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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
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.
0002-0729
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)

Record type: Article

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.

Text
AA-25-2377.R1_proof_simulation_paper - Accepted Manuscript
Restricted to Repository staff only until 5 March 2027.
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Text
AA-25-2377.R1_proof simulation paper
Restricted to Repository staff only
Request a copy

More information

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
ORCID for Bronagh Walsh: ORCID iD orcid.org/0000-0003-1008-0545
ORCID for Tracey England: ORCID iD orcid.org/0000-0001-7565-4189
ORCID for Sally Brailsford: ORCID iD orcid.org/0000-0002-6665-8230
ORCID for Carole Fogg: ORCID iD orcid.org/0000-0002-3000-6185
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 24 Apr 2026 16:30
Last modified: 25 Apr 2026 02:42

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Contributors

Author: Bronagh Walsh ORCID iD
Author: Tracey England ORCID iD
Author: Carole Fogg ORCID iD
Author: Simon Fraser ORCID iD
Author: Simon de Lusignan
Author: Scott Harris
Author: Andrew Clegg

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