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Photo of an elderly women and carer laughing

Work Package 4


Outputs will feed into the care pathways model (WP10) and also allow estimation of life expectancies with critical, short and long interval need, and disability-free life expectancies.

Micro-simulation epidemiological model

This work package has developed a new dynamic micro-simulation model called the Population, Ageing and Care Simulation (PACSim). Its aim is to model (a) the health and associated care needs of the English population over the coming decades; and (b) the impact of interventions for risk factor reduction, disease prevention and treatments that slow down progression to disease and disability.


The model builds on two similar ones: firstly a previous epidemiological macro-simulation model, SIMPOP, which linked multiple diseases to disability to project future disability burden in people aged 65 years and over; and secondly DynoptaSim, an Australian dynamic micro-simulation model of the health and functional status of the Australian population aged 45 years and over.  


The base population for PACSim is individuals aged 35 years and over from three longitudinal studies: the new CFAS cohort; the English Longitudinal Study of Ageing (ELSA); and Understanding Society (waves 1 and 2). Baseline characteristics generated on individuals include: sociodemographic (age, sex, living arrangements/marital status, education, occupation, retirement); lifestyle behaviours (smoking, physical activity, BMI, social engagement); diseases/geriatric conditions (dementia/cognitive impairment, CHD, stroke, hypertension, diabetes, arthritis, cancer, respiratory disease, hearing impairment, visual impairment). The outcome variable is disability as measured by the interval of need scale, and categorising people on the basis of activities of daily living and cognitive function on the intensity of care required. The technical report gives further detail about the construction of PACSim.


Outputs on intensity of care by age, gender and year in the presence of dementia will form inputs to the macro-simulation model (WP3). Scenarios for risk factor reduction and treatment strategies will be informed by reviews on costs, effectiveness and cost-effectiveness of interventions to prevent or delay dementia onset, being undertaken in other parts of the project (e.g. exercise, social engagement; WP5, WP6, WP7). Outputs will also include life expectancies with different care needs (to feed into the care pathways model in WP10) and years spent with and without individual diseases and multimorbid to allow exploration of the likelihood of compression or expansion of morbidity/disability given different health scenarios.


Kingston A, Jagger C (2017) Population Ageing and Care Simulation Model (PACSim). Baseline Dataset and Model Construction (Version 241017), MODEM, London (PDF, 194Kb)

Carol Jagger

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