Over the past 50 years, the share of the population aged 65 and over has doubled on average across OECD countries, increasing from less than 9% in 1960 to 18.5% in 2023. Declining fertility rates and longer life expectancy (see section on “Life expectancy at birth” in Chapter 3) have meant that older people make up an increasing proportion of the population in OECD countries. Across the 38 OECD Member countries, more than 252 million people were aged 65 and over in 2023, including more than 67 million who were at least 80 years old. These demographic trends underscore the need for health systems to adapt and strengthen their capacity to meet the growing and evolving demands of an ageing population.
Across OECD countries, the share of the population aged 65 and over is projected to continue increasing in the coming decades, rising on average from 18.5% in 2023 to 26.4% by 2050 (OECD, 2024[1]) (Figure 10.1, left panel). In five countries (Korea, Japan, Greece, Portugal and Italy), the share of the population aged 65 and over is expected to exceed one‑third by 2050. At the other end of the spectrum, the population aged 65 and over in Israel, Mexico, Australia, Colombia and Iceland will represent less than one‑fifth of the population in 2050, owing to higher fertility and migration rates.
While the rise in the share of the population aged 65 and over across OECD countries is striking, the increase has been particularly rapid among the oldest group – people aged 80 and over. Between 2023 and 2050, the share of the population aged 80 and over is predicted to double on average across OECD countries – from 4.9% to 9.6% (OECD, 2024[1]) (Figure 10.1, right panel). At least one in ten people may be 80 and over in nearly half (18) of these countries by 2050, including five countries (Korea, Japan, Greece, Portugal and Italy) where more than one in eight people may be 80 and over.
While most OECD accession and Key Partner countries have a younger age structure than many Member countries, population ageing will nonetheless occur rapidly in the coming years, and sometimes at a faster pace than among OECD countries. In China, the share of the population aged 65 and over is likely to increase much more rapidly than in OECD countries – more than doubling from 14.3% in 2023 to 30.1% in 2050. The share of the Chinese population aged 80 and over is expected to rise even more quickly, increasing more than four‑fold from 2.5% in 2023 to 10.3% in 2050. Brazil – whose share of the population aged 65 and over was slightly more than half the OECD average in 2023 – will see similarly rapid growth, with nearly 22% of the population projected to be aged 65 and over by 2050. The speed of population ageing has varied markedly across OECD countries, with Greece, Chile and Lithuania experiencing rapid ageing over the past three decades. In the coming years, Korea is projected to undergo the most rapid population ageing among OECD countries, with the share of the population aged 80 and over increasing almost fourfold – from below the OECD average in 2023 (4.4% versus 4.9%) to well above it (16.5% versus 9.6%) by 2050.
Despite the gains in healthy life expectancy seen in recent years (see section on “Life expectancy and healthy life expectancy at older ages”), health systems will have to adapt to meet the needs of an ageing population, which are likely to include greater demand for labour-intensive long-term care (LTC) and more integrated person-centred care. These trends are placing and will place significant pressure on countries’ fiscal capacities to provide adequate LTC. Despite public benefits, out-of-pocket costs can be substantial in some countries, especially for those with severe care needs and low incomes. Eliminating these costs would require a 6% annual increase in LTC spending until 2050 (OECD, 2024[1]). It would also require investing in the people who provide care and support. The COVID‑19 pandemic further exposed the workforce shortcomings of the LTC sector. While the total number of LTC workers has increased in a number of countries, it has not kept pace with population ageing (see section on “Long-term care workers”). These shortages are closely tied to poor job quality as care work is physically and emotionally demanding, often poorly paid and lacking in social recognition (OECD, 2023[2]). Addressing these challenges will require co‑ordinated reforms across health, labour and social policy systems to build integrated and sustainable LTC systems.
