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Photo of an elderly woman doing a puzzle

Work Package 3


We are interested in the economic implications of dementia over the next 25 years – how to reduce or contain costs while improving the outcomes.

Macro-simulation projection model 

We are developing a suite of linked quantitative models (micro- and macro-simulation) to project future numbers of people with dementia, unpaid and formal care and associated expenditure, and to estimate typical life-time costs of dementia, under varying assumptions about risk factors, patterns of care and support, and preferences.


Our modelling of future expenditure on long-term care for people with dementia uses an expanded version of the existing PSSRU cognitive impairment macro-simulation model. This model projects future numbers of people with dementia, long-term care service use and associated public expenditure under variant assumptions about trends in mortality rates, cognitive impairment, supply of informal care, patterns of care services and unit costs of care. 


We are updating the PSSRU model as part of the new cohort study of the MRC Cognitive Function and Ageing Study (CFAS). We are also developing the model further by expanding the sections which (a) distinguish between groups of people with dementia by severity of cognitive impairment and physical disability; and (b) assign packages of care based on characteristics including severity of condition. 


These developments will facilitate linkage with the micro-simulation models (WP4) and enable the impact of interventions to be examined in greater detail.


The work involves analyses of CFAS and English Longitudinal Study of Ageing (ELSA) data, and new data collected as part of this study.

Adelina Comas-Herrera, Raphael Wittenberg, Bo Hu

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