Professor Sarah HarperUniversity of Oxford

IMF Tokyo

June 5, 2017

Questions of life expectancy and longevity

Oxford Institute of Population Ageing

Will increases in both life expectancy and in life extension or longevity continue?

will there be an increase in average years lived by humans and also maximum years attained by a human being?

Will life expectancy increase in line with life extension?

will we all enjoy the benefits of longevity or will it be for a few?

Will increases in life expectancy be accompanied by increases in life extension or are we seeing a compression of longevity after 100?

will the predicted increases in centenarians over the coming century be accompanied by increases in super-centenarians?

Will advances in life expectancy be matched by advances in healthy life expectancy?

Oxford Institute of Population Ageing

Will increases in both life expectancy and in life extension or longevity continue?

will there be an increase in average years lived by humans and also maximum years attained by a human being?

Will life expectancy increase in line with life extension? will we all enjoy the benefits of longevity or will it be for a few?

Will increases in life expectancy be accompanied by increases in life extension or are we seeing a compression of longevity after 100? will the predicted increases in centenarians over the coming century be accompanied by increases in super-centenarians?

Will advances in life expectancy be matched by advances in healthy life expectancy?

Period expectation of life at birth 1841 to 2012

Source: ONS (2015)Period expectation of life at birth (years), from English Life Tables (ELT) No.s 1 to 17Based on data for England and Wales, 1841 to 2010‐2012June 20, 2017

Life expectancy, selected OECD countries, men and women, birth

Source: OECD

June 20, 2017

Life expectancy, selected OECD countries, men and women, age 65

Source: OECD

June 20, 2017

Life expectancy, selected OECD countries, men and women, age 80

Source: OECD

June 20, 2017

Oxford Institute of Population Ageing

Female life expectancy at birth in 2030

Kontis et al 2017 THE LANCET 6736(16)32381-9

Posterior distribution of life expectancy and its median value. Red dots show the posterior medians.

Oxford Institute of Population Ageing

Female life expectancy at birth in 2030: Top 10

Oxford Institute of Population Ageing

Female life expectancy at 65 in 2030

1990 2000 2010 2020 2030

Oldest age at which at least 50% of a birth cohort is still

alive (Birth Cohorts 2000-2007)

Source: Human Mortality Data Base, Christiansen et al Lancet 2009June 20, 2017

Oxford Institute of Population Ageing

Centenarians

Leeson, G. (2014) Future prospects for longevity. Post Reproductive Health, 20 (1), 17-21

Oxford Institute of Population Ageing

Source: Oxford Institute of Population Ageing Human Mortality Data Base

2010 2020 2030 2040 2050 2060 2070 2080

CentenariansProjected number of centenarians in the USA

6m

5m

4m

3m

2m

1m

>1m

Oxford Institute of Population Ageing

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0 10 20 30 40 50 60 70 80 90 100 110

Age

Propo

rtion surviving

1851

18711891

1911

19311951

Proportion of persons surviving to successive ages

197119912011

Source: ONS / Oxford Institute of Population Ageing

Oxford Institute of Population Ageing

UK Male Mortality 1911-2005

Source: ONS / Oxford Institute of Population Ageing

June 20,

Smoking prevalence in the over 60sSource: ONS (2016)

June 20, 2017

Contributions of mortality decline in three age groups (0–29 years, 30–64 years, and 65 years and older) towards the projected increase in life expectancy at birth

June 20, 2017

Oxford Institute of Population Ageing

Will increases in both life expectancy and in life extension or longevity continue?

will there be an increase in average years lived by humans and also maximum years attained by a human being?

Will life expectancy increase in line with life extension? will we all enjoy the benefits of longevity or will it be for a few?The Inequality question

Will increases in life expectancy be accompanied by increases in life extension or are we seeing a compression of longevity after 100?

Will advances in life expectancy be matched by advances in healthy life expectancy?

Oxford Institute of Population Ageing

Increase in Disabled Years

Age 55 Reduced LE Increased DYObesity 1.4 5.9Smoking 4 3.8Alcohol 3 3.1

(Klijs et al., 2011Obesity, smoking, alcohol consumption and years lived with disability, BMC Public Health 11:378)

Oxford Institute of Population Ageing

Change in dementia prevalence over time.

Wu et al, 2015 Dementia in Western Europe: epidemiological evidence and implications for policy making, The Lancet

Oxford Institute of Population Ageing

Dementia prevalence declined significantly, from 11.6%in 2000 to 8.8% in 2012.

21,000 US adults 65 years or older from the nationally representative Health and Retirement Study.

Langa et al, 2016 A Comparison of the Prevalence of Dementia in the United States in

2000 and 2012 JAMA Intern Med..2016.6807

Life expectancy (LE) and healthy life years (HLY), selected EU

countries and regions, men at Age 65

Source: European Health and Life Expectancy Information System

June 20, 2017

Life expectancy (LE) and healthy life years (HLY), selected EU

countries and regions, men at Age 85

Source: European Health and Life Expectancy Information System

June 20, 2017

Oxford Institute of Population Ageing

Will increases in both life expectancy and in life extension or longevity continue?

will there be an increase in average years lived by humans and also maximum years attained by a human being?

Will life expectancy increase in line with life extension?

will we all enjoy the benefits of longevity or will it be for a few?

The Inequality question

Will increases in life expectancy be accompanied by increases in life extension or are we seeing a compression of longevity after 100?

Will advances in life expectancy be matched by advances in healthy life expectancy?

Oxford Institute of Population Ageing

Determinants of the shape of mortality and morbidity in 21st Century

Healthy Living Disease Prevention and Cure Regenerative medicine Age-Retardation.

Key QuestionHow much life expectancy can we expect to gain without the intensive application of scientific medicine?

Estimate the impact on life expectancy of delaying the onset of we know to be age-related diseases rather than eliminating them altogether.

Oxford Institute of Population Ageing

Impact of daily fruit and vegetable portions on chances of illness

Source: International Journal of Epidemiology

Oxford Institute of Population Ageing

Male Mortality – deaths per million-aged 65-74

Cause 2001 2004 Reduction 2001-2004 Annual Average

Cancer 10,032 7,917 21% 1.80%

IHD 7,500 2,953 61% 6.9%

Circulatory 4,223 1,985 53% 5.6%

Respiratory 2,863 2,139 25% 2.2%

Digestive 1,022 881 14% 1.1%

Other 2,436 2,309 5% 0.4%

All causes 28,076 18,183 35% 3.3%

Source: WillisTowerWatson

Oxford Institute of Population Ageing

Determinants of the shape of mortality and morbidity in 21st Century

Healthy Living Disease Prevention and Cure Regenerative medicine Age-Retardation.

Key QuestionHow much life expectancy can we expect to gain with the intensive application of scientific medicine?

Oxford Institute of Population Ageing

Bio-Technology

Oxford Institute of Population Ageing

Fontana, L. Partridge, L 2015Promoting Health and Longevity through Diet: From Model Organisms to Humans CELL V161, Issue 1, p106–118

Dietary Restriction

Oxford Institute of Population Ageing

Therapeutic cell type

Skin Cell

Reprogramming

Stem Cells

Picture: Time (left) Paul J Fairchild, Dunn School of Pathology (right)

Human

Oxford Institute of Population Ageing

In our genes? Do some of us simply age less fast than others…..?

Robine et al 2003 The emergence of extremely old people:

the case of Japan Experimental Gerontology 38 735‒739

“….longevity case participants were healthier than controls despite the fact they were on average 10.8 years older. They possessed significantly better biological and physiological risk factor profiles, less age-related disease, and better physical and cognitive function”

Concluding with

“the concept of a “healthy aging” phenotype, whereby certain individuals are somehow able to delay or avoid major clinical disease and disability until late in life”

Oxford Institute of Population Ageing

www.ageing.ox.ac.uk

Oxford Institute of Population Ageing

Picture: Nasir Hamid/Oxford University