questions of life expectancy and longevity · disease prevention and cure regenerative medicine...
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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