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The Longevity Dividend: Altering the Future Course of Health and Longevity
S Jay Olshansky Ph DS. Jay Olshansky, Ph.D.
University of Illinois at Chicago
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SummaryMessage 1 Gompertz saw biology in the life table, and he was right – there is a law of mortality.
Message 3 A life expectancy of 100 is highly unlikely, but the number of centenarians will rise dramatically.
Message 2 Future trends in mortality and longevity will be driven by biology, not past trends. Linear thinking got us in trouble in the past, and it's still getting us in trouble today.
Message 4 Life expectancy is likely to rise rapidly for some, and decline dramatically for others. Education is a longevity trump card.
Message 5 If the retirement age was indexed to longevity as originally intended, it would be much higher than it is today. However, raising the retirement age has dramatically different effects on population subgroups.
Message 6 Two forthcoming revolutions in medicine and aging science are about to permanently change the landscape of human longevity in the future.
y p p g p
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Gompertz (1825) – summarized in Olshansky and Carnes (1997)
Ever Since Gompertz
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The Bridge of Life
The Chances of Death by Karl Pearson (1897)
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The American Naturalist (1922)
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Solving the law of mortalityrequired conditions that were
diffi ldifficult to overcome
• The ability to reliably measure Intrinsicy yMortality
• Access to reliable intrinsic mortality rates for different species
• Scaling Time
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Demonstration of consistency in the
timing of deathtiming of death.
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Source: Carnes and Olshansky, 2001
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Source: Carnes and Olshansky, 2001
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Source: Olshansky, Carnes and Grahn. 1998. American Scientist 86: 52-61
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Why Do We Age and Live as Long as We Do?
Is There Biology in the Life Table?
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"Nothing in biology makes sense except inmakes sense except in the light of evolution."
Theodosius DobzhanskyThe American Biology Teacher, March 1973
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BOTH Michelangelo and Darwin WERE RIGHT
The human body is a miraculous machine that works with near artistic perfection – for a while.
Time reveals the “flaws” in a body design that was not intended for long-term use.
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THE EVOLUTIONARY THEORY OF SENESCENCE
CHARLESCHARLES DARWIN
SIR PETER MEDAWAR
Mutation Accumulation Genetic Dustbin
GEORGE WILLIAMS
Antagonistic
TOM KIRKWOOD
Disposable Soma
In a world with limited h i l i lAlleles with detrimental
affects are “pushed” by natural selection to either side of the reproductive
window.
Pleiotropy
Genes that are harmful late in life are selected if they are
favorable early in the lifespan.
physiological resources, selection favors investment
in reproduction at the expense of immortality.
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WHY DO WE LIVE AS LONG AS WE DO?
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There is a remarkable consistency to the timing of death across speciesThere is a remarkable consistency to the timing of death across species.
Duration of life is calibrated to the onset and length of a species’reproductive window.
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77 000 d
55,000 days Sea Turtle
77,000 days Bowhead
Whale
29,000 days Human
26,000 days Elephant
1,000 days Mouse
5,000 days Dog
Elephant
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Although there is no genetic program that limits how fast humans are capable of running, there are nevertheless bi h i l t i t i dbiomechanical constraints on running speed.
Although there is no genetic program that limits the duration of life, there are nevertheless biomechanical constraints on the functioning of body parts that influence how long we live.
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Can most live to 100?
Can we really add decades of life toCan we really add decades of life to people aged 70+ today faster than we
added decades of life to children b i th l 20th t ?born in the early 20th century?
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Daniel Perry Richard A. Miller Robert N. Butler
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Does History Repeat Itself?• Forecasters have a long history of both underestimating and overestimating longevity. Today a new
set of errors are being made because they are relying almost exclusively on the extrapolation of past trends into the future. There is definitive evidence that some cohorts in some countries will live shorter lives and others will live longer lives than anticipated from actuarial models.
Source: Olshansky, 1988Source: Olshansky et al., 2005
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No!
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79.5
100
90
100
110
21.5
49
58.3
9.5
50
60
70
80
Expectan
cy at B
irth
9.3
10
20
30
40
Life
E
Source: US Social Security Administration and Christensen et al., 2009
0 US Period Life Expectancy
(1900) US Cohort Life Expectancy
(1900) US Period Life Expectancy
(2000) US Cohort Life Expectancy Forecast by Christensen and
Vaupel
Period and Cohort Life Expectancy at Birth (US, 1900 and 2000)
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Olshansky et al., 1990. Science.
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Olshansky et al., 2001. Science.
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Maximum Lifespan Potential = 122
Maximum Observed Age at Death = 105, 113 *
U.S. FEMALES
Period Life Expectancy at Birth = 49, 80 *
Modal Age at Death = 73, 88 *
200
19000
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There is no demographic,There is no demographic, actuarial, or biological
justification for concludingjustification for concluding that most (or even half of the
population) can live to 100 p p )
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EducationThe Longevity Trump Card
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White Males with 16+ Years of Education[LE 134 th ]
St d d U S Lif T bl
[LE = 134 months]
Standard U.S. Life Table[LE = 132 months]
The average duration of life will be only 2 months greater, but the distribution of death by age will be dramatically different.
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Source: Olshansky, S.J. 2011. Aging of US Presidents. JAMA 36(21): 2328-29
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90
95
100
9
14
11
13 12
1 James R. Dow 2 Joseph F. Knapp 3 John R. Hegeman 4 Haley Fiske 5 Frederick E. Ecker 6 Leroy A. Lincoln 7 Charles G. Taylor Jr. 8 Frederick W. Ecker
5
70
75
80
85
rved or E
xpected Lifespan
7
6
9 Gilbert W. Fitzhugh 10 Richard R. Shinn 11 John J. Creedon 12 Robert G. Schwartz 13 Harry P. Kamen 14 Robert H. Benmosche
3
4
10
55
60
65
Obse
2
8
50 50 55 60 65 70 75 80 85 90 95 100
Es mated Lifespan with Longevity Benefits of Race and Educa on
1
Source: Olshansky, SJ. 2012. Longevity of CEOs of MetLife.
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A Possible Decline in Life Expectancy in the United States in the 21st Century?
S. Jay Olshansky, Ph.D.University of Illinois at ChicagoUniversity of Illinois at Chicago
Douglas J. Passaro, M.D.University of Illinois at Chicago
Ronald C. Hershow, M.D.University of Illinois at Chicago
Jennifer Layden, MPHUniversity of Illinois at Chicago
New England Journal of Medicine 2005 352:1103-1110.
y g
Bruce A. Carnes, Ph.D.University of Oklahoma
Jacob Brody, M.D.University of Illinois at Chicago
Leonard Hayflick, Ph.D.University of California at San Francisco
Robert N. Butler, M.D.International Longevity Center
David B. Allison, Ph.D.University of Alabama at Birmingham
David S. Ludwig, M.D., Ph.D.Children’s Hospital, Boston
Funding: NIH/NIA; NIDDK; IGPA
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Obesity Trends* Among U.S. Adults
1985(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: CDC
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends Among U.S. Adults
1990
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends Among U.S. Adults
1995
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends Among U.S. Adults
2000
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends Among U.S. Adults
2004
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
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Obesity Trends Among U.S. Adults
2010
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Obesity is a global pandemic
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Olshansky SJ et al. 2012. Health Affairs.
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Resetting Social Security: What is Fair?
Olshansky et al., 2014MacArthur Research Network on an
Aging Society [in preparation]
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“When it is realized that too large a proportion of the population would probably be left idle with a retirement age of 65, the general
feeling will undoubtedly be that a constant retirement age should be banished, or that it should be left as a balancing item” (p.8)
Williamson and Myers 1937Williamson and Myers, 1937
“we can therefore expect a considerable shift in the retirement age. Advancing it five years would make a lot of difference. There may be
times when it could be reduced” (p.8) Williamson and Myers, 1937
“Similarly, in the future when there are a great many persons over 65, most of the able-bodied individuals will and should continue
working to age 70 or 75 if their services seem needed” (p 18)
Source: Olshansky et al., 2014. Resetting Social Security: What is Fair? MacArthur Foundation Research Network on an Aging Society. (in preparation)
working to age 70 or 75 if their services seem needed” (p.18)Myers, 1938
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Olshansky et al., 2014. Resetting Social Security: What is Fair? MacArthur Foundation Research Network on an Aging Society. (in preparation)
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Figure 1. Observed and hypothetical full retirement ages indexed to life expectancy at age 65 (U.S., 1935, 1983, 2010)
Olshansky et al., 2014. Resetting Social Security: What’s Fair? MacArthur Foundation Research Network on an Aging Society. (in preparation)
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Figure 2. Hypothetical full retirement ages indexed to life expectancy at age 65 for White Females by Level of Completed Education, 2010
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The Next Health and Longevity Revolution is Forthcoming
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Redesign / Replace Body Parts Already in Existence
BRAIN TRANSPLANT
ONE ORGAN WE WILL HAVE A DIFFICULT TIME “FIXING”
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Sex and trait selection
Modifying the Underlying Biology of Humans
Germ line modification
Therapeutic cloning
Genetic engineering to treat or eliminate diseases
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Exciting Advances in gBiomedical TechnologyPersonalized Medicine
Person 1: 5.5 mg. of medicine X
Person 2: 6.2 mg. of medicine X
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Reducing the risk of fatal diseases by
treating them as if they are independent of
each other may extend ythe period of old age.
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Daniel Perry Richard A. Miller Robert N. Butler
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July, 2008
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LDI Leading Organizations / Research Advisory Committee
Affiliated Research Institutions and Universities
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The Private Sector
Source: New York Times, September 16, 2013.
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Frailty/Sarcopenia
AGING BIOLOGY IS AT THE CORE OF CHRONIC DISEASES
Diabetes
Cancer
CKD
Neurodegenerative
AGINGFrailty
Resilience
Stroke
CVDHIV/AIDS
Menopause
COPD/ Pulmonary Fibrosis
Arthritis/Osteoporosis
Blindness
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Do We Need to Know in Advance Which Scientific Pathways to the Longevity Dividend Will Work?
Genetics of long-lived people
Caloric restriction
Compounds with properties that appear to slow aging
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LDI Primary Goals
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300 Word Video
