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TRANSCRIPT
50 Shades of “de Grey”
International Drivers of Longevity Outliers
12th March 2019
Dr. Chris Reynolds FIA
Cillian Ryan FSAI
The views expressed in this presentation are
those of the presenters and not necessarily
of the Society of Actuaries in Ireland
Disclaimer
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
Living Forever : The Oldest Old
13 March 2019
• 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
• 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
• 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
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
Mortality Improvements
13 March 2019 9
Japan - Females
Source: mortality.org
Mortality Improvements
13 March 2019 10
UK - Females
Source: mortality.org
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
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
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.
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
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
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
Life Expectancy at Birth
13 March 2019 17Source: mortality.org
Life Expectancy at Birth
13 March 2019 18Source: mortality.org
Life Expectancy at 65
13 March 2019 19Source: mortality.org
Life Expectancy at 65
13 March 2019 20Source: mortality.org
Gap Between Best and Worst
13 March 2019 21Source: mortality.org
Gap Between Best and Worst
13 March 2019 22Source: mortality.org
Modal Age of Death
13 March 2019 23
Japanese Females
Age
Source: mortality.org
Modal Age of Death
13 March 2019 24
Japanese Females
Age
Source: mortality.org
Modal Age of Death
13 March 2019 25
Irish Females
Age
Source: mortality.org
Modal Age of Death
13 March 2019 26
Irish Females
Age
Source: mortality.org
Modal Age of Death
13 March 2019 27
Irish Females
Age
Source: mortality.org
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
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
Mortality by Cause
13 March 2019
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
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
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
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
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
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
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
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
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
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
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
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
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
Limits of Human Lifespan
13 March 2019
• "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)
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
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
Survival Improvement Rate Drop-off?
13 March 2019 48Source: mortality.org (own calculations)
Survival Improvement Rate Drop-off?
13 March 2019 49Source: mortality.org (own calculations)
13 March 2019 50
Survival Improvement Rate Drop-off?
Source: mortality.org (own calculations)
What does Aubrey say?
13 March 2019 Source: https://www.flickr.com/photos/shareconference/6838320854/
• 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
What is Ageing?
13 March 2019 53
Metabolism Damage Pathology(life-long) (late life)
Source: sens research foundation
What is Ageing?
13 March 2019 54
Metabolism Damage Pathology(life-long) (late life)
Gerontology Geriatrics
Source: sens research foundation
What is Ageing?
13 March 2019 55
Metabolism Damage Pathology(life-long) (late life)
Gerontology
Maintenance
Geriatrics
Source: sens research foundation
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
Oldest living person?
13 March 2019 57Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)
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
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)
Oldest living person?
13 March 2019 60
A realisticlimit?
Source: Gerontology Research Group (http://www.grg.org/Adams/C.HTM)
• 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
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
50 Shades of “de Grey”
International Drivers of Longevity Outliers
Q&A