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At each period of the history of mankind, since the most At each period of the history of mankind, since the most primitive times, a small number of individuals were able to primitive times, a small number of individuals were able to live up to 100 years and to thus carry out the potential live up to 100 years and to thus carry out the potential maximum longevity of the species. maximum longevity of the species.
Biology of aging and longevityBiology of aging and longevity
R Cutler, 1985R Cutler, 1985
There is no evidence that the maximum human life span has There is no evidence that the maximum human life span has changed from what it was about a hundred thousand years changed from what it was about a hundred thousand years ago… ago…
… … If the human life span is really increasing, then, for If the human life span is really increasing, then, for example we might find that the oldest humans were reaching example we might find that the oldest humans were reaching the age of 100 years in 1850, 115 years in 1900, and 120 the age of 100 years in 1850, 115 years in 1900, and 120 years in 1950. This would be good evidence that maximum years in 1950. This would be good evidence that maximum life span is increasing, especially if large numbers of people life span is increasing, especially if large numbers of people in each period reached these very old ages.in each period reached these very old ages.
Hayflick, 1996Hayflick, 1996
European Health ForumEuropean Health ForumGastein, October 5th 2005Gastein, October 5th 2005
Perspectives for extendingPerspectives for extendinghealthy life expectancyhealthy life expectancy
Jean-Marie RobineJean-Marie RobineINSERM, Health and Demography, CRLC, University of INSERM, Health and Demography, CRLC, University of
Montpellier, FranceMontpellier, France
During the 18th century…During the 18th century…The first limits for the The first limits for the human life spanhuman life span Alexandre de Moivre (1724) : 86 ansAlexandre de Moivre (1724) : 86 ans Isaac de Graaf (1729) : 92 ans Isaac de Graaf (1729) : 92 ans
As for what is alleged, that by some observations of late years, it appears, that life is carried to 90, 95, and even to 100 years ; I am not more moved by it, than by the example of Parr, or Jenkins, the first of which lived 152 years, and the other 167.
de Moivre, 1724
Increase in life expectancyIncrease in life expectancy
Female life expectancy in the record-holding country since 1840…
Oeppen & Vaupel, 2002
40
45
50
55
60
65
70
75
80
85
90
1820 1840 1860 1880 1900 1920 1940 1960 1980 2000 2020
Increase in life expectancy in SwitzerlandIncrease in life expectancy in Switzerland
80
100
120
140
160
180
200
220
1860 1880 1900 1920 1940 1960 1980 2000 2020
SMe0
SMe60
SMe80
Extrapolation linéaire
Extrapolation linéaire
Extrapolation linéaire
80
100
120
140
160
180
200
220
1860 1880 1900 1920 1940 1960 1980 2000 2020
SFe0
SFe60
SFe80
Extrapolation linéaire
Extrapolation linéaire
Extrapolation linéaire
Robine & Paccaud, 2005
… … fall of mortality among the fall of mortality among the oldest-oldoldest-old
Mortality Mortality decline at decline at age 80age 80
Thatcher, 1999
England& Wales
Mortality rates at ages100-104 and 105 and Mortality rates at ages100-104 and 105 and over in Japan since 1975, femaleover in Japan since 1975, female
30,0
40,0
50,0
60,0
70,0
80,0
90,0
100,0
1975 1980 1985 1990 1995 2000
Females 100-104
Females 105+
Trend 100-104
Trend 105+
Robine & al, 2003
Mortality trajectories?Mortality trajectories?
Modelisation…Modelisation…
Thatcher-Kannisto, database, 1998
0
0,2
0,4
0,6
0,8
1
92 96 100 104 108 112 116 120
Prob
abil
ity
of d
eath
Vincent
Vaupel et al
Thatcher et al
Th-K Database IDL
Tokyo, June 2004, females, n=517
Robine & Vaupel, 2005
… … emergence of the oldest-oldemergence of the oldest-old
Emergence of the oldest-old in France Emergence of the oldest-old in France during the 20th centuryduring the 20th century
France 1901-1999, females
100
1000
10000
100000
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000
8081828384858687888990919293949596979899
23,000 centenarians in Japan in 200323,000 centenarians in Japan in 2003
Robine & Saito, 2003
0
4000
8000
12000
16000
20000
24000
1955 1965 1975 1985 1995 2005
Total
Males
Females
More than 800 persons aged 105 and More than 800 persons aged 105 and over in Japan in 2002over in Japan in 2002
Robine & Saito, 2003
0
200
400
600
800
1000
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
Total
Males
Females
105+
Emergence of super-centenarians: more than 20 cases in Japan in 2002
Robine & Saito, 2003
0
5
10
15
20
25
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
110+
Lenghening of lifeLenghening of life
Distribution of deaths in SwitzerlandDistribution of deaths in Switzerland1876-1880, 1929-1932, 1988-19931876-1880, 1929-1932, 1988-1993
0
1 000
2 000
3 000
4 000
5 000
6 000
20 40 60 80 100 120
1876-80
1929-32
1988-93
Increase in the modal length of life and decrease in the Increase in the modal length of life and decrease in the standard deviation,standard deviation,
males and females, Switzerland,1876-1880 to 2001-2002males and females, Switzerland,1876-1880 to 2001-2002
65
70
75
80
85
90
1876-18801881-18851886-18901891-18951896-19001901-19051906-19101911-19151916-19201921-19251926-19301931-19351936-19401941-19451946-19501951-19551956-19601961-19651966-19701971-19751976-19801981-19851986-19901991-19951996-20002001-2002
M(N
orm
al)
5
6
7
8
9
10
11
SD(M
+),M
(Nor
mal
),dx(
LT)
M(Normal)
SD(M+),M(Normal),dx(LifeTable)
Males
65
70
75
80
85
90
1876-18801881-18851886-18901891-18951896-19001901-19051906-19101911-19151916-19201921-19251926-19301931-19351936-19401941-19451946-19501951-19551956-19601961-19651966-19701971-19751976-19801981-19851986-19901991-19951996-20002001-2002
M(N
orm
al)
5
6
7
8
9
10
11
SD(M
+),M
(Nor
mal
),dx(
LT)
M(Normal)
SD(M+),M(Normal),dx(LifeTable)
Females
Cheung, Robine, Paccaud, 2005
Maximum age reported at death, SwitzerlandMaximum age reported at death, Switzerland
94
96
98
100
102
104
106
108
110
112
1860 1880 1900 1920 1940 1960 1980 2000 2020
Sexe masculin
Sexe féminin
Maximum age reported at death, Switzerland 1876-2001
Robine & Paccaud, 2005
Frail population…Frail population…
Frail persons…Frail persons…
Distribution of the deaths according to the seasons
0
5
10
15
20
25
30
35
40
Spring Summer Autumn Winter
Perc
enta
ge o
f obs
erve
d de
aths
Super-Centenarians
French Centenrians
Robine & Vaupel, 2001
In this context…In this context…
To give a priority to the quality of life even if this probably will lengthen it more.
Trends in LE and DFLE at age 65 in the European Union, 1995-2003, for women
4
6
8
10
12
14
16
18
20
22
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Ex
pe
cte
d y
ea
rs o
f lif
e
Austria Belgium Denmark Finland France Germany Greece
Ireland Italy Netherland Portugal Spain Sweden United Kingdom
LE
DFLE
Jagger and the EHEMU team, 2005
Trends in proportion of life spent disability-free at age 65
in the European Union, Women
= gain of 5% +
= loss of 5% +
= gain or loss of less than 5%
30
35
40
45
50
55
60
65
70
75
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Year
Pro
po
rtio
n o
f L
E s
pen
t d
isab
ility
-fre
e at
ag
e 65
Austria Belgium Denmark Finland France Germany Greece
Ireland Italy Netherland Portugal Spain Sweden United Kingdom
Jagger and the EHEMU team, 2005
Who will care for the oldest old?
0,00
0,05
0,10
0,15
0,20
0,25
0,30
0,35
0,40
0,45
1880 1900 1920 1940 1960 1980 2000 2020 2040 2060
BR (HMD)
BR (IDB)
Adj BR (Sc 0)
Adj BR (Sc NLTCS)
Adj BR (Sc 1)
Adj BR (Sc 2)
Rapport entre le nombre des personnes de 85 ans et pluset les femmes âgées de 50 à 75 ans en France de 1900 à 2050;
rapport ajusté selon les taux de dépendance du NLTCS et divers scénarios
Keeping the share betweenKeeping the share betweeninformal, informal + formal and formal LTC?informal, informal + formal and formal LTC?
More oldest old?More oldest old? More oldest old with LTC needs?More oldest old with LTC needs?
Disability declineDisability decline Use of technical equipmentUse of technical equipment
More families with oldest old (actual numbers / proportion)?More families with oldest old (actual numbers / proportion)? More available children?More available children?
ChildlessChildless Number of living childrenNumber of living children
Same willingness to care for?Same willingness to care for? Impact of divorce (father/daughter)…Impact of divorce (father/daughter)… Son participation in caringSon participation in caring
Same demand / same expectationSame demand / same expectation Ability to afford paid servicesAbility to afford paid services Level of education (SES differentials)Level of education (SES differentials)
Same level of disability for the oldest old with LTC needs?Same level of disability for the oldest old with LTC needs? Ability to care forAbility to care for
Informal use onlyInformal use only Informal and formalInformal and formal Formal onlyFormal only
Thank youThank you
Horizontalization of Horizontalization of the survival curve, the survival curve,
women, Switzerland, from women, Switzerland, from 1876-80 to 2001-021876-80 to 2001-02
0.0
0.2
0.4
0.6
0.8
1.0
0 20 40 60 80 100 120Age
Pro
port
ion
surv
ivin
g to
age
x (l
x)
1876-80
1956-60
0.0
0.2
0.4
0.6
0.8
1.0
0 20 40 60 80 100 120Age
Pro
po
rtio
n s
urv
ivin
g t
o a
ge
x (l
x)
2001-02
1956-60
Cheung, Robine, Paccaud, 2005
Verticalization of the Verticalization of the survival curves,survival curves,
women in Switzerland, 1876-women in Switzerland, 1876-80 and 2001-0280 and 2001-02
0.0
0.2
0.4
0.6
0.8
1.0
0 20 40 60 80 100 120Age
Pro
port
ion
surv
ivin
g to
age
x (l
x)1876-80
Theoretical SC
0.0
0.2
0.4
0.6
0.8
1.0
0 20 40 60 80 100 120Age
Pro
port
ion
surv
ivin
g to
age
x (l
x)
2001-02
Theoretical SC
Cheung, Robine, Paccaud, 2005