The New Science of Ageing

Kaare ChristensenThe Danish Ageing Research Centre

The New Science of AgeingThe New Science of Ageing

Sociology

Psychology

Economy

Politics

Epidemiology

DemographyStatistics

BiologyGenetics

AgeingEngineering

Computer Science

Medicine

Bioinformation

Mathematics

The New Science of AgeingThe New Science of Ageing

Sociology

Psychology

Economy

Politics

Epidemiology

DemographyMedicine

BiologyGenetics

AgeingEngineering

Computer Science

Statistics

Bioinformation

Mathematics

The New Science of AgeingThe New Science of Ageing

Sociology

Psychology

Economy

Politics

Epidemiology

DemographyMedicine

BiologyGenetics

Engineering

Computer Science

Statistics

Bioinformation

Mathematics

EU and AgeingEU and Ageing

The New Science of AgeingThe New Science of Ageing

Sociology

Psychology

Economy

Politics

Epidemiology

DemographyMedicine

BiologyGenetics

AgeingEngineering

Computer Science

Statistics

Bioinformation

Mathematics

Mean Life Expectancy

Years below highest life expectancy

Yea

rs a

bove

low

est l

ife d

ispa

rity

0 5 10 15 20

02

46

810

113 points: The country with the lowest life disparity usually has the highest life expectancy

USA 2005

Source: Vaupel et al., Science 2009

Medical treatment of very old people – are we doing good ?

Does exceptional longevity lead to

exceptional levels of disability?

Medical treatment of very old people – are we doing good ?

Does exceptional longevity lead to

exceptional levels of disability?

The Fourth Age

2,262(63%)

1,086(78%)

437(77%)

166(74%)

862 died 522 died 213 died

314 Drop-outs

127 Drop-outs

58 Drop-outs

1998 2000 2003 2005

19051905--Cohort Cohort -- DenmarkDenmark

♂

♀

♂ + ♀

0 92 1001:30

0 92 100

0 92 100

1:30

1:101:10

1:15 1:15

92 years 92 years –– half way to 100half way to 100

Independence in the 1905Independence in the 1905--CohortCohort

2234223422342234106010601060

422422 15638.9% 36.1%31.8% 32.7%

010

2030

4050

6070

8090

100

Perc

ent

92 94 96 98 100Age

Christensen et al. PNAS, 2008

Independence in the 1905Independence in the 1905--CohortCohort

2234223422342234106010601060

422422 15638.9%32.7%

69.9%

36.1%31.8%

010

2030

4050

6070

8090

100

Perc

ent

92 94 96 98 100Age

Christensen et al. PNAS, 2008

The Fourth AgeThe Fourth Age

EXTREME AGES

100 year olds are doing

as good as 92 year olds

EXTREME AGES

100 year olds are doing

as good as 92 year olds

50% more made it to 100 yearsin the 1905-Cohort

compared to the 1895-Cohort

Still no increased disability level

50% more made it to 100 yearsin the 1905-Cohort

compared to the 1895-Cohort

Still no increased disability level

The Fourth AgeThe Fourth Age

Engberg et al. J Gerontol, 2008

European Twin RegistriesEuropean Twin Registries

Heritability

- Lifespan 25%

- Functioning 50%

- Alzheimer 70%

- Parkinson 5%

Twin DesignTwin Design

Molecular pathways Molecular pathways that lengthen lifespanthat lengthen lifespanin C. elegans and the corresponding components in humans

HumansC.elegans

Christensen, Johnson, and Vaupel: Nat Rev Genet. 2006

Education and good ageing – causal or selection ?

- US Twin studies indicate causal- Danish Twin study indicate selection- Other European countries ?

Twin Studies: Combining genetics and social sciencesTwin Studies: Combining genetics and social sciences

Number of Danish centenarians 1970Number of Danish centenarians 1970--20082008

Females

Males

Calendar year

Count

0

100

200

300

400

500

600

700

1970 1980 1990 2000 2010

Female advantage in life expectancy at birth in 2004

1,0

4,0

4,7

5,0

5,1

6,7

6,9

7,0

7,1

13,4

0 2 4 6 8 10 12 14

Bangladesh*

Morocco*

Denmark**

Cuba*

USA**

Spain**

Japan**

Brazil*

France**

Russia**

Male Excess Mortality

Biological?

Behavioral?

Are males seeking medical help too late?

Serious diseases –little reaction

Trivial diseases –big reaction

Denmark 2005

All contacts to GPs: 34.8 Mio

All somatic hospitalizations: 1.2 Mio

Are males seeking health care too late?

Juel & Christensen 2008

0

1

2

3

4

0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 ≥85

Age group

Fem

ale/

mal

e ra

tio

Contacts to general practitioners

All hospital admissions

Without sex-specific admissions

Male health

Juel & Christensen 2008

MEN in Europe MEN in Europe

Falling behind

Biological barriersBehavioral barriersCultural barriers