Abstract
BackgroundRecent life expectancy gains in high-income Asia-pacific countries have been largely the result of postponement of death from non-communicable diseases in old age, causing rapid demographic ageing. This study compared and quantified age- and cause-specific contributions to changes in old-age life expectancy in two high-income Asia-pacific countries with ageing populations, South Korea and Japan.MethodsThis study used Pollard’s actuarial method of decomposing life expectancy to compare age- and cause-specific contributions to changes in old-age life expectancy between South Korea and Japan during 1997 and 2017.ResultsSouth Korea experienced rapid population ageing, and the gaps in life expectancy at 60 years old between South Korea and Japan were reduced by 2.47 years during 1997 and 2017. Decomposition analysis showed that mortality reductions from non-communicable diseases in South Korea were the leading causes of death contributing to the decreased gaps in old-age life expectancy between the two countries. More specifically, mortality reductions from cardiovascular diseases (stroke, ischaemic and hypertensive heart disease) and cancers (stomach, liver, lung, pancreatic cancers) in South Korea contributed to the decreased gap by 1.34 and 0.41 years, respectively. However, increased mortality from Alzheimer and dementia, lower respiratory tract disease, self-harm and falls in South Korea widened the gaps by 0.41 years.ConclusionsAge- and cause- specific contributions to changes in old-age life expectancy can differ between high-income Asia-pacific countries. Although the gaps in old-age life expectancy between high-income Asia-pacific countries are primarily attributed to mortality changes in non-communicable diseases, these countries should also identify potential emerging threats of communicable diseases and injuries along with demographic ageing in pursuit of healthy life years in old age.
Highlights
Recent life expectancy gains in high-income Asia-pacific countries have been largely the result of postponement of death from non-communicable diseases in old age, causing rapid demographic ageing
This study focuses on population data between 1997 and 2017 and observes (1) age structural changes; (2) age-standardised mortality rates; and explores (3) age- and cause-specific contributions to increasing life expectancy at 60 years in South Korea and Japan and (4) age- and cause-specific contributions to decreasing gaps in life expectancy at 60 years between South Korea and Japan
The study showed that age- and causespecific contributions to the changes in old-age life expectancy differed in the two high-income Asiapacific countries, and the result revealed that the decreasing gaps between the two countries were largely
Summary
Recent life expectancy gains in high-income Asia-pacific countries have been largely the result of postponement of death from non-communicable diseases in old age, causing rapid demographic ageing. Recent comparative studies of life expectancy and causes of death between high-income Asia-pacific countries showed that causes of death contributing to the changes in life expectancy can differ between them [5,6,7]. Previous studies have substantially concentrated on life expectancy at birth, but this approach may not necessarily correspond to life expectancy at an older age, or may overlook different mortality trajectories among the elderly population in high-income Asia-pacific countries. This study provides new insights into the gaps in old-age life expectancy between high-income Asia-pacific countries in an era of global population ageing
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