years): All groups reported feeling younger than in reality, and the older the group the greater this age gap! The 50 – 64 group said 49 years, 65 – 74 said 57; 75 – 84 said 66; and 85+ said 74. 123 How old respondent would like to be (in years): All age groups wanted to be even younger, the gap again increasing with age. The 50 – 64 group said 40 years, 65 – 74 said 45; 75 – 84 said 49; and 85+ said 54.124 Understanding Society data suggests that those at oldest old ages are much less satisfied with their health. Only 49.7 per cent of those ages 85+ are satisfied with their health compared to 62.3 per cent of those aged 65 to 84.125 Those at youngest old ages demonstrates greater life satisfaction overall with 82 per cent stating that they felt satisfied whereas 76.4 per cent of the oldest old felt the same way. 126 Oldest Old fact sheet - last updated 8 March 2013 11 Dying Only 8.5 per cent of those dying of cancer aged over 85 die in a hospice, compared to 20 per cent of all cancer deaths 127 Although 33 per cent of all deaths are people aged 85 and over, only 9-15 per cent of people gaining access to specialist palliative care are in this age group128 Palliative care for older people: Better practices. Published: 14-05-2011. Written By: Hall et al. WHO Home and Care Home care When asked in which ways care and support services helped them, the most common answers where personal care (68%), feeling safe and secure (55%), meals (54%), keeping my home clean and comfortable (51%), to have control over daily life (49%), social contact with people I like (42%), and doing things a value and enjoy (33%). There was a marked difference in age groups in the following: personal care – 62% for ages 65-74 vs 73% for ages 85+; meals – 43% for 65-74s and 62% for 85+; feeling safe and secure – 50% for 6574s and 58% for 85+; doing things I value and enjoy – 37% for 65-74s and 31% for 85+.129 Residential care Only about 16% of people over 85 live in residential care.130 Approximately 30 per cent of people aged 85 and over die in a residential care home.131 The UK average annual fee for a single room in a private residential home is £26,104 (£502 per week). For a nursing home, it is £36,296 (£698 per week)132 On average, weekly fees for residential care in England in 2008 were £60 higher than the standard council payment 133 Oldest Old fact sheet - last updated 8 March 2013 12 Older people as carers Nearly 50,000 people aged 85+ provide unpaid care to a partner, family member, or other person.134 Carers UK estimate that 58% of carers (all ages) are female.135 A fifth of all carers (20%) aged 75+ provide 50 or more hours of informal care each week 136 A quarter (26%) of care recipients aged 85 or over need continuous care 137 Research shows older people feel that looking after someone else had damaged their health.138 Caring for another person can also take its toll mentally, damaging psychological wellbeing, and worsening mental health.139 Subsequently, the Princess Royal Trust for Carers wants GPs to provide health checks and screening for depression to carers once a year, and home visits where needed. It also recommends that training and lifting equipment should be provided to carers who need it and that breaks should be funded by the NHS and local councils.140 Housing and homelessness As of the previous census, over 61% of people aged 85+ lived in houses they owned. 141 No association between age and home ownership in men, but renting one’s home becomes more prevalent in older ages among women, reaching 37% in those aged 85 and over.142 Only about 16% of people over 85 live in residential care.143 10.4% of Newcastle study 85+ participants were in institutional care. 144 61% of older people not in institutional care were living alone, which has implications for the availability of help with activities of daily living and hence to providers of social care.145 Money Matters Pensions Average gross income for single pensioners aged 75 or over is £274 per week (£14,248 per year). For couples aged 75+, it is £498 a week (£25,896 a year). This compares to annual gross income for pensioners aged under 75 of £16,744 for single and £34,164 for couples. 146 Older pensioners tend to have lower levels of income from sources other than pension and benefits, as savings are used up and private pension income loses its real value over time. Savings 4 per cent of people aged 85 and over have no bank or post office account, and 3% of households where the head is 85-plus 147 Income and wealth There is evidence that the oldest old are, as a group, at greater risk of poverty than younger older people (aged 65-84).148 The DWP estimates that 19% of households with people aged 85+ are in poverty.149 Material deprivation seems to be fairly equally distributed between the old age cohorts (8-9%), until a slight peak in the 85+ group (12%).150 Total net wealth (including state pension wealth) is generally found to decline with age after 65, reaching its lowest for oldest old (85+), who on average have £155,600 compared to the Oldest Old fact sheet - last updated 8 March 2013 13 £379,200 of older people aged 65-69. However, up to 10% of the oldest old have total net wealth of £3,000 or less.151 "In the context of current care funding policy, the very oldest members of society are perhaps most likely to have exhausted any private capital and to be in receipt of state funding for their care."152 However, in general the 85+ group rated their financial situations better than the younger age groups (though only statistically significant from the 50 – 64 year olds). They were more likely to say they ‘never’ find they have too little money to spend on the things they want, and rated themselves as ‘about the same’ compared financially to other people nearby, though ‘a bit worse off’ compared to most of their friends (which was similar to all age groups).153 Similarly, Sinclair (2010) found that those aged 90+ were the least likely to feel that they had too little money to spend (15% of those aged 90+, compared to 19% aged 85-89 and 21% aged 80-84).154 The 85+ group was significantly less likely than younger groups to say they had too little money which: stops them buying first choice, stops them having friends/family, means do not have outfit to wear, means cannot keep home reasonable, means cannot repair/replace broken appliances, means cannot pay fares or transportation, means cannot take sorts of holidays they’d like, or means cannot treat themselves .155 In the over 80 age group in ROI, 71% of income on average comes from social transfers, compared to an average of 58% for 65+.156 5.1 per cent of the oldest old claim Disability Living Allowance and this compares to 8.4 per cent of the youngest old.157 4.9 per cent of the oldest old claim Carer’s Allowance, higher than the share of the youngest old who claim this benefit at 2.3 per cent.158 Spending On average, 75+ households spend more of their annual expenditure on housing and fuel: over 17%, compared to an all-age average of 12.5% 159 Fuel poverty Nearly one in three of the oldest households in England (where the oldest person is aged 75+) live in housing which has failed the official decent homes standard.160 One in eight of these 75+ households live in housing which fail the decent homes standard because of sub-standard heating and insulation. 161 Older people in private rented housing are most at risk of living in non-decent homes.162 People in later life in the UK are more likely to worry about the cost of heating in winter than in comparable European countries. They are also more likely to turn heating off to save money, wear outdoor clothing inside and go to bed early to save on heating costs.163 A higher proportion of people dread the winter in the UK than in Sweden.164 More people in later life in the UK also feel cold in their own homes than in Sweden or Germany.165 Travel and Lifestyle Transport and accessibility Just over half (52%) of people aged 70+ in Great Britain have a full car driving licence 166 18% of adults aged 60-69 have a mobility difficulty, and 38% of adults aged 70+ do. This is compared to 12% of everyone aged 16 and over.167 20% of men and women aged 80 and over use public transport often. Whilst 24% of those aged 85 and over with no car often use public transport, 64% only occasionally or never do so, Oldest Old fact sheet - last updated 8 March 2013 14 which could indicate a lack of independence in this group to move around outside the immediate area.168 43% (1.25 million people) of those aged 80+ find it difficult to get to the nearest hospital, 24% (700,000 people) find it difficult to get to the post office, bank, GP surgery and supermarket, 18% (about 500,000 people) find it difficult to get to their corner shop, and 14% (about 400,000 people) leave their homes once a week or less169 57% of rural households are within 13 minutes’ walk of an hourly or better bus service 170 28% of rural households do not have access to a supermarket within 4km 171 Community and citizenship 31% of people aged 65-74 and 21% of 75+ in England are participating in formal volunteering at least once a month. The average for all ages is 37% 172 However, 30% of people 65-74 and 29% of people 75+ feel they can affect decisions in their local area, as opposed to 38% of adults in England173 Leisure and time use Over-65s are estimated to spend an average of 80% of their time in the home - 90% for people over 85 174 Digital inclusion Internet use is low in prevalence at oldest old ages with only 10.4 per cent stating that they had use it compared to 40 per cent of those aged 65 to 84. Of those who use the internet people, people at oldest old ages were less likely to use it as frequently as the youngest old. Almost a half (47.8 per cent) of the youngest old use the internet everyday compared to only 29 per cent of the oldest old. Social participation Half of all people aged 75 and over live alone175 Under 10% of the oldest old took up membership of organisations (such as political, environmental, religious and charitable groups) between 2002–03 and 2008–09. Around 15% stopped being a member of any organisations over the period. Over 50% were members of at least one organisation in 2002–03 and in 2008–09. Contact with children, other family and friends was also stable for the great majority of the oldest old between 2002–03 and 2008– 09.176 Whether felt lonely much of the time during past week: 25% of 85+ said yes, significantly higher than people 50-64, 65-74, and 75-84 (11%, 12%, and 19% respectively)177 17% of have less than weekly contact with family, friends and neighbours 178 30 per cent of over-80s have limited access to services such as shops and GPs, and 25 per cent are cut off from family and friends179 Living alone, being widowed, and poor self-rated health is strongly related to feelings of loneliness in people 85+180 Volunteering 8.1 per cent of the oldest old volunteered in the last 12 months. A greater share at 21 per cent of those aged 65 to 84 had volunteered in the last 12 months.181 Oldest Old fact sheet - last updated 8 March 2013 15 Crime As an age group, the 75+ group is least likely to have a high level of worry about burglary, car crime and violent crime.182 Work and Learning Employment According to the last ELSA survey, 0.3% of people aged 85+ said they were in paid employment; if this is representative, this equates to 4,440 people in this age group in the UK.183 Learning 17% of 65-74 year-olds and 13% of those aged 75+ have taken part in learning in the last three years 184 References 1 Mid-2010 Population Estimates UK Office for National Statistics, 2011 Mid-2010 Population Estimates UK Office for National Statistics, 2011 3 National population projections, 20010-based, Office for National Statistics, 2011 4 National population projections, 20010-based, Office for National Statistics, 2011 5 Department of Work and Pension estimate based on ONS population projections, DWP press release, 30 December 2010 6 Population Trends 42, Office for National Statistics, December 2010 www.statistics.gov.uk/populationtrends/ptissue 7 Labour Force Survey, ONS, 2011 8 General Lifestyle Survey 2009 (Table 5.2), ONS, 2011 9 Office for National Statistics (ONS) Table PEEGC309: LAD 2009 Single Year of Age by Ethnic Group, mid-2009. 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