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50 Shades of “de Grey” International Drivers of Longevity Outliers 12 th March 2019 Dr. Chris Reynolds FIA Cillian Ryan FSAI

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Page 1: 50 Shades of “de Grey” - web.actuaries.ie 50 Shades... · Even Older? 13 March 2019 14 •“The world’s oldest man has been named as Indonesian Mbah Gotho, who is 145 years

50 Shades of “de Grey”

International Drivers of Longevity Outliers

12th March 2019

Dr. Chris Reynolds FIA

Cillian Ryan FSAI

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The views expressed in this presentation are

those of the presenters and not necessarily

of the Society of Actuaries in Ireland

Disclaimer

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Survival

&

Mortality

Today’s Topic

13 March 2019 3Source: By Ciaurlec - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16214368

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Living Forever : The Oldest Old

13 March 2019

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• Mortality gains – in most countries

• Historical gains in life expectancy have been attributed to a reduction in early-life mortality

• More recent data, however, show evidence for a decline in late-life mortality

What we know

13 March 2019 5Source: mortality.org

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• Mortality gains – in most countries

• Historical gains in life expectancy have been attributed to a reduction in early-life mortality

• More recent data, however, show evidence for a decline in late-life mortality

What we know

13 March 2019 6Source: mortality.org

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• Mortality gains – in most countries

• Historical gains in life expectancy have been attributed to a reduction in early-life mortality

• More recent data, however, show evidence for a decline in late-life mortality

What we know

13 March 2019 7Source: mortality.org

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What we know - Ireland

13 March 2019 8

• Mortality gains – in most countries

• Historical gains in life expectancy have been attributed to a reduction in early-life mortality

• More recent data, however, show evidence for a decline in late-life mortality

Source: mortality.org

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Mortality Improvements

13 March 2019 9

Japan - Females

Source: mortality.org

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Mortality Improvements

13 March 2019 10

UK - Females

Source: mortality.org

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Madame Jeanne-Louise Calment

13 March 2019 11

1875 1997

20 40 60 113 122

Jan 28, 1887Eiffel Tower construction

started

Mar 10, 1876 First

telephone call

Jan 1, 1996Google is invented

Oct 1, 1908Ford Model T

enters production

May 6, 1935Silver Jubilee

celebrations for King George V

Source: http://www.grg.org/jcalmentgallery.htm

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Madame Jeanne-Louise Calment

13 March 2019 12

• Good genes - mother lived until 86, father lived until 93

• Wealth - married a wealthy man

• Exercise - Spent much time playing tennis, swimming and cycling. Cycled until she was 100 years old.

• Relaxing - Learned to play the piano and enjoyed the opera

• Smoking – smoked from 21 until 116

• Diet – Ate ~1kg of chocolate per week. Drank port wine as part of her daily diet.

Source: http://www.grg.org/jcalmentgallery.htm

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Madame Jeanne-Louise Calment

13 March 2019 13

Or was it all an elaborate tax fraud?

Source: http://www.grg.org/jcalmentgallery.htm

• Good genes - mother lived until 86, father lived until 93

• Wealth - married a wealthy man

• Exercise - Spent much time playing tennis, swimming and cycling. Cycled until she was 100 years old.

• Relaxing - Learned to play the piano and enjoyed the opera

• Smoking – smoked from 21 until 116

• Diet – Ate ~1kg of chocolate per week. Drank port wine as part of her daily diet.

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Even Older?

13 March 2019 14

• “The world’s oldest man has been named as Indonesian Mbah Gotho, who is 145 years old, with documentation that says he was born in 1870.”

• Has official documentation which shows his age

• If documents can be independently verified will go down in the record books

Source: http://www.telegraph.co.uk/news/2016/08/27/longest-lived-human-says-he-is-ready-for-death-at-145

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Competing Camps

No Limits Limits

• Human life expectancy steadilyincreased since the 19th century

• Past is not necessarily a guide to the future

• Increasing reports of supercentenarians

• Limited scope for future improvements

• Lifespans of animals can be extended through genetic or dietary modifications

• Increase in life expectancy & maximum human lifespan will eventually stop

13 March 2019 15

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Oeppen and Vaupel:

1. Experts have repeatedly asserted that life expectancy is approaching a ceiling – these experts have repeatedly been proven wrong

2. The apparent levelling off of life expectancy in various countries is an artefact of laggards catching up and leaders falling behind

3. If life expectancy were close to a maximum, then the increase in the record expectation of life should be slowing – it is not.

Limits on Life Expectancy?

13 March 2019 16Source: Oeppen and Vaupel, Broken Limits to Life Expectancy, Science – Vol 296 – 10 May 2002

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Life Expectancy at Birth

13 March 2019 17Source: mortality.org

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Life Expectancy at Birth

13 March 2019 18Source: mortality.org

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Life Expectancy at 65

13 March 2019 19Source: mortality.org

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Life Expectancy at 65

13 March 2019 20Source: mortality.org

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Gap Between Best and Worst

13 March 2019 21Source: mortality.org

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Gap Between Best and Worst

13 March 2019 22Source: mortality.org

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Modal Age of Death

13 March 2019 23

Japanese Females

Age

Source: mortality.org

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Modal Age of Death

13 March 2019 24

Japanese Females

Age

Source: mortality.org

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Modal Age of Death

13 March 2019 25

Irish Females

Age

Source: mortality.org

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Modal Age of Death

13 March 2019 26

Irish Females

Age

Source: mortality.org

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Modal Age of Death

13 March 2019 27

Irish Females

Age

Source: mortality.org

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Modal Age of Death

13 March 2019 28

• Calculate modal age of death for each country and year

• For each year take the maximummodal age across all countries

Source: mortality.org

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1940 – 1944France and

Finland

Modal Age of Death

13 March 2019 29

1914 – 1917France and

Italy

Source: mortality.org

• Calculate modal age of death for each country and year

• For each year take the minimum modal age across all countries

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Mortality by Cause

13 March 2019

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Mortality rates by cause – England & Wales

13 March 2019 31Source: ONS

-

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

18.00

Dea

ths

per

1,0

00

Males 70-74

-

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00Females 70-74

Cardiovascular

Cancer

Respiratory

Other

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Mortality rates by cause – England & Wales

13 March 2019 32Source: ONS

-

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

Dea

ths

per

1,0

00

Males 85+

-

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

Females 85+

Cardiovascular

Cancer

Respiratory

Other

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Mortality by cause – Ireland – 1990

13 March 2019 33

51% 12%

12%

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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Mortality by cause – Ireland – 1990

13 March 2019 34

29% 14%

11%

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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13 March 2019 35

Mortality by cause – Ireland – 2017

1990: 29%2017: 19%

1990: 14%2017: 10%

1990: 11%2017: 17%

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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13 March 2019 36

Mortality by cause – Ireland – 2017

1990: 51%2017: 39% 1990: 12%

2017: 17%

1990: 12%2017: 19%

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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Mortality by cause – Japan – 2017

13 March 2019 37

Ireland: 19%Japan: 13%

Ireland: 10%Japan: 12%

Ireland: 17%Japan: 24%

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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Mortality by cause – Global, all ages – 1990

13 March 2019 38Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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Mortality by cause – Global, all ages – 2017

13 March 2019 39Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed February 2019

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Mortality by cause

13 March 2019 40

Neopl CVD CVD Neopl

Neurodisorders

Neurodisorders

Top 5 Countries – deaths per 100,000 – 80+

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed October 2016

Infectious diseases

Infectious diseases

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Mortality by cause

13 March 2019 41

Neopl CVD CVD Neopl

69%

92%

73%

41% 35%

70%

69%

62%

Neurodisorders

Lowest per category, relative

to UK

Neurodisorders

Top 5 Countries – deaths per 100,000 – 80+

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from http:// vizhub.healthdata.org/gbd-compare. Accessed October 2016

Infectious diseases

Infectious diseases

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Take best in class for each group and apply to UK mortality for “Top 4” causes

Total impact is 30% reduction in mortality

Potential for life expectancy at 65 to increase to 88.5 –based on current best in class

Life expectancy consistent with current life expectancy for subsets of UK

Life Expectancy & “best in class” by cause

13 March 2019 42

65

70

75

80

85

90

95

100

105

110

115

19

50

19

52

19

54

19

56

19

58

19

60

19

62

19

64

19

66

19

68

19

70

19

72

19

74

19

76

19

78

19

80

19

82

19

84

19

86

19

88

19

90

19

92

19

94

19

96

19

98

20

00

20

02

20

04

20

06

20

08

20

10

20

12

Period life expectancy & 99.0% percentile survival (females age 65)

LE Japan LE Iceland LE Switzerland

LE France LE United Kingdom 99% "best in class"

LE AF08 LE S2FA LE Proprietary Model

Source: HMD / CMI & Own Calculations

Bes

t in

cla

ss

AF0

8

S2P

FA

Pro

pri

etar

y M

od

el

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Take best in class for each group and apply to UK mortality for “Top 4” causes

Total impact is 30% reduction in mortality

Potential for life expectancy at 65 to increase to 88.5 – based on current best in class

Life expectancy consistent with current life expectancy for subsets of UK

Potential for large gain in top percentile survival?

Life Expectancy & top percentile survival

13 March 2019 43

65

70

75

80

85

90

95

100

105

110

115

19

50

19

52

19

54

19

56

19

58

19

60

19

62

19

64

19

66

19

68

19

70

19

72

19

74

19

76

19

78

19

80

19

82

19

84

19

86

19

88

19

90

19

92

19

94

19

96

19

98

20

00

20

02

20

04

20

06

20

08

20

10

20

12

Period life expectancy & 99.0% percentile survival (females age 65)

LE Japan LE Iceland LE Switzerland

LE France LE United Kingdom 99% Japan

99% Iceland 99% Switzerland 99% France

99% United Kingdom LE "best in class" 99% "best in class"

LE AF08 99% AF08 LE S2FA

99% S2FA LE Proprietary Model 99% Proprietary Model

Source: HMD / CMI & Own Calculations

Bes

t in

cla

ss

AF0

8

S2P

FA

Pro

pri

eta

ry M

od

el

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Limits of Human Lifespan

13 March 2019

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• "For the first time in history we've been able to see this, it looks like the maximum life span -this ceiling, this barrier - is about 115.”

Nice headline … but what did the paper show?

The Answer's 115

13 March 2019 45Source: http://www.bbc.com/news/health-37552116 (5th October 2016)

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Dong et al – Evidence for a Limit to Human Lifespan

13 March 2019 46

• Used data from the Human Mortality Database

• Regression of the fraction of people surviving to old age since 1900

log(l(x, t)) = ax + bx t

• Chart is essentially y(x) = bx

Drop OffRate of improvement in survival peaks and then declines for very old ages

Source: Evidence for a limit to human lifespan, Dong, Milholland & Vijg - Nature doi:10.1038/nature.2016.20750

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13 March 2019 47

• If no upper limit on lifespan abiggest increase in survival should be experienced by ever-older age groups.

• Found that age with greatest improvement in survival got steadily higher since the early 20th century then started to plateau at about 99 in 1980.

Survival PlateauThe age that experienced the greatest annual increase in survival stopped significant increasing after 1980

Dong et al – Evidence for a Limit to Human Lifespan

Source: Evidence for a limit to human lifespan, Dong, Milholland & Vijg - Nature doi:10.1038/nature.2016.20750

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Survival Improvement Rate Drop-off?

13 March 2019 48Source: mortality.org (own calculations)

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Survival Improvement Rate Drop-off?

13 March 2019 49Source: mortality.org (own calculations)

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13 March 2019 50

Survival Improvement Rate Drop-off?

Source: mortality.org (own calculations)

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What does Aubrey say?

13 March 2019 Source: https://www.flickr.com/photos/shareconference/6838320854/

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• Ageing is a consequence of physics, not biology

• It is the life-long accumulation of “damage” to the body that

occurs as an intrinsic side-effect of the body’s normal

operation

• The body can tolerate some damage, but too much of it

causes disease and disability

What is Ageing?

13 March 2019 52Source: sens research foundation

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What is Ageing?

13 March 2019 53

Metabolism Damage Pathology(life-long) (late life)

Source: sens research foundation

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What is Ageing?

13 March 2019 54

Metabolism Damage Pathology(life-long) (late life)

Gerontology Geriatrics

Source: sens research foundation

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What is Ageing?

13 March 2019 55

Metabolism Damage Pathology(life-long) (late life)

Gerontology

Maintenance

Geriatrics

Source: sens research foundation

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Seven Deadly Things

13 March 2019 56

Ageing Damage Rejuvenation Biotechnology

Cell loss, cells atrophy Replace, using stem cells

Division-obsessed cells Resist, using telomere control

Death-resistant cells Remove, using suicide genes etc.

Mitochondrial mutations Resist, using backup copies

Intracellular waste products Remove, using foreign enzymes

Extracellular waste products Remove, using immune system

Extracellular matrix stiffening Repair, using crosslink-breakers

Source: sens research foundation

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Oldest living person?

13 March 2019 57Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)

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Oldest living person?

13 March 2019 58Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)

Source: https://www.bbc.com/news/av/world-47508518/oldest-living-person-very-grateful-for-award

Kane Tanaka

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Oldest living person?

13 March 2019 59

Increasing at 0.13 years per

calendar year

Will reach 1000 in year 9000 ?

Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)

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Oldest living person?

13 March 2019 60

A realisticlimit?

Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)

Page 61: 50 Shades of “de Grey” - web.actuaries.ie 50 Shades... · Even Older? 13 March 2019 14 •“The world’s oldest man has been named as Indonesian Mbah Gotho, who is 145 years

• Diet – Rosemary & Anchovies

• Environment – Unpolluted

• Stress – a stress-free life

• Active – spending time outdoors

– Swimming

– Gardening

Acciaroli – Early Findings

13 March 2019 61Source: By Ciaurlec - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16214368

Page 62: 50 Shades of “de Grey” - web.actuaries.ie 50 Shades... · Even Older? 13 March 2019 14 •“The world’s oldest man has been named as Indonesian Mbah Gotho, who is 145 years

Acciaroli – Early Findings

13 March 2019 62

• Diet – Rosemary & Anchovies

• Environment – Unpolluted

• Stress – a stress-free life

• Active – spending time outdoors

– Swimming

– Gardening

– Sex

Source: By Ciaurlec - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16214368

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50 Shades of “de Grey”

International Drivers of Longevity Outliers

Q&A