Period and cohort-specific trends in life expectancy at different ages: Analysis of survival in high-income countries

Abstract

The number of older adults is increasing in high-income countries as survival chances continue to improve. We investigate changes in survival at older ages in high-income countries and show that although survival chances have improved, these improvements are concentrated at the top of the survival distribution where there is a small share of the population. Among females who survive to age 85 in the most recently birth cohort (1925), for example, about half die within 8 years while those in the top 25% of the survival distribution live at least 50% longer (12 years or more). Importantly, these results indicate that having some individuals reach exceptionally old age does not imply that the majority of the population is living longer. In addition, estimates of lifespan inequality at older ages suggests that years of life lost because of death have increased in recent times and among recently born cohorts leading to an increase uncertainty in the age at death at older ages. Thus, slow survival improvements at ages 65+ suggest that most of the population is unlikely to reach long life expectancies in the near future, which may lead to lower than expected fraction of adults reaching older ages.

Projected prevalence and incidence of dementia accounting for secular trends and birth cohort effects: a population-based microsimulation study

“…The gender distribution in the birth cohorts is based on the historic gender distribution in the given decade [ 17 ]. Improvements in survival of birth cohorts in the Netherlands are similar to those observed in other high-income countries [ 26 ], including the United States and the United Kingdom (see Appendix A for a direct comparison).…”

“…First, this model was developed on the basis of Dutch data. Although changes in population structure and relative reductions in dementia incidence are similar across high-income countries [ 6 , 26 ], this may hamper generalizability of the projections. Also, the Rotterdam Study population is predominantly White.…”

Projections of costs and quality adjusted life years lost due to dementia from 2020 to 2050: A population‐based microsimulation study

“…The aim of providing projections for the Dutch population also presents another limitation. Although changes in population structure and relative reductions in dementia incidence are similar across high‐income countries, 27,47 this may hamper the generalizability of the projections. Furthermore, cost and quality‐of‐life estimates are often country specific and depend on a variety of factors, such as policy recommendations, family values, and accessibility of the healthcare system.…”

Mortality as a Function of Survival

“…They showed that con clu sions about com pres sion or dis per sion of deaths are heavily driven by reli ance on chro no log i cal age. Wilmoth and Horiuchi (1999), CanudasRomo (2008), and Beltrán-Sánchez and Subramanian (2019 alluded to this, whereas Zuo et al (2018) pro vided com pel ling evi dence of shifting pat terns in the age dis tri bu tion of deaths.…”

“…The selec tion of the onset age dis re gards the mor tal ity dynam ics at youn ger ages. Steady shifts in death per cen tiles start well before age 65 as there is evi dence that major reduc tions in death rates have taken place at youn ger ages (e.g., Beltrán-Sánchez and Subramanian 2019;BergeronBoucher et al 2015). Ages before and after 65 are both part of the same con tin u ous pro cess of aging.…”