Transcript Demography of Aging

Demography of Aging
Chapter 2
Demography
The statistical study
of
human populations
especially with reference to:
Size
&
Density distribution
Vital statistics (epidemiology: births, deaths, diseases)
Percent Surviving
Survival Curves for U.S. Population, 1900 to 2002
100
2002
80
1950
1900
60
40
20
0
0
10
20
30
40
50
60
70
80
90
100
Age
Source: Arias E. United States Life Tables, 2002. National Vital Statistics Reports; vol. 53,
no. 6. Hyattsville, MD: National Center for Health Statistics, 2004.
Probability of 50 year old living to
90, 1900 to 2002
30
26.6
25
20
Percent
15.2
15
Men
Women
9.6
10
5
2.7
3.8
5.0
0
1900
1950
2002
Source: Computed from U.S. life tables in: Arias E. United States life tables, 2002. National
vital statistics reports; vol. 53, no. 6. Hyattsville, MD: National Center for health Statistics, 2004.
Figure 2.1: Life expectancy at birth by sex, France 1806-1997
Increase in Average Life Expectancy in Years
in Some Countries, 1950-1995, Total (MF)
Developed Countries
Developing Countries
Japan
15
China
30
Italy
11
Turkey
24
France
10
India
22
United Kingdom
7
Egypt
19
USA
7
Kenya
18
Sweden
6.1
Brazil
15
Argentina
9
Life expectancy and infant mortality throughout human history
Life expectancy Infant mortality rate
at birth (years) (per 1000 live births)
Prehistoric
20-35
200-300
Sweden, 1750s
37
210
India, 1880s
25
230
U. S., 1900
48
133
France, 1950
66
52
Japan, 1996
80
4
Proportion of population aged 0-14 versus 65+(In Italy)
Figure 2.5: Maximum life span in Sweden
Annual number of
females reaching 100
years in the North
European countries
Number of centenarians
per million inhabitants in
Denmark (1800-1994)
Centenarians:
USA 1990: Harvard University started New England Centenarian Study
(JAMA 288:18 p. 2247, 2002).
Data from this study refute the idea that aging represents an inexorable
march…characterized by a steady decline.
Rather, centenarians are generally in very good health.
They are either:
- Escapers “People who have escaped any disease”
- Late onset of disease, 85+
- Early onset of disease which was overcome
JAPAN 2004: Reports identify
- SSC (Semi-Super Centenarians), age 105+ years.
- SC (Super Centenarians), 110+ years
In both groups, alterations in the gene coding for I / IGF-1 receptor
Dr. John Wilmoth
Christian Mortensen
1882-1998
Average Lifespan at Birth for Females, 1990-1995
and Lifespan Differential in Years
Developed Countries
F-M
Japan
82
6
Sweden
81
6
Italy
80
6
France
81
8
United Kingdom
77
5
USA
80
7
USSR (previous)
75
10
Developing Countries
Argentina
75
China
73
Turkey
70
Brazil
69
Egypt
63
India
61
Kenya
61
7
3
5
6
2
1
4
Probable causes for longevity in
favor of women:
• Genetic (XX vs. XY) or Environmental (geography,
country, income)
• Other causes:
Lesser life stress in females
Less smoking
Protective action of estrogens?
Lesser accumulation of mDNA deletions/mutations with
better protection against oxidative damage
Others?
Implication for prevention and treatment
Older women whose parents survived past age 90 are
generally healthier than women whose parents did
not survive as long. These women …
•
•
•
•
•
overall death rates
die of cardiovascular disease
report a diagnosis of diabetes
mental and mobility limitaions
risk of hip fracture and non-spine fractures*
• have higher self-rated quality of life
• have faster walking speed and better measures of grip strength
*reduced fracture risk seen for maternal, but not paternal
survival past age 90
Data from the Study of Osteoporotic Fractures (SOF), Peggy Cawthon
Survival of Female Offspring (65+ years) from
Cardiovascular Disease Death based on
Maternal Longevity
100
%
Survival
95
90
HR=0.78, p=0.001
85
80
Mother died before age 90
Mother survived past age 90
0
2
4
6
8 10 12 14 16
Follow-up time from study entry (years)
Women whose mothers survived past age 90 had an approximately
20% lower risk of cardiovascular disease death compared to
women whose mothers did not live as long
Data from the Study of Osteoporotic Fractures (SOF), Peggy Cawthon