LTCcovid Country Profiles

Responses to 1.01. Population size and ageing context

The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It is compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project are moderating the entries and editing as needed.

The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.

To cite this report (please note the date in which it was consulted as the contents changes over time):

Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Pharoah D (eds.) and LTCcovid contributors. LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science. https://doi.org/10.21953/lse.mlre15e0u6s6

Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.

Overview

In the absence of global estimates on the numbers of people who receive care from others and are supported by long-term care services, increases in the numbers of older people are often used to approximate expected increases in need for care. This is because, while there are many reasons why people rely on care and support by others that are not linked to age, as people reach older ages, they are more likely to need some support from others in their daily lives. Out of a global population of nearly 7,713 million people in 2019 (https://population.un.org/wpp/), 703 million people were aged 65 years or over. This number is expected to grow to 1.5 billion by 2050, when older people would represent 16% of the global population. The number of people aged 80 and over is expected to grow from 143 million in 2019, to 426.4 in 2050, with the largest increases projected for Northern Africa, and Western Asia (source: https://www.un.org/development/2019_worldpopulationageing_report.pdf).

As the proportion and total number of people requiring assistance increases, health and care systems need to prepare for increases in demand for treatment, care and support. Cardiovascular diseases, cancer and nervous system disorders are the leading causes of death and disability-adjusted life-years, whereas musculoskeletal disorders, sense organ diseases and cardiovascular diseases are the leading causes of years lived with disability (Institute for Health Metrics and Evaluation http://www.healthdata.org). The COVID-19 pandemic is only exacerbating these pressures.

International reports and sources

The World Health Organization’s Ageing Data Portal brings together data on global indicators to monitor the health and well-being of older people:  https://www.who.int/data/maternal-newborn-child-adolescent-ageing/ageing-data. 

Data on global population projections is also available from United Nations at:  https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_worldpopulationageing_report.pdf.

Australia has a population of just over 25 million people. In 2019, 15.9% of Australia’s population were over the age of 65 and 2% of the population is over the age of 85.  Australians are living longer than ever before. The number of Australians aged 85 years and over is expected to increase from 515,700 in 2018–2019 to more than 1.5 million by 2058 (sources: Statista; Royal Commission into Aged Care Quality and Safety).

Last updated: December 22nd, 2021   Contributors: Adelina Comas-Herrera  |  Ben Admin  |  


In 2016 Austria had a population of 8.6 million, of whom 0.81 million required help from others to carry out activities of daily life (source: https://ec.europa.eu/info/sites/default/files/economy-finance/ip105_en.pdf). Furthermore, 18.2% of the Austrian population (1.5 million people) are aged 65 years and older, with demographic ageing being observed particularly in rural areas. Approximately 20% of Austrians with LTC needs live in one of the 930 care homes. These homes, on average, can house about 80 people (source: https://journal.ilpnetwork.org/articles/10.31389/jltc.54/).

Last updated: November 23rd, 2021


As of 2019, the total population in BC is 5,071,336. There are 948,062 people over the age of 65 and 118,479 people over the age of 85 (source: https://bcstats.shinyapps.io/popApp/).

Last updated: November 6th, 2021


In 2017 there were nearly 3,500,000 people aged 60 or over in Chile, of whom 14.2% (489,000) had some degree of functional dependency (Browne et al., 2020).

References

Browne J, Fasce G, Pineda I, Villalobos P (2020) Policy responses to COVID-19 in Long-Term Care facilities in Chile. LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 24 July 2020.

Last updated: December 22nd, 2021


Denmark has a population of just under 6 million (5 840 045 in 2021). In 2021, 19.4% of the population were over 65 (1, 134, 564) with 4.1% over 80 (240, 398) and 1.9% (110, 396) over 85 (source: https://www.dst.dk/en/Statistik). These numbers are expected to rise significantly, and according to calculations from Statistics Denmark, by 2053, 10% of the population will be over 80 (source: https://www.sst.dk/da/viden/aeldre).

Last updated: August 3rd, 2021


The current population of Finland is 5,546,270. As of 2019, the number of people aged 70 and over was 874,314. Finland is a rapidly aging country, with the number of people over 70 growing by 100,000 in just three years (source: https://findikaattori.fi/en/14).

Last updated: November 23rd, 2021


France has a population of 67.1 million (2018). In 2018 19.6% of the population were aged 65 years and older (13.1 million people) (source: Statistics France).

Last updated: December 3rd, 2021   Contributors: Camille Oung  |  


Germany has a population of 83.1 million. In 2018, 17.9 million people were aged 65 years and older (22% of the population). According to the German Federal Statistical Office (Destatis), in 2019 there were 4.1 million people with long-term care needs, 62% women (source: https://ltccovid.org/wp-content/uploads/2020/05/Germany_LTC_COVID-19-26-May-2020.pdf). Furthermore, population age is not distributed evenly across the country. A larger share of population with care needs have been identified in Federal States in the East of Germany, which may in part be due to higher average age and a larger share of women, who more frequently experience care needs compared to men of the same age (source: https://www.iwkoeln.de/fileadmin/publikationen/2015/244405/IW-Trends_2015-03-04_Kochskaemper_Pimpertz.pdf).

Last updated: November 23rd, 2021


WHO has estimated that in Ghana, more than 50% of people between the ages of 65 years and 75 years require some assistance with daily activities. For those 75 years and older, the percentage jumps to more than 65% (source: https://www.who.int/publications/i/item/9789241513388).

Last updated: August 3rd, 2021


In 2015, the total population of Israel was 8.46 million, of whom 939,000-11%- were aged 65 and over. One in four households in the country included a person aged 65 or more (source: Brookdale Report).  

Last updated: December 3rd, 2021   Contributors: Sharona Tsadok-Rosenbluth  |  


In 2020, 23.2 % of the total population in Italy was 65 years and older, the share of older people in the Italian society has been growing constantly in recent years. According to 2019 data, the country was considered to have the largest percentage of elderly population in Europe. This share is projected to rise up to 34% by 2045.

In 2019, 32.5% of people aged 65 and above reported living with chronic diseases, rising up to 47.7% among those abed 85 and over. 1 million persons aged 65+ require care or support devices.

Sources:

https://www.statista.com/statistics/785104/elderly-population-in-italy/, https://www.istat.it/it/files//2018/05/previsioni_demografiche.pdf and https://www.istat.it/it/files//2021/07/Report-anziani-2019.pdf

Last updated: November 8th, 2021   Contributors: Eleonora Perobelli  |  Elisabetta Notarnicola  |  


Japan has one of the largest populations of older adults in the world. In 2020, 28.4% of the population was over the age of 65 (source: https://www.stat.go.jp/english/data/handbook/pdf/2020all.pdf#page=23).

Last updated: November 25th, 2021


There was a 0.3% increase in Malta’s population from 2019 to 2020; the estimated population of residents of Malta and Gozo standing at 516,100 at the end of 2020.  People aged 65 and over amounted to 18.9% of the population, and 2,223 females and 984 males were aged 90 years and over. There was a 10.7% increase in the resident deaths in 2020 from 2019 largely, owing directly or indirectly to the COVID-19 pandemic.  In 2020, 4,084 resident deaths were registered, of these, 66% were people aged 75 or over, deaths among this group increased by 12.5% of deaths compared to 2019 (source: https://nso.gov.mt/en/News_Releases/Documents/2021/07/News2021_122.pdf).

Malta forming part of Southern Europe together with Croatia, Greece, Italy, Portugal, Serbia, Slovenia and Spain are the oldest region in the world where 21% of the population is aged 65 years and over (source: https://www.prb.org/resources/countries-with-the-oldest-populations-in-the-world/).

Last updated: November 9th, 2021   Contributors: Maria Aurora Fenech  |  


The Government of Mauritius foresees rising rates of dementia and disability and increased overall demand for long-term care. It is planning for a 52% increase in publicly funded residential bed capacity by 2030 (source: https://www.who.int/publications/i/item/9789241513388).

Last updated: August 3rd, 2021


Data shows that in 2020, the Netherlands had a population of about 17.4 million. Nearly 114,000 people aged 65 and over live in residential care and nursing homes.

Last updated: November 25th, 2021


Poland has one of the most rapidly ageing populations in the European Union (EU): by 2060, the proportion of the population aged 65–79 is expected to double and the proportion of the population aged 80+ is expected to triple (source: Poland Country Report).

Last updated: November 24th, 2021   Contributors: Joanna Marczak  |  Agnieszka Sowa-Kofta  |  


In 2020, the population was 51.27 million out of which 8.10 million (16%) were aged 65+. This proportion is projected to almost 43% by 2060 (source: The-Long-Term-Care-COVID19-situation-in-South-Korea-7-May-2020.pdf).

Last updated: November 25th, 2021


The total population of Romania in 2019 was 19.4 million inhabitants, registering a decline of 0.4 million with respect to 2015, as result of low natality and external migration.

The age structure of the Romanian population bears the characteristic marks of a rapid demographic ageing process. While the total population has declines over the past 5 years, the group aged 65 and over has increased by 225.2 thousand persons over the same period, to reach 19.7% of the total population in 2019.

Current projections point to a continued decline over the next decades, with an expected total population of 17.7 million in 2030 and 15.5 million by 2050.

Source: National Institute of Statistics (2020) Proiectarea populaiei României pe regiuni de dezvoltare i judee, la orizontul 2070. Available at: https://insse.ro/cms/sites/default/files/field/publicatii/proiectarea_populatiei_pe_medii_de_rezidenta_la_orizontul_anului_2070.pdf

Last updated: December 5th, 2021   Contributors: Stefania Ilinca  |  


In 2021 there are 5.4 million people living in Singapore, of whom 3.9 million are residents (comprising 3.5 million Singapore citizens and 488,700 permanent residents).

Singapore’s population is ageing rapidly, in the population aged 65 and over was 639,000 (15.9%) out of its 4 million resident population. This is expected to rise to 23.8% of the population of residents by 2030.

Sources: Department of Statistics Singapore

Last updated: November 2nd, 2021


In South Africa, 35% of people between the ages of 65 years and 75 years require some assistance with daily activities. For those 75 years and older, the percentage increases to 45% (source: https://www.who.int/publications/i/item/9789241513388).

Last updated: November 23rd, 2021


In 2019, the total population in Catalonia was estimated to be 7.619.494, of which 51% were women and 49% were men. Like most European regions, Catalonia has an ageing population, with 18,9% of the population aged 65 or older, and 6% of the population aged 80 or older. These figures follow an increasing tendency over the last decades and are expected to continue to do so (22,3% of the population is expected to be aged 65 or older in 2030 according to mid-range scenario projections). (Source: https://www.idescat.cat/pub/?id=aec&n=253&t=2010)

Last updated: November 6th, 2021   Contributors: Gemma Drou-Roget  |  


In 2019, approximately 15.9% of the population of Sri Lanka was older than 60 years of age, with 9.2% aged 60–69 years, 5.1% aged 70–79 years, and 1.6% over 80 years of age. Projections suggest that these proportions will increase, more than doubling between 2030 and 2050; 60% will be women. This also represents a significant increase in absolute numbers. The “old-age dependency ratio” is projected to rise steadily, from 20% in 2015 to 43% in 2050 (source: Country Diagnostic Study on Long-Term Care in Sri Lanka (adb.org).

Last updated: September 8th, 2021


In 2019 Swedish population was 10.33 million. Twenty percent of the Swedish population were 65 years and older; 5.2 % were 80 years and older and 1 % were 90 years or older (source: https://www.statista.com/statistics/525637/sweden-elderly-share-of-the-total-population-by-age-group/)

Last updated: November 23rd, 2021


The Thai population was 69,625,582 in 2019, life expectancy at birth was 73.12 years for men and 80.62 years for women in 2019. The number of older persons is expected to increase from 11.3 million (16.7% of the Thai population) in 2017 to 22.9 million (33% of the Thai population) by 2040 (source: Country Diagnostic Study on Long-Term Care in Thailand (adb.org)).

Last updated: September 8th, 2021


The total population in the United Kingdom in mid-2020 was 67,081,000. The median population age is 40.4, with 18.6% aged 65 and over, and 2.5% 85 and over.

 

Last updated: January 2nd, 2022


By mid-2020 the population in England was estimated to be 56,550,000, representing 84% of the total population of the United Kingdom. The median population age in England was 40.2 years. The share of the population aged 65 years and over was 18.5% and the share aged 85 and over was 2.5% (Source: ONS).

Last updated: December 4th, 2021   Contributors: Adelina Comas-Herrera  |  


In mid-2020 the total population in Northern Ireland was 1,896,000, which represents 2.8% of the total population of the United Kingdom. The median population age was 39.2. The share of the population aged 65 and more was 16.9% and share aged 85 and over was 2.1%.

Source: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2020#population-change-for-uk-countries

Last updated: November 8th, 2021


In mid-2020, the total population of Scotland was 5,466,000, representing 8.1% of the total population of the United Kingdom. The media population age was 42.1 years. The share of population aged 65 or over was 19.3% and the share aged 85 or over was 2.3% (source: ONS).

Last updated: December 5th, 2021   Contributors: Jenni Burton  |  David Bell  |  David Henderson  |  Elizabeth Lemmon  |  


In mid-2020 the total population of Wales was 3,170,000, which represents 4.7% of the total population in the United Kingdom. The median age of the population was 42.4. The share of the population aged 65 and over was 21.1% and the share aged 85 and over was 2.7.

Source: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2020#population-change-for-uk-countries

Last updated: November 8th, 2021


As of 2019, approximately 16.5% of Americans were aged 65 and older, constituting more than 54 million people in a population of 320+ million (source: https://www.census.gov/topics/population/older-aging.html). Moreover, the number of people aged 65 and older is expected to double in the next 40 years (source: https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging).

Last updated: November 23rd, 2021


Vietnam is a lower-middle income country in Southeast Asia with a population of just over 97 million people (source: World Bank). Since 1999, the percentage of the population aged 65 and over has been increasing, representing 7.9% of the total population by 2020 (source: World Bank). Meanwhile, the younger population (aged 14 and below) has been decreasing. These trends are predicted to persist (source: Vietnam Population Census); thus Vietnam is undergoing a demographic transition and is predicted to be an aging population by 2040 (source: United Nations). Vietnam is also one of the fastest aging countries globally (source: WHO). The growing elderly population in Vietnam poses a challenge to the social welfare system; the World Bank have therefore stressed the importance of developing relevant and timely health and social care solutions to ensure country capacity.

People in Vietnam are considered who are 60 years and older are considered “elderly”. The majority (more than 70%) of older people live in rural areas. There are more females than males in the aging population in Vietnam; an imbalance which is also higher in rural than urban areas. A minority (5.8%) of older people live alone (with most of these individuals being women in rural areas), and few (11.5%) live only with a spouse. Most older people in Vietnam are household heads and live with a child. As such, children and grandchildren are the main caregivers (Van Hoi et al., 2012). More recently, however, increasing employment opportunities in urban centres have resulted in temporary migration of the younger generations, leaving the more elderly members of the population on their own and with less emotional and physical support from family (Van Hoi et al., 2012).

References:

Van Hoi, L., Thi Kim Tien, N., Van Tien, N., Van Dung, D., Thi Kim Chuc, N., Goran Sahlen, K., & Lindholm, L. (2012). Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam. BMC Health Services Research, 12(1), 1–12. https://doi.org/10.1186/1472-6963-12-36/TABLES/7

Last updated: December 30th, 2021   Contributors: Daisy Pharoah  |  


Contributors to the LTCcovid Living International Report, so far:

this list is regularly updated to reflect contributions to the report, if you’d like to contribute please email a.comas@lse.ac.uk

Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Jorge Browne Salas, Jenni Burton, William Byrd, Sara CharlesworthAdelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin HämelNina Hemmings, David Henderson, Stefania Ilinca, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’DonovanCamille Oung, Disha Patel, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. SchmidtAgnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jessica J. Yu

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.