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The Actuary The magazine of the Institute & Faculty of Actuaries

Longevity: What the future holds

Life expectancy at birth in the UK has reached 81.5 years for women and 77.2 years for men, an increase of two years for women and three for men over the last decade. Life expectancy at age 65 has also increased by 1.6 years for women and 2.4 years for men over the same time period, and although this is less in absolute years than for increases in life expectancy at birth, this represents a greater percentage increase.

While we know that Japan leads the world in life expectancy for women of over 85 years, the variation between European countries, which we might think are more homogeneous, is surprising. Within the 15 countries in the European Union (EU), the variation in life expectancy at birth is 3.3 years for men (from 78.8 years in Sweden to 75.5 years in Portugal) and 3.7 years in women (from 84.4 years in France to 80.7 years in Denmark). Values for the newly acceded countries (EU10) are on the whole considerably lower, but more variable. At 65.3 years, Lithuania has the lowest male life expectancy at birth and Latvia the lowest female life expectancy at 76.4 years.

Of course, the big question remains unanswered: are the extra years of life healthy ones? A new EU structural indicator (Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis, Jagger C, Gillies C, et al) suggested that the variation in healthy life years is much greater than the variation in the quantity of remaining life, and that the countries with the longest life expectancy at age 50 were not necessarily the ones with the highest number of healthy life years (Figure 1). Indeed, there were 10 countries where the number of healthy life years at age 50 was less than 15, suggesting that, in these countries, raising the proportion of older workers in the labour force might be problematic. Of course, cultural differences in reporting may play a part in these differences, but what part does health play in longevity?

Underlying the puzzles about health and longevity is a set of issues about the forces acting on the intrinsic biology of the ageing process. The continuing increases in life expectancy over recent decades were not foreseen and came largely as a surprise. It used to be thought that ageing was programmed as an integral component of our biological make-up, and so longevity was expected to bump into a fixed ceiling. However, recent scientific advances have shown that ageing is not strictly programmed after all. It results from a gradual, lifelong accumulation of cell and molecular damage and is more malleable than we used to think. Many factors, including genetics, lifestyle and environment, all play a part and the crosschallenge is to understand how these will impact on future patterns of health and survival.

To address these matters, the Mortality Research Steering Group will host a conference entitled Joining forces on mortality and longevity, to take place on 21-22 October 2009 at the Royal College of Physicians in Edinburgh and chaired by Professor Tom Kirkwood. The aim is to bring together multi-disciplinary researchers to better understand past, present and future trends in mortality and longevity. There will be three workstreams: ‘What are the drivers for change?’, ‘How do cohorts differ and why?’ and ‘From populations to individuals –— drilling down to individualised risk’.

Each workstream will feature a leading international speaker in the field and cover topics such as the role lifestyle factors play in mortality trends; whether UK cohort effects can be explained by socio-economic composition; future mortality prospects in the light of Swedish and Japanese trends; the impact of migration on mortality; and which treatments have the greatest potential to improve longevity. If you want new, up-to-date research to understand current trends and the future prospects for mortality, this conference is for you.

Tom Kirkwood is director of the Institute for Ageing and Health at the University of Newcastle. Carol Jagger is professor of epidemiology at the University of Leicester and director of the Leicester Nuffield Research Unit. Both are members of the Profession’s Mortality Research Steering Group