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.