TY - JOUR T1 - Future care for older people in general practice: paradigm shifts are needed JF - British Journal of General Practice JO - Br J Gen Pract SP - 500 LP - 501 DO - 10.3399/bjgp17X693221 VL - 67 IS - 664 AU - Niek J de Wit AU - Marieke J Schuurmans Y1 - 2017/11/01 UR - http://bjgp.org/content/67/664/500.abstract N2 - The population is growing worldwide. The World Health Organization (WHO) estimates that the global population will approach 10 billion by the year 2050.1 In addition, the population is ageing rapidly in all continents. In 2050 almost 35% of the European population will be >60 years of age, as compared with 25% at present.2 This will have marked impact on the population composition of most European countries; at the end of this century 40% of the so-called ‘dependant population’, which is the joint proportion of those aged <18 years and >60 years, will consist of older people and 60% of <18-year-olds, as compared with 15% of >60-year-olds and 85% of <18-year-olds at present.1 This will have large economic, societal, and healthcare consequences, as it brings up the fundamental question: who will take care of whom in future? Finally, ageing is affected by societal inequity: in the UK there is an almost 10-year difference in life expectancy between the most and the least deprived.3 This is even more striking for disability-free life expectancy, where this difference is almost 17 years.Health at older age is very heterogeneous; individual factors such as genetics, biology, lifestyle, and disease, as well as the environment people live in, determine the physical and mental condition of the ageing individual. From a medical perspective the prevalence of disease among older people varies widely across age groups. Across Europe multimorbidity, defined as the presence of at least two major chronic conditions, increases from 6–16% at 55 years to 13–20% at 65 years, and >20% at 75 years of age.4 The standardised prevalence of Alzheimer’s disease among … ER -