Experts' Seminar on Ageing and Long-Term Care Needs
LSE, Friday, 20 May 2011
The longevity revolution
Jean-Marie Robine
INSERM, Paris & Montpellier, France
How many newborn are becoming adults?
sex women
100000
Somme de lx
100000
90000
100000
80000
98000
70000
95000
country
Denmark
England
France
Japan
Netherlands
Norway
Sweden
Switzerland
USA
60000
96000
90000
50000
40000
94000
85000
30000
92000
80000
20000
10000
75000
90000
0
2010
2000
1990
19801985
1970 1980
1960 1975
1950 1970
1940 1965
1930
1920
1950
1955
1960
1990
1995
1751
1776
1801
1826
1851
1876
1901
1926
1951 2000
1976 20052001
Year
How far will the adult longevity go up?
Halley, first life table, 1693
10000
9000
Halley 1687-1691
8000
7000
6000
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Sweden, 1754-1756,
data sent by Wargentin to Deparcieux
10000
9000
Halley 1687-1691
8000
Sweden 1754-1756
7000
6000
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Switzerland, 1876-1880
10000
9000
Halley 1687-1691
Sweden 1754-1756
8000
Switzerland 1876-1880
7000
6000
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Japan, 1950-1954
10000
9000
Halley 1687-1691
Sweden 1754-1756
8000
Switzerland 1876-1880
7000
Japan 1950-1954
6000
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Japan, 1950-1954
10000
9000
Halley 1687-1691
Sweden 1754-1756
8000
Switzerland 1876-1880
7000
Japan 1950-1954
6000
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Japan 1980-1984
10000
9000
Halley 1687-1691
8000
Sweden 1754-1756
Switzerland 1876-1880
7000
Japan 1950-1954
6000
Japan 1980-1984
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
How long are adult life durations?
6 000
5 000
Modal length of life (M)
4 000
1876-80
1929-32
3 000
1988-93
2 000
Standard deviation above M
1 000
Maximum life span
0
20
40
60
80
100
Distribution of the ages at death in Switzerland
1876-1880, 1929-1932, 1988-1993
120
60
Years
Life expectancy, median life and modal age
at death, Switzerland from 1876
90
Men
80
70
50
Mode
Median
LE(0)
40
30
2006
1876-1880
1886-1890
1881-1885
1896-1900
1891-1895
1901-1905
1911-1915
1906-1910
1921-1925
1916-1920
1926-1930
1936-1940
1931-1935
1946-1950
1941-1945
1951-1955
1961-1965
1956-1960
1971-1975
1966-1970
1976-1980
1986-1990
1981-1985
1996-2000
1991-1995
2001-2002
Cheung et al,
Japan 1980-1984
10000
9000
Halley 1687-1691
8000
Sweden 1754-1756
Switzerland 1876-1880
7000
Japan 1950-1954
6000
Japan 1980-1984
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Japan 2000-2004
10000
9000
Halley 1687-1691
Sweden 1754-1756
8000
Switzerland 1876-1880
7000
Japan 1950-1954
Japan 1980-1984
6000
Japan 2000-2004
5000
4000
3000
2000
1000
0
10
20
30
40
50
60
70
80
90
100
110
120
Compression of or shift in mortality ?
Increase in the modal length of life (M), since 1751:
a selection of 7 countries
95
90
85
80
Denmark
England
France
75
Japan
Netherlands
Sweden
70
Switzerland
65
60
55
1751
1776
1801
1826
1851
1876
1901
1926
1951
1976
2001
Correlation between the modal lenght of life (M) and the
mean deviation above (eM) in 4188 life tables since 1751,
males and females – (HMD)
14
12
10
e(M)
8
6
4
2
0
60
65
70
75
80
Modal age at death
85
90
95
Correlation between the modal lenght of life (M) and the
mean deviation above (eM) in 4188 life tables since 1751,
males and females – (HMD)
14
12
10
e(M)
8
6
4
2
0
60
65
70
75
80
Modal age at death
85
90
95
Change in the modal length of life and in SDM+ for
women in Japan from 1950-54 to 2000-2004
5000
1950-1954
1960-1964
d(x) function, life table
4000
100
1980-1984
1990-1994
3000
2000-2004
9
2000
1000
8
90
0
0
10
20
30
40
50
60
70
80
90
Age
7
80
SD(M+) (years)
Modal age at death (years)
Women
1970-1974
100
6
Mode
SD(M+)
70
5
2000-04
1995-99
1990-94
1985-89
1980-84
1975-79
1970-74
1965-69
1960-64
1955-59
1950-54
Cheung and Robine, 2007
110
120
Change over time in the distribution of the ages at
death in France since 1827, female
- for 100.000 newborn
5000
Nombre de décès (dx)
4000
3000
2000
1000
0
0
10
1827
20
1847
30
1867
40
1887
50
1907
60
70
1927
80
1947
90
1967
100
1987
110
2007
120
Emergence of the centenarians
&
Strong increase in the numbers of
the oldest old people
Change in the number of centenarians in Europe vs Japan
Japan
45000
40000
40000
35000
35000
Male
Female
Total
Females
Males
Total
2010
2005
2000
1995
1990
1985
1980
2010
2005
2000
1995
1990
1985
1980
1975
1970
1965
0
1960
0
1955
5000
1950
5000
1975
10000
1970
10000
15000
1965
15000
20000
1960
20000
25000
1955
25000
30000
1950
30000
1945
Number of centenarians (100+)
45000
1945
Number of centenarians (100+)
Fourteen European countries
More than 40,000 centenarians in Japan in 2009
August 14, 2010
45000
Number of centenarians
40000
Centenarians in Japan
35000
30000
25000
20000
15000
Total
10000
Males
5000
Females
0
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
22
Change in the number of centenarians in Europe vs. Japan
Japan
45000
40000
40000
35000
35000
Male
Female
Total
Females
Males
Total
2010
2005
2000
1995
1990
1985
1980
2010
2005
2000
1995
1990
1985
1980
1975
1970
1965
0
1960
0
1955
5000
1950
5000
1975
10000
1970
10000
15000
1965
15000
20000
1960
20000
25000
1955
25000
30000
1950
30000
1945
Number of centenarians (100+)
45000
1945
Number of centenarians (100+)
Fourteen European countries
Europe vs. Japan
Robine and Saito, in press
Divergence, variability and
uncertainty
Divergence in life expectancy at age 65
24
Females
22
22
20
20
Number of years
Number of years
24
18
16
18
16
14
14
12
12
10
10
1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Denmark
France
Japan
Spain
Sweden
USA
Males
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Denmark
France
Japan
Spain
Sweden
USA
Divergence in life expectancy at age 65
24
Females
22
22
20
20
Number of years
Number of years
24
18
16
18
16
14
14
12
12
10
10
1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Denmark
France
Japan
Spain
Sweden
UK
USA
Males
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Denmark
France
Japan
Spain
Sweden
UK
USA
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.
Population estimates: 100 years
Females
Males
Total
233
250
265
245
47
46
36
43
280
296
301
288
719
773
4841
5210
5722
Denmark
2005
2006
2007
• Are older people more likely to become
2008 centenarians
because they are in better health France
or because it is much
2005
4189
652
easier to survive today?
2006
4491
4949
2007
• In Denmark, where the number of centenarians
is
Japan
increasing relatively slowly, the functional
health
status
2005
7674
1533
9207
of female centenarians (100) significantly
improved
over
2006
8991
1609
10600
9769
1766
11535
the last decade (Engberg et al, 2008). 2007
2008
12483
2232
14715
• 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.
Prevalence of centenarians confined to the room
• Are
peopleSampling
more likely
to tobecome
Year older
Population
% confined
the room centenarians
% bedridden
size
ratebetter
Males
Malesit is much
Females
because they
are in
healthFemales
or because
1973 (1)
405
28.9
19.1
37.5
14.3
21.9
easier
to
survive
today?
1975 (2)
548
39.1
38.5
46.8
15.4
25.7
(3)
1072
94.2
33.1
50.7
18.2
27.9
• 1981
In
Denmark,
where
the
number
of
centenarians
is
1992 (4)
4152
13.2
36.5
59.8
21.2
36.6
increasing
relatively
the functional
health
status
1993
(5)
4802
59.9 slowly,
39.3
61.1
17.9
34.4
2000
(6)
13036
14.6
57,0 significantly
78,0
22.2
41.1
of female
centenarians
(100)
improved
over
the last decade.
Research reports
•(1) Tokyo
Onmetropolitan
the other
hand in Japan, where the number of
institute of aging (1973)
centenarians
has
increased
more than 3-fold every
(2) Center
for development of elderly
welfare
(1976)
(3) Japan
Health promotion
and Fitness
(1992)occasional centenarian surveys
decade
since
theFoundation
1970s,
(4) Japan College of Social Work (1992)
demonstrated
significant
(5) Japan
Health promotion and Fitness
Foundation (1993) declines in the functional
(6) Japan
Health promotion
and Fitness
Foundation (2002) centenarians.
health
status
of Japanese
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
1891-1898
1899-1903
1909-1913
1921-1925
1926-1930
1935-1936
1947
1950-1952
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
qx series, males
0,8
0,7
0,6
0,5
0,4
0,3
0,2
0,1
0
0
10
20
30
40
50
60
70
80
90
100
110
1891-1898
1899-1903
1909-1913
1921-1925
1926-1930
1935-1936
1947
1950-1952
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
1
0,1
0,01
0,001
0,0001
0,00001
0
10
20
30
40
50
60
70
80
90
100
110
120
1891-1898
1899-1903
1909-1913
1921-1925
1926-1930
1935-1936
1947
1950-1952
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
0,8
0,7
0,6
0,5
0,4
0,3
0,2
0,1
0
0
120
qx series, males
qx series, females
10
20
30
40
50
60
70
80
90
100
110
120
1891-1898
1899-1903
1909-1913
1921-1925
1926-1930
1935-1936
1947
1950-1952
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
qx series, females
1
0,1
0,01
0,001
0,0001
0,00001
0
20
40
60
80
100
120
140
Mortality trajectory…
Tokyo, June 2004, females, n=517
1
Probability of death
Vincent
0,8
Thatcher et al
0,6
0,4
IDL
Th-K Database
Vaupel et al
0,2
0
92
96
100
104
108
112
116
120
Robine & Vaupel, 2005
Mortality trajectory…
Tokyo, June 2004, females, n=517
1
Probability of death
Vincent
0,8
Thatcher et al
0,6
0,4
IDL
Th-K Database
Vaupel et al
0,2
0
92
96
100
104
108
112
116
120
Robine & Vaupel, 2005
Mortality trajectory…
Tokyo, June 2004, females, n=517
1
Probability of death
Vincent
0,8
Thatcher et al
0,6
0,4
IDL
Th-K Database
Vaupel et al
0,2
0
92
96
100
104
108
112
116
120
Robine & Vaupel, 2005
Mortality trajectory…
Tokyo, June 2004, females, n=517
1
Probability of death
Vincent
0,8
Thatcher et al
0,6
0,4
IDL
Th-K Database
Vaupel et al
0,2
0
92
96
100
104
108
112
116
120
Robine & Vaupel, 2005
Thank you for your attention!
Experts' Seminar on Ageing and Long-Term Care Needs
LSE, Friday, 20 May 2011
The longevity revolution
Jean-Marie Robine
INSERM, Paris & Montpellier, France
Change in the distribution of ages at death for
women in Japan from 1950-54 to 2000-2004
5000
1950-1954
1960-1964
1970-1974
d(x) function, life table
4000
1980-1984
1990-1994
3000
2000-2004
2000
1000
0
0
10
20
30
40
50
60
70
80
90
100
110
120
Age
Cheung and Robine, 2007
Change in the distribution of ages at death for
women in Japan from 1950-54 to 2000-2004
5000
1950-1954
1960-1964
1970-1974
d(x) function, life table
4000
1980-1984
1990-1994
3000
2000-2004
2000
1000
0
0
10
20
30
40
50
60
70
80
90
100
110
120
Age
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
Centenarian increase in Japan
100000
Number of centenarians
Total 100+
10000
Total 105+
Total 110+
1000
100
10
1
1960
1970
1980
1990
Calendar year
2000
2010