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9. Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model

Author

Kingston, Andrew, Robinson, Louise, Booth, Heather, Knapp, Martin, Jagger, Carol, MODEM project, Adelaja, Bayo, Avendano, Mauricio, Bamford, Sally-Marie, Banerjee, Sube, Berwald, Sharne, Bowling, Ann, Burgon, Clare, Bustard, Elizabeth, Comas-Herrera, Adelina, Dangoor, Margaret, Dixon, Josie, Farina, Nicolas, Greengross, Sally, Grundy, Emily, Hu, Bo, King, Derek, Lombard, Daniel, Lorenz, Klara, McDaid, David, Park, A-La, Pikhartova, Jitka, Rehill, Amritpal, and Wittenberg, Raphael

Abstract

Background\ud models projecting future disease burden have focussed on one or two diseases. Little is known on how risk factors of younger cohorts will play out in the future burden of multi-morbidity (two or more concurrent long-term conditions).\ud \ud Design\ud a dynamic microsimulation model, the Population Ageing and Care Simulation (PACSim) model, simulates the characteristics (sociodemographic factors, health behaviours, chronic diseases and geriatric conditions) of individuals over the period 2014–2040.\ud \ud Population\ud about 303,589 individuals aged 35 years and over (a 1% random sample of the 2014 England population) created from Understanding Society, the English Longitudinal Study of Ageing, and the Cognitive Function and Ageing Study II.\ud \ud Main outcome measures\ud the prevalence of, numbers with, and years lived with, chronic diseases, geriatric conditions and multi-morbidity.\ud \ud Results\ud between 2015 and 2035, multi-morbidity prevalence is estimated to increase, the proportion with 4+ diseases almost doubling (2015:9.8%; 2035:17.0%) and two-thirds of those with 4+ diseases will have mental ill-health (dementia, depression, cognitive impairment no dementia). Multi-morbidity prevalence in incoming cohorts aged 65–74 years will rise (2015:45.7%; 2035:52.8%). Life expectancy gains (men 3.6 years, women: 2.9 years) will be spent mostly with 4+ diseases (men: 2.4 years, 65.9%; women: 2.5 years, 85.2%), resulting from increased prevalence of rather than longer survival with multi-morbidity.\ud \ud Conclusions\ud our findings indicate that over the next 20 years there will be an expansion of morbidity, particularly complex multi-morbidity (4+ diseases). We advocate for a new focus on prevention of, and appropriate and efficient service provision for those with, complex multi-morbidity.

Published
2018

13. Disease severity accounts for minimal variance of quality of life in people with dementia and their carers: analyses of cross-sectional data from the MODEM study.

Author

Farina, Nicolas, King, Derek, Burgon, Clare, Berwald, Sharne, Bustard, Elizabeth, Feeney, Yvonne, Habibi, Ruth, Comas-Herrera, Adelina, Knapp, Martin, Banerjee, Sube, On behalf of the MODEM group, Adelaja, Bayo, Avendano, Mauricio, Bamford, Sally-Marie, Bowling, Ann, Dangoor, Margaret, Dixon, Josie, Greengross, Sally, Grundy, Emily, and Hu, Bo

Subjects
MINI-Mental State Examination, SENILE dementia, COGNITION disorders, DEMENTIA, CROSS-sectional method, DATA analysis, QUALITY of life
Abstract

Background: Due to the progressive nature of dementia, it is important to understand links between disease severity and health-related outcomes. The aim of this study is to explore the relationship between disease severity and the quality of life (QoL) of people with dementia and their family carers using a number of disease-specific and generic measures.Methods: In the MODEM cohort study, three-hundred and seven people with clinically diagnosed dementia and their carers were recruited on a quota basis to provide equal numbers of people with mild (standardised Mini-Mental State Examination (sMMSE), n = 110), moderate (sMMSE 10-19, n = 100), and severe (sMMSE 0-9, n = 97) cognitive impairment. A series of multiple regression models were created to understand the associations between dementia severity and the QoL of people with dementia and the QoL of their carers. QoL was measured using self- (DEMQOL, EQ-5D, CASP-19) and proxy-reports (DEMQOL-Proxy, EQ-5D) of disease-specific and generic QoL of the person with dementia. Carer generic QoL was measured by self-report (EQ-5D, SF-12).Results: Disease severity, as measured by the sMMSE, was not significantly associated with the QoL of the person with dementia or the carer (p > 0.05), even after controlling for potential confounding variables for self-reported instruments. Proxy measures (rated by the carer) differed systematically in that there were small, but statistically significant proportions of the variance of QoL was explained by severity of cognitive impairment in multiple adjusted models. We also found little in the way of statistically significant relationships between the QoL of people with dementia and that of their carers except between DEMQOL-Proxy scores and the carer EQ-5D scores and carer SF-12 mental sub-scores.Conclusions: The data generated supports the somewhat counterintuitive argument that severity of cognitive impairment (and therefore severity of dementia) is not associated with lower QoL for the person with dementia when self-report measures are used. However, in absolute terms, as judged by the variance in the multivariate models, it is clear that the contribution of dementia severity to the QoL of people with dementia is minimal whatever the measurement used, be it self- or proxy-rated, or disease-specific or generic. [ABSTRACT FROM AUTHOR]

Published
2020
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15. The right to love

Author

Greengross, Sally

Subjects
Aged -- Sexual behavior, Psychology and mental health, Sociology and social work
Abstract

There can be problems associated with meeting the sexual needs of elderly people living in residential or nursing homes in the UK. Carers sometimes treat elderly people like children, and fail to acknowledge their emotional needs. Problems can also arise because of lack of privacy in such environments. It is important that care staff in residential homes are trained in sexuality, with this training including discussion of their own ageing and sexuality.

Published
1998

16. Population ageing and health

Author

Lloyd-Sherlock, Peter, primary, McKee, Martin, additional, Ebrahim, Shah, additional, Gorman, Mark, additional, Greengross, Sally, additional, Prince, Martin, additional, Pruchno, Rachel, additional, Gutman, Gloria, additional, Kirkwood, Tom, additional, O'Neill, Desmond, additional, Ferrucci, Luigi, additional, Kritchevsky, Stephen B, additional, and Vellas, Bruno, additional

Published
2012
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17. The Emotional and Sexual Lives of Older People

Author

Greengross, Sally

Subjects
The Emotional and Sexual Lives of Older People (Book) -- Book reviews, Books -- Book reviews, Health, Psychology and mental health, Seniors, Sociology and social work
Published
1992

18. It is cost of dying - not ageing - that is expensive

Author

Greengross, Sally Baroness

Subjects
Medical economics, Banking, finance and accounting industries, Business, Business, international
Abstract

From Baroness Greengross. Sir, PwC's report correctly highlights that public spending will increase in future to meet rising demand for health services ('NHS to push up spending, PwC says', August [...]

Published
2005

19. Aging: a subject that must be at the top of world agendas

Author

Greengross, Sally, Murphy, Elaine, Quam, Lois, Rochon, Paula, and Savage, Richard

Subjects
Aging -- Health aspects -- Research, Geriatrics -- Research -- Health aspects, Health, Research, Health aspects
Abstract

Today we join some 100 other medical journals from over 30 countries in publishing an issue devoted to aging. Our aims are to alert readers, the public, and governments to [...]

Published
1997

20. Look, listen and learn

Author

Greengross, Sally, Bright, Les, and Pitkeathley, Jill

Subjects
Executives -- Beliefs, opinions and attitudes, Aged -- Long term care, Psychology and mental health, Sociology and social work, Age Concern England -- Beliefs, opinions and attitudes
Abstract

The Director General of Age Concern England suggests that the Royal Commission into long-term care in the UK must take heed of users opinions and should utilize the research facilities of interested groups. The Deputy Manager of Counsel and Care wants the commission to make provision for people to choose where they live and to set a guaranteed level of service for all users. The Chief Executive of the Carers National Association calls for members of the commission not to only listen to the views of representative bodies but to make personal visits to users and carers.

Published
1997

22. Brave new world

Author

Greengross, Sally

Subjects
Aged -- Care and treatment, Psychology and mental health, Sociology and social work
Abstract

Voluntary organisations involved in the care of elderly people are having to adapt to rapidly changing conditions. They are now obliged to compete for contracts, rather than relying on receiving grants, and are facing lower funding levels. Many elderly people are finding that they cannot have access to the services which will ensure that they can remain a part of their community, and this approach could well prompt a crisis in the care of the elderly.

Published
1996

25. Dementia and its Diagnosis in the United Kingdom.

Author

Bamford, Sally-Marie and Greengross, Sally

Subjects
DIAGNOSIS of dementia, DEMENTIA patients, TREATMENT of dementia, COGNITION disorders
Abstract

The article discusses increased cases of dementia in the Great Britain. It mentioned that diagnosis level of dementia in the Great Britain are estimated at almost 40 per cent. It further discussed Great Britain's recent policy response to dementia and directions that will be taken regarding diagnosis.

Published
2011

27. Age of no concern

Author

Greengross, Sally

Subjects
Aged -- Care and treatment, Discrimination in medical care -- Research, Age discrimination -- Research, Health, Age Concern England -- Research
Abstract

Research by Age Concern will show that the elderly do not receive National Health Service treatment because they are considered by the medical profession to be too old. Clinical decisions are based on assumptions about the quality of life of an elderly person, and a younger person may be considered to be more deserving. Invitations for breast cancer screening stop when a woman reaches 65 years, although she is more likely to get breast cancer as she gets older and some women who have asked for screening have been refused. Age Concern is keen to challenge this age discrimination.

Published
1997

28. Happy endings

Author

Greengross, Sally

Subjects
Aging -- Social aspects, Demographic transition -- Analysis, General interest, News, opinion and commentary
Abstract

Debate of the Age executive chair Sally Greengross believes that the three defining trends of the 21st century will be globalisation, the IT revolution and demographic ageing. She argues that a holistic response is needed to demographic ageing since an ageing society has an impact on all the generations. The challenge is to change the ageing society into an ageless society. Homes, towns and products should be designed in such a way that people of all ages and abilities can use them. Age should become irrelevant, with individuals being judged only on their merit or requirements.

Published
1999

29. A new life in the Third Age

Author

Greengross, Sally

Subjects
Western States -- Demographic aspects, Age distribution (Demography) -- Statistics, General interest, News, opinion and commentary
Abstract

Western society will have to change to accommodate a growing proportion of older people who are aged 50 years and over. One quarter of the European population will be 50 and over by the year 2000. Britain, America and Europe need to review the social and economic structures which dictate the health, finance and employment of older people. Some employers currently view 40 and above as being undesirable. Older celebrities include the movie star, Clint Eastwood, and football manager, Bobby Robson.

Published
1996

31. The Government needs to take steps to increase participation in elections by British expatriates

Author

Clifton-Brown, Geoffrey, Greengross, Sally, Lexden, Alistair, Norton, Philip, Parekh, Bhikhu, Tyler, Paul, Clifton-Brown, Geoffrey, Greengross, Sally, Lexden, Alistair, Norton, Philip, Parekh, Bhikhu, and Tyler, Paul

Abstract

Millions of UK nationals live abroad, but only a tiny proportion of these make use of their right to vote in British elections. A cross-party group of parliamentarians has considered why this is the case and what can be done to address the democratic deficit among expatriates. Their recommendations include making voter registration easier, experimenting with online voting and setting a new target for the Electoral Commission to increase participation.

38. Ageing well.

Author

Greengross, Sally

Subjects
*AGING, *HEALTH promotion
Abstract

Focuses on Ageing Well Europe which is an innovative pan-European health promotion programme for and with older people. Aim of the programme; Response of the programme to a number of key developments in health policy; Purpose of Ageing Well projects in nine European countries; Examples of some of the innovative and influential work going on in projects across Europe.

Published
1997

39. The generation gap.

Author

Greengross, Sally, Butler, Robert, and Forette, Francoise

Subjects
*LETTERS to the editor, *AGING
Abstract

A letter to the editor is presented in response to the article "How to manage an aging workforce" in the February 18th, 2006 issue of "The Economist."

Published
2006

40. CONTRIBUTIONS ARE WELCOMED ON HOW TO PREVENT DEMENTIA.

Author

Greengross, Sally

Subjects
*DEMENTIA prevention, *DEMENTIA risk factors, *PUBLIC health
Abstract

A letter to the editor is presented which is concerned with invitations to discuss dementia risk reduction which were issued to public health professionals by the the International Longevity Centre UK, Alzheimer's Research UK and Improving Care.

Published
2014
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41. Face to face. Interview by Ruth Williams.

Author

Greengross S

Subjects
Aged, Humans, United Kingdom, Health Services for the Aged organization & administration, Nurse's Role, Quality of Health Care
Published
2009

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