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?

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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

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1920 1930 1940 1950 1960 1970 1980 1990 2000 201090000

92000

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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

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Halley 1687-1691

Sweden, 1754-1756,data sent by Wargentin to Deparcieux

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Japan, 1950-1954

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Japan, 1950-1954

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Halley 1687-1691

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Japan 1950-1954

Japan 1980-1984

How long are adult life durations?

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1 000

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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

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90

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1991-1995

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Yea

rs

Mode

Median

LE(0)

Men

Cheung et al,

2006

Japan 1980-1984

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Halley 1687-1691

Sweden 1754-1756

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Japan 1950-1954

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Japan 2000-2004

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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

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60

65

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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)

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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)

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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

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2000-04

Mo

dal

ag

e at

dea

th (

year

s)

5

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8

9

SD

(M+

) (y

ears

)

Mode

SD(M+)

Women

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Age

d(x

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Change over time in the distribution of the ages at death in France since 1827, female

- for 100.000 newborn

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Nom

bre

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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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Num

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(100

+)

Japan

Females Males Total

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Fourteen European countries

Male Female Total

More than 40,000 centenarians in Japan in 2009

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Males

Females

Centenarians in Japan

August 14, 2010

Change in the number of centenarians in Europe vs. Japan

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Females Males Total

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Fourteen European countries

Male Female Total

Europe vs. Japan

Robine and Saito, in press

Divergence, variability and uncertainty

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Num

ber o

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rs

Females

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18

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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

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Females

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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

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qx series, males 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005 0

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qx series, females 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005

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qx series, males 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005 0,00001

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1

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qx series, females 1891-18981899-19031909-19131921-19251926-19301935-193619471950-195219551960196519701975198019851990199520002005

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92 96 100 104 108 112 116 120

Prob

abil

ity

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eath

Vincent

Vaupel et al

Thatcher et al

Th-K Database IDL

Tokyo, June 2004, females, n=517

Robine & Vaupel, 2005

Mortality trajectory…

0

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Prob

abil

ity

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eath

Vincent

Vaupel et al

Thatcher et al

Th-K Database IDL

Tokyo, June 2004, females, n=517

Robine & Vaupel, 2005

Mortality trajectory…

0

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Prob

abil

ity

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eath

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Vaupel et al

Thatcher et al

Th-K Database IDL

Tokyo, June 2004, females, n=517

Robine & Vaupel, 2005

Mortality trajectory…

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Vaupel et al

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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

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Age

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1960-1964

1970-1974

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2000-2004

Change in the distribution of ages at death for women in Japan from 1950-54 to 2000-2004

Cheung and Robine, 2007

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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

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1960 1970 1980 1990 2000 2010

Nu

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ns

Calendar year

Centenarian increase in Japan

Total 100+

Total 105+

Total 110+