Projected trends in frailty prevalence and associated health service use and costs in the over-50s in England, 2025 to 2040: a simulation modelling study
Projected trends in frailty prevalence and associated health service use and costs in the over-50s in England, 2025 to 2040: a simulation modelling study
Aim: To model projected trends in frailty prevalence, associated service use and costs in people aged 50 and over in England to 2040.
Design: System Dynamics simulation modelling.
Setting: Adult population (aged 50 and over) of England.
Participants: Routine data from primary care patients aged 50 and over (2.2 million individuals), from participating practices from the Royal College of General Practitioners Research Surveillance Centre (RCGP RSC) database between 2006 and 2017.
Outcome measures: Projected frailty prevalence, primary, secondary and urgent care service use and costs in those aged 50 and over between 2025 and 2040.
Results: The population of England aged 50 and over is projected to increase from 23.1 million in 2025 to 24 million in 2040. Frailty prevalence in this group will rise from 70.2% to 76.1%, with associated service use costs increasing by £10 billion. Measures to reduce frailty incidence or progression could reduce costs by £310 million/annum and £644 million/annum respectively.
Conclusions: Frailty prevalence and associated service use and costs will increase substantially in the ageing population. A shift in focus to prevention and slowing progression in middle age and the younger old would substantially reduce service use and costs by older people living with frailty.
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
England, Tracey
8f99b32a-1670-4e20-b6c6-30ae96940ca2
Brailsford, Sally
634585ff-c828-46ca-b33d-7ac017dda04f
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
de Lusignan, Simon
ff8f6923-47a6-4c8e-8f12-c0517e6e3724
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Clegg, Andrew
5a338a9b-4a35-4de1-8f32-5cb5166f3745
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
England, Tracey
8f99b32a-1670-4e20-b6c6-30ae96940ca2
Brailsford, Sally
634585ff-c828-46ca-b33d-7ac017dda04f
Fogg, Carole
42057537-d443-462a-8944-c804252c973b
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
de Lusignan, Simon
ff8f6923-47a6-4c8e-8f12-c0517e6e3724
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Clegg, Andrew
5a338a9b-4a35-4de1-8f32-5cb5166f3745
Walsh, Bronagh, England, Tracey, Brailsford, Sally, Fogg, Carole, Fraser, Simon, Roderick, Paul J., de Lusignan, Simon, Harris, Scott and Clegg, Andrew
(2026)
Projected trends in frailty prevalence and associated health service use and costs in the over-50s in England, 2025 to 2040: a simulation modelling study.
Age and Ageing.
(In Press)
Abstract
Aim: To model projected trends in frailty prevalence, associated service use and costs in people aged 50 and over in England to 2040.
Design: System Dynamics simulation modelling.
Setting: Adult population (aged 50 and over) of England.
Participants: Routine data from primary care patients aged 50 and over (2.2 million individuals), from participating practices from the Royal College of General Practitioners Research Surveillance Centre (RCGP RSC) database between 2006 and 2017.
Outcome measures: Projected frailty prevalence, primary, secondary and urgent care service use and costs in those aged 50 and over between 2025 and 2040.
Results: The population of England aged 50 and over is projected to increase from 23.1 million in 2025 to 24 million in 2040. Frailty prevalence in this group will rise from 70.2% to 76.1%, with associated service use costs increasing by £10 billion. Measures to reduce frailty incidence or progression could reduce costs by £310 million/annum and £644 million/annum respectively.
Conclusions: Frailty prevalence and associated service use and costs will increase substantially in the ageing population. A shift in focus to prevention and slowing progression in middle age and the younger old would substantially reduce service use and costs by older people living with frailty.
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AA-25-2377.R1_proof_simulation_paper
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AA-25-2377.R1_proof simulation paper
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Accepted/In Press date: 5 March 2026
Identifiers
Local EPrints ID: 510888
URI: http://eprints.soton.ac.uk/id/eprint/510888
ISSN: 0002-0729
PURE UUID: 855e9431-d0dd-487c-8e5d-0256506b6373
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Date deposited: 24 Apr 2026 16:30
Last modified: 25 Apr 2026 02:42
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Contributors
Author:
Simon de Lusignan
Author:
Andrew Clegg
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