experts' seminar on ageing and long-term care needs lse, friday, 20 may 2011 the longevity...
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Experts' Seminar on Ageing and Long-Term Care NeedsLSE, Friday, 20 May 2011
The longevity revolution
Jean-Marie Robine INSERM, Paris & Montpellier, France
How many newborn are becoming adults?
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
1751 1776 1801 1826 1851 1876 1901 1926 1951 1976 2001
Denmark
England
France
Japan
Netherlands
Norway
Sweden
Switzerland
USA
sex women
Somme de lx
Year
country
75000
80000
85000
90000
95000
100000
1920 1930 1940 1950 1960 1970 1980 1990 2000 201090000
92000
94000
96000
98000
100000
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
How far will the adult longevity go up?
Halley, first life table, 1693
0
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10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden, 1754-1756,data sent by Wargentin to Deparcieux
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1000
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4000
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6000
7000
8000
9000
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10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland, 1876-1880
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1000
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3000
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5000
6000
7000
8000
9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan, 1950-1954
0
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5000
6000
7000
8000
9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan 1950-1954
Japan, 1950-1954
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1000
2000
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4000
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6000
7000
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9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan 1950-1954
Japan 1980-1984
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7000
8000
9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan 1950-1954
Japan 1980-1984
How long are adult life durations?
0
1 000
2 000
3 000
4 000
5 000
6 000
20 40 60 80 100 120
1876-80
1929-32
1988-93
Modal length of life (M)
Standard deviation above M
Maximum life span
Distribution of the ages at death in SwitzerlandDistribution of the ages at death in Switzerland1876-1880, 1929-1932, 1988-19931876-1880, 1929-1932, 1988-1993
Life expectancy, median life and modal ageat death, Switzerland from 1876
30
40
50
60
70
80
90
1876-1880
1881-1885
1886-1890
1891-1895
1896-1900
1901-1905
1906-1910
1911-1915
1916-1920
1921-1925
1926-1930
1931-1935
1936-1940
1941-1945
1946-1950
1951-1955
1956-1960
1961-1965
1966-1970
1971-1975
1976-1980
1981-1985
1986-1990
1991-1995
1996-2000
2001-2002
Yea
rs
Mode
Median
LE(0)
Men
Cheung et al,
2006
Japan 1980-1984
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan 1950-1954
Japan 1980-1984
Japan 2000-2004
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
10 20 30 40 50 60 70 80 90 100 110 120
Halley 1687-1691
Sweden 1754-1756
Switzerland 1876-1880
Japan 1950-1954
Japan 1980-1984
Japan 2000-2004
Compression of or shift in mortality ?
Increase in the modal length of life (M), since 1751:a selection of 7 countries
55
60
65
70
75
80
85
90
95
1751 1776 1801 1826 1851 1876 1901 1926 1951 1976 2001
Denmark
England
France
Japan
Netherlands
Sweden
Switzerland
Correlation between the modal lenght of life (M) and the mean deviation above (eM) in 4188 life tables since 1751,
males and females – (HMD)
0
2
4
6
8
10
12
14
60 65 70 75 80 85 90 95
Modal age at death
e(M
)
Correlation between the modal lenght of life (M) and the mean deviation above (eM) in 4188 life tables since 1751,
males and females – (HMD)
0
2
4
6
8
10
12
14
60 65 70 75 80 85 90 95
Modal age at death
e(M
)
Change in the modal length of life and in SDM+ for women in Japan from 1950-54 to 2000-2004
Cheung and Robine, 2007
70
80
90
100
1950-54
1955-59
1960-64
1965-69
1970-74
1975-79
1980-84
1985-89
1990-94
1995-99
2000-04
Mo
dal
ag
e at
dea
th (
year
s)
5
6
7
8
9
SD
(M+
) (y
ears
)
Mode
SD(M+)
Women
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Age
d(x
) fu
nct
ion
, li
fe t
able
1950-1954
1960-1964
1970-1974
1980-1984
1990-1994
2000-2004
Change over time in the distribution of the ages at death in France since 1827, female
- for 100.000 newborn
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Nom
bre
de d
écès
(dx
)
1827 1847 1867 1887 1907 1927 1947 1967 1987 2007
Emergence of the centenarians
&Strong increase in the numbers of
the oldest old people
Change in the number of centenarians in Europe vs Japan
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5000
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15000
20000
25000
30000
35000
40000
45000
1945
1950
1955
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1965
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1995
2000
2005
2010
Num
ber o
f cen
tena
rians
(100
+)
Japan
Females Males Total
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15000
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25000
30000
35000
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45000
1945
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1955
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1965
1970
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1980
1985
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1995
2000
2005
2010
Num
ber o
f cen
tena
rians
(100
+)
Fourteen European countries
Male Female Total
More than 40,000 centenarians in Japan in 2009
22
0
5000
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15000
20000
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30000
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45000
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Num
ber
of c
ente
nari
ans
Total
Males
Females
Centenarians in Japan
August 14, 2010
Change in the number of centenarians in Europe vs. Japan
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1965
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2000
2005
2010
Num
ber o
f cen
tena
rians
(100
+)
Japan
Females Males Total
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15000
20000
25000
30000
35000
40000
45000
1945
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1955
1960
1965
1970
1975
1980
1985
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1995
2000
2005
2010
Num
ber o
f cen
tena
rians
(100
+)
Fourteen European countries
Male Female Total
Europe vs. Japan
Robine and Saito, in press
Divergence, variability and uncertainty
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12
14
16
18
20
22
24
1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Num
ber o
f yea
rs
Females
Denmark France Japan Spain Sweden USA
10
12
14
16
18
20
22
24
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010N
umbe
r of y
ears
Males
Denmark France Japan Spain Sweden USA
Divergence in life expectancy at age 65
10
12
14
16
18
20
22
24
1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Num
ber o
f yea
rs
Females
Denmark France Japan Spain Sweden UK USA
10
12
14
16
18
20
22
24
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010N
umbe
r of y
ears
Males
Denmark France Japan Spain Sweden UK USA
Divergence in life expectancy at age 65
The centenarian rate in Europe
Robine and Saito, 2009
Are centenarian people healthy people?
• The few representative studies of centenarians have demonstrated that they are in relatively poor health with a significant proportion being bedridden and/or demented– only 1% of Italian centenarians are fully independent– none of them continued social or productive activities that
could be considered as examples of successful ageing
• On the other hand several studies suggested that these extremely old people were in relatively good health 5 or 10 years before (Christensen et al, 2008). Differential mortality must have eliminated the frailer dependant nonagenarians.
• Are older people more likely to become centenarians because they are in better health or because it is much easier to survive today?
• In Denmark, where the number of centenarians is increasing relatively slowly, the functional health status of female centenarians (100) significantly improved over the last decade (Engberg et al, 2008).
• On the other hand in Japan, where the number of centenarians has increased more than 3-fold every decade since the 1970s, occasional centenarian surveys demonstrated significant declines in the functional health status of Japanese centenarians.
Females Males TotalDenmark
2005 233 47 2802006 250 46 2962007 265 36 3012008 245 43 288
France2005 4189 652 48412006 4491 719 52102007 4949 773 5722
Japan2005 7674 1533 92072006 8991 1609 106002007 9769 1766 115352008 12483 2232 14715
Population estimates: 100 years
• Are older people more likely to become centenarians because they are in better health or because it is much easier to survive today?
• In Denmark, where the number of centenarians is increasing relatively slowly, the functional health status of female centenarians (100) significantly improved over the last decade.
• On the other hand in Japan, where the number of centenarians has increased more than 3-fold every decade since the 1970s, occasional centenarian surveys demonstrated significant declines in the functional health status of Japanese centenarians.
YearMales Females Males Females
1973 (1) 405 28.9 19.1 37.5 14.3 21.91975 (2) 548 39.1 38.5 46.8 15.4 25.71981 (3) 1072 94.2 33.1 50.7 18.2 27.91992 (4) 4152 13.2 36.5 59.8 21.2 36.61993 (5) 4802 59.9 39.3 61.1 17.9 34.42000 (6) 13036 14.6 57,0 78,0 22.2 41.1
Prevalence of centenarians confined to the room
Population size
Sampling rate
% confined to the room % bedridden
(1) Tokyo metropolitan institute of aging (1973)(2) Center for development of elderly welfare (1976)(3) Japan Health promotion and Fitness Foundation (1992)(4) Japan College of Social Work (1992)(5) Japan Health promotion and Fitness Foundation (1993)(6) Japan Health promotion and Fitness Foundation (2002)
Research reports
The Five Country Oldest Old Project (5-COOP): Relationships between the level of mortality selection and the health status of the oldest old
Denmark, France, Japan, Sweden & Switzerland
Robine et al, Centenarians today: New insights on selection from the 5-COOP study. CGGR 2011
The oldest old support ratio
World wide decline in the oldest old support ratio
As the number of people aged 50-74 for each person aged ≥ 85
Mortality trajectory
Mortality trajectory with age
0
0,1
0,2
0,3
0,4
0,5
0,6
0,7
0,8
0 10 20 30 40 50 60 70 80 90 100 110 120
qx series, males 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005 0
0,1
0,2
0,3
0,4
0,5
0,6
0,7
0,8
0 10 20 30 40 50 60 70 80 90 100 110 120
qx series, females 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005
0,00001
0,0001
0,001
0,01
0,1
1
0 10 20 30 40 50 60 70 80 90 100 110 120
qx series, males 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005 0,00001
0,0001
0,001
0,01
0,1
1
0 20 40 60 80 100 120 140
qx series, females 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005
0
0,2
0,4
0,6
0,8
1
92 96 100 104 108 112 116 120
Prob
abil
ity
of d
eath
Vincent
Vaupel et al
Thatcher et al
Th-K Database IDL
Tokyo, June 2004, females, n=517
Robine & Vaupel, 2005
Mortality trajectory…
0
0,2
0,4
0,6
0,8
1
92 96 100 104 108 112 116 120
Prob
abil
ity
of d
eath
Vincent
Vaupel et al
Thatcher et al
Th-K Database IDL
Tokyo, June 2004, females, n=517
Robine & Vaupel, 2005
Mortality trajectory…
0
0,2
0,4
0,6
0,8
1
92 96 100 104 108 112 116 120
Prob
abil
ity
of d
eath
Vincent
Vaupel et al
Thatcher et al
Th-K Database IDL
Tokyo, June 2004, females, n=517
Robine & Vaupel, 2005
Mortality trajectory…
0
0,2
0,4
0,6
0,8
1
92 96 100 104 108 112 116 120
Prob
abil
ity
of d
eath
Vincent
Vaupel et al
Thatcher et al
Th-K Database IDL
Tokyo, June 2004, females, n=517
Robine & Vaupel, 2005
Mortality trajectory…
Thank you for your attention!
Experts' Seminar on Ageing and Long-Term Care NeedsLSE, Friday, 20 May 2011
The longevity revolution
Jean-Marie Robine INSERM, Paris & Montpellier, France
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Age
d(x
) fu
nct
ion
, li
fe t
able
1950-1954
1960-1964
1970-1974
1980-1984
1990-1994
2000-2004
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Age
d(x
) fu
nct
ion
, li
fe t
able
1950-1954
1960-1964
1970-1974
1980-1984
1990-1994
2000-2004
Change in the distribution of ages at death for women in Japan from 1950-54 to 2000-2004
Cheung and Robine, 2007
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Age
d(x
) fu
nct
ion
, li
fe t
able
1950-1954
1960-1964
1970-1974
1980-1984
1990-1994
2000-2004
0
1000
2000
3000
4000
5000
0 10 20 30 40 50 60 70 80 90 100 110 120
Age
d(x
) fu
nct
ion
, li
fe t
able
1950-1954
1960-1964
1970-1974
1980-1984
1990-1994
2000-2004
Change in the distribution of ages at death for women in Japan from 1950-54 to 2000-2004
Cheung and Robine, 2007
There is no evidence that the maximum human life span has changed from what it was about a hundred thousand years ago… … If the human life span is really increasing, then, for example we might find that the oldest humans were reaching the age of 100 years in 1850, 115 years in 1900, and 120 years in 1950. This would be good evidence that maximum life span is increasing, especially if large numbers of people in each period reached these very old ages.
Hayflick, 1996
Number of oldest old in Japan by 5-year age group
1
10
100
1000
10000
100000
1960 1970 1980 1990 2000 2010
Nu
mb
er
of
cen
ten
aria
ns
Calendar year
Centenarian increase in Japan
Total 100+
Total 105+
Total 110+