Professor Carol Jagger, AXA Professor of Epidemiology of Ageing at Newcastle University's Institute of Health & Society, delivered the IFoA's Autumn Lecture to a full house of actuaries, scientists and policymakers at the Royal College of Physicians of Edinburgh on 1 October. She presented a range of unique, published and unpublished research on the effects of old age.
Multi-morbidity is the norm for the very old, with multiple conditions and diseases contributing to disability, including high rates of hypertension, osteoarthritis, cataracts and atherosclerosis. Over their lifetime, men enjoy a longer disability-free period, and experience relatively faster decline, requiring a shorter phase of intermittent care, while women are more likely to live longer and experience extended periods requiring intermittent and then regular care, together with lengthier periods of cognitive impairment. While life-expectancy inequalities between men and women are reducing, disability-free life expectancy (DFLE) inequalities are not.
A particular challenge is that DFLE also varies widely across ethnicities, with Pakistani and Bangladeshi men and women in England experiencing a much shorter DFLE than average. Lifestyle and regional factors also contribute to variance in DFLE. The north-east and west of England vary considerably from London and the south.
Jagger also highlighted the effect of these on carers. For men, two years are spent needing daily or constant help. For women, this figure is three years. Often the care is provided by children who are themselves in their early 60s with poor health. However, Jagger stressed that most old age is not spent dependant or physically or cognitively impaired.
On the whole, the course of old age disability was predictable, with public policymakers aware of the issues. However, elderly care and wellbeing still presents unmet challenges.
IFoA president Nick Salter was extremely pleased to present both Jagger and Sir Philip Mawer, former chair of the Professional Regulation Executive Committee, with Honorary Fellowship of the IFoA at the lecture.
The lecture will be made available on the IFoA website shortly.