Select Committee on Science and Technology Appendices to the Minutes of Evidence


Memorandum submitted by Research into Ageing


  Research into Ageing is the national medical research charity dedicated to improving the health and quality of life of elderly people through the initiation, funding and support of medical research relevant to the conditions that affect them. Since its foundation in 1976, Research into Ageing has committed around £7 million to over 200 research projects at universities and hospitals throughout the UK, seeking prevention or treatment of the extensive range of diseases and disabilities that become more common in later life.

  Research into Ageing has been involved in the EQUAL initiative from an early stage, and was invited to submit evidence to the Science and Technology Committee inquiry into this initiative.


  The United Kingdom, in common with other developed countries, has experienced the ageing of its population throughout the twentieth century. A fall in mortality has combined with a long-term downward trend in fertility to create a decline in the proportion of the population made up of young people, while the proportion of older people has risen. The Government Actuary's National Population projections (1996) show that the total population of the UK is expected to continue to grow during the first two decades of the next century. The current population of 58 million is expected to increase to 61 million by 2020 and then decrease slightly to 57 million by 2050. During this same period, expectation of life at birth is projected to increase from 73.9 years for males and 79.2 for females in 1994, to 77.7 and 82.6 respectively by 2020 and to 78.9 and 83.8 by 2050. The size of the very old section of the population is projected to rise the most rapidly with numbers of those aged over 75 estimated to increase from the current figure of 4 million to 5 million by 2020 and 8 million by 2050. By the middle of the next century the number of people aged over 75 will have doubled while the population over age 90 will have more than tripled.

  Current debate focuses on whether rates of morbidity and disability will decline in parallel with rates of mortality or whether this decline will be faster or slower. Some individuals argue that the ageing of the population will be accompanied by a pandemic of generative diseases and chronic mental disorders as surgical and medical interventions enable the survival of people with significant long-term health needs. On the other hand, Fries (1980) argues that life expectancy is unlikely to increase much beyond present levels and that the adoption of healthier lifestyles and scientific advances will result in the compression of morbidity into an increasingly brief period before death. In between these two positions, Manton (1982) argues that there is no evidence that we have reached, or will soon reach, a mortality "ceiling". He believes that life expectancy will continue to increase but that the balance between mortality and morbidity will be maintained.

  The challenges posed by this rapid ageing of the population and associated disabilities are not only medical and social, but extend to the research community as a whole.


  The report of the Royal Commission on Long Term Care highlighted the enormous range within which future costs of long term care are likely to fall. The cost of £11.1 billion in 1995 (64 per cent public; 36 per cent private) is likely to increase to £14.7 billion in 2021; £19.9 billion in 2021; £28 billion in 2031 and £45.3 billion in 2051. The biggest influence on these costs is the level of physical and mental impairment which might be anticipated at the end of life. A reduction of, say, 50 per cent—from 10 years to 5 years years of long term care—would have a dramatic impact on these projected costs. Prevention of dependency should, therefore, form a major part of the Government's investment in research and development.

  The factors which influence dependency are not always obvious. for example, the absence of teeth leads to poor nutrition which, in turn, leads to ill health and frailty. Loss of flexibility and dexterity can lead to a failure to cut toenails, which, in turn, can lead to loss of mobility and pain. More importantly, however, it is often not the most expensive interventions or drug treatments which will lead in due course to a major reduction in the cost of care, but simple low-tech solutions which enable an individual to remain for longer in their own home.

  The Continuing Care Conference, in its evidence to the Royal Commission, highlighted the need for "the compression of morbidity to be an explicit policy objective across all departments of government. To achieve this, priority should be given to research . . . into preventive strategies and rehabilitation."


To what extent has Research into Ageing been involved?

  When it was launched in July 1995, the EQUAL initiative was heralded as addressing the science and technology challenges of an ageing population. Research into Ageing was involved at a number of levels with Research Councils as they worked up their own responses to the call. The Director of the charity was invited to the first EQUAL seminar as well as preliminary meetings of EPSRC, ESRC and BBSRC. Other key advisers to the charity were also involved at an early stage of the initiative.

  The Director encouraged the Director General of Research Councils at that time to consider appointing an EQUAL co-ordinator at a high level to encourage and facilitate the development of Research Council activity. It is unfortunate that this has not been done since such an appointment would have helped the OST to evaluate the impact and effectiveness of EQUAL.

Has the initiative identified and supported the most appropriate research areas?

  The EQUAL initiative has certainly stimulated research across a wide front. This has been important in identifying and supporting a range of new and existing research areas. It is perhaps too early to evaluate whether or not it has stimulated the most appropriate research areas but, clearly, much appropriate research has been funded.

  There is however a question about whether the initiative has simply "heated up the economy" of ageing research, thus raising the expectations of the scientific community, with no real hope of the Research Councils building on the new communities that have resulted.

To what extent has EQUAL stimulated research in new areas?

  EQUAL has stimulated research in several new areas across the field, particularly via a range of Research Council initiatives. It has also raised the profile of the field, thereby encouraging established researchers to turn their attention to the problems covered by EQUAL.

Is research in this area receiving sufficient Government funding?

  There has been a reasonable level of research funding from the BBSRC "SAGE" initiative; the EPSRC "EQUAL" initiative; and the ESRC designated programme. This has drawn new researchers into the field of ageing research and provided training opportunities for them. The MRC has not funded a specific programme or call for research on an EQUAL theme, so it is difficult to judge whether they are funding research in ageing to a greater, lesser or similar level than they were prior to the summer of 1995. As research in this area develops, through the success of EQUAL, there will be need for significantly increased funding.

  In summary, therefore, the initiative has made an important start in addressing a major challenge for our society, but it is only a start!


  From Research into Ageing's perspective, the most important result of EQUAL has been to help reinforce our message that research is vitally important if we are to see an improvement in quality of later life for our society. This is the message which the charity has been delivering for 24 years and will continue to do so.

  A number of key officers of Research Councils have expressed the view that ring-fencing money leads to lower quality research proposals. Having observed the ageing programmes for BBSRC and EPSRC, this does not appear to be the case for ageing research.

  EQUAL should be continued. It should be continued in order to encourage the Research Councils to build on their notable achievements to date. But it should be continued with a central mechanism for managing a ring-fenced research budget to be distributed across a wide range of disciplines aimed at reducing dependency in later life. This should also do as much as possible to promote research that spans traditional disciplinary boundaries.


  Manton KG; Changing concepts of morbidity and mortality in the elderly population. Millbank Mem Fund Quart 1982 60(2): 183-244.

  Fries JF; Aging, natural death and the compression of morbidity. New Eng J Med 1980; 303(3): 407-428.

  Prophet H; Fit for the Future: the prevention of Dependency in Later Life. Continuing Care Conference, 1998.

  National Diet and Nutrition Survey; HMSO. 1998.

21 January 2000

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