Cohort Life Expectancy Research Articles

Addressing the life expectancy gap in pension policy

Understanding the systematic relationship between period and cohort life expectancy and how the relationship evolves over time are critical issues in formulating the design of retirement income products, evaluating the actuarial balance of pension schemes, and more generally for all analyses where demographic projections are involved. In this study, estimates of the life expectancy gap at all ages are performed using data for 1960–2018 from the Human Mortality Database and projections are generated through 2050 for the 42 national populations, disaggregated by sex. Contrary to previous research that often uses a single deemed to be «best» model to forecast mortality rates, we use a novel adaptive Bayesian Model Ensemble of heterogeneous parametric generalized age-period-cohort stochastic mortality models, principal component methods, and smoothing approaches. The procedure involves both the selection of the model confidence set and the determination of optimal weights. Model-averaged Bayesian credible prediction intervals are derived accounting for both the uncertainty arising from model error and parameter uncertainty. With intergenerational actuarial fairness and neutrality as the guiding principles the study then explores potential policy interventions to address the consequences of the life expectancy gap - spanning over adjustments in the accumulation, benefit determination, and payout stages. Comprehensive numerical results are provided for two policy options: (i) introducing a sustainability factor; and (ii) conditional pension indexation. The results show that: (i) the life expectancy gap is positive and significant for almost all countries and years studied, (ii) it will continue to increase, (iii) the magnitude of the subsidy rates between generations can be sizeable demanding important initial pension benefit reduction and/or a gradual diminution in the annual indexation rate of pensions to correct them.

Intergenerational Actuarial Fairness When Longevity Increases: Amending the Retirement Age

Continuous longevity improvements and population ageing have led countries to modify national public pension schemes by increasing the standard and early retirement ages in a discretionary, scheduled, or automatic way, and by making it harder for people to retire prematurely. To this end, countries have adopted alternative retirement age strategies, but our analyses show that the measures taken are often poorly designed and consequently misaligned with the pension scheme’s ultimate goals. In addition, our analyses demonstrate that countries risk falling short of their goals given their use of projection methods that underestimate life expectancy. This paper discusses how to implement automatic indexation of the retirement age to life expectancy developments while respecting the principles of intergenerational actuarial fairness and neutrality among generations. We show that in policy designs in which extended working lives translate into additional pension entitlements, the pension age must be automatically updated to keep the period in retirement constant. Alternatively, policy designs that pursue a fixed replacement rate are consistent with retirement age policies targeting a constant balance between active years in the workforce and years in retirement. The empirical strategy employed to project the relevant cohort life expectancy uses a Bayesian Model Ensemble approach to stochastic mortality modelling to generate forecasts of intergenerationally and actuarially fair pension ages for 23 countries and regions from 2000 to 2050. The empirical results show that the pension age increases needed to accommodate the effect of longevity developments on pay-as-you-go equilibrium and to reinstate equity between generations are sizeable and well beyond those employed and/or legislated in most countries. A new wave of pension reforms may be at the doorsteps.

A large decrease in the magnitude of seasonal fluctuations in mortality among elderly explains part of the increase in longevity in Sweden during 20th century

BackgroundMortality rates are known to depend on the seasons and, in temperate climates, rates are highest during winter. The magnitude of these seasonal fluctuations in mortality has decreased substantially in many countries during the 20th century, but the extent to which this decrease has contributed to the concurrent increase in life expectancy is not known. Here, I describe how the seasonality of all-cause mortality among people ages 60 years or more has changed in Sweden between 1860 and 1995, and investigate how this change has contributed to the increase in life expectancy observed during the same time period.MethodsYearly sex-specific birth cohorts consisting of all people born in Sweden between 1800 and 1901 who reached at least 59 years of age were obtained from a genealogical database. The mortality rates for each cohort were modeled by an exponential function of age modulated by a sinusoidal function of time of year. The potential impact of seasonal fluctuations on life expectancy was investigated by a novel decomposition of the total mortality rate into a seasonal part and a part independent of the seasons. Cohort life expectancy at age 60 was used to quantify changes in lifespan during the time period.ResultsThe magnitude of seasonal fluctuations in mortality rates decreased substantially between 1860 and 1995. For cohorts born in 1800, the risk of dying during the winter season was almost twice that of dying during summer. For cohorts born in 1900, the relative increase in winter mortality was 10%. Cohort life expectancy at age 60 increased by 4.3 years for men and 6.8 years for women, and the decrease in seasonal mortality fluctuations accounted for approximately 40% of this increase in average lifespan.ConclusionBy following a large number of extinct cohorts, it was possible to show how the decrease in seasonal fluctuations in mortality has contributed to an increase in life expectancy. The decomposition of total mortality introduced here might be useful to better understand the processes and mechanisms underlying the marked improvements in life expectancy seen over the last 150 years.

Private Information and Misinformation in Subjective Life Expectancy

Good retirement planning requires accurate estimation of the time horizon, that is, the lifespan. People may overestimate or underestimate their lifespan and, as a result, under- or over-save for their retirement. Determining to what extent a person overestimates or underestimates their lifespan requires the separation of private information (e.g. family longevity history) and misinformation (e.g. misperception of one’s related cohort life expectancy). This paper proposes a method to identify and separate the effects of private information and misinformation on one’s subjective life expectancy. The method requires the person to provide their subjective life expectancy estimations for not only themselves but also for their peers. We apply the method to a sample of about 700 Chinese adults aged 40 and above. We find that misinformation leads the respondents to overestimate their remaining lifespan by 18% on average. We also find that private information leads the respondents in our sample to believe that their remaining lifespan will be 12% longer on average than their peers of the same age and gender. However, the dispersion of the individual estimates is large, meaning that some people may significantly overestimate their lifespan while others significantly underestimate. Also, as age increases, the relative importance of private information in the subjective life expectancy increases as compared to misinformation.

Getting life expectancy estimates right for pension policy: period versus cohort approach

AbstractIn many policy areas it is essential to use the best estimates of life expectancy, but it is vital to most areas of pension policy. This paper presents the conceptual differences between static period and dynamic cohort mortality tables, estimates the differences in life expectancy for Portugal and Spain, and compares official estimates of both life expectancy estimates for Australia, the United Kingdom, and the United States for 1981, 2010, and 2060. These comparisons reveal major differences between period and cohort life expectancy in and between countries and across years. The implications of using wrong estimates for pension policy, including financial sustainability, are explored.

Killing off cohorts: Forecasting mortality of non-extinct cohorts with the penalized composite link model

Mortality forecasting has crucial implications for insurance and pension policies. A large amount of literature has proposed models to forecast mortality using cross-sectional (period) data instead of longitudinal (cohort) data. As a consequence, decisions are generally based on period life tables and summary measures such as period life expectancy, which reflect hypothetical mortality rather than the mortality actually experienced by a cohort. This study introduces a novel method to forecast cohort mortality and the cohort life expectancy of non-extinct cohorts. The intent is to complete the mortality profile of cohorts born up to 1960. The proposed method is based on the penalized composite link model for ungrouping data. The performance of the method is investigated using cohort mortality data retrieved from the Human Mortality Database for England & Wales, Sweden, and Switzerland for male and female populations.

MP59-15 TUMOUR-BEARING KIDNEYS AS POTENTIAL TRANSPLANT DONORS : A NATIONAL ONLINE UK SURVEY

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery III (MP59)1 Apr 2020MP59-15 TUMOUR-BEARING KIDNEYS AS POTENTIAL TRANSPLANT DONORS : A NATIONAL ONLINE UK SURVEY Matthew Trail*, Ali Thwaini, Wesam Elbaroni, Aisling Courtney, Tim Brown, Ghulam Nabi, David Cranston, David Nicol, and Zeeshan Aslam Matthew Trail*Matthew Trail* More articles by this author , Ali ThwainiAli Thwaini More articles by this author , Wesam ElbaroniWesam Elbaroni More articles by this author , Aisling CourtneyAisling Courtney More articles by this author , Tim BrownTim Brown More articles by this author , Ghulam NabiGhulam Nabi More articles by this author , David CranstonDavid Cranston More articles by this author , David NicolDavid Nicol More articles by this author , and Zeeshan AslamZeeshan Aslam More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000928.015AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The deficiency in available donor organs for patients with end-stage renal failure (ESRF) awaiting renal transplantation is an increasingly important global health issue. In the UK, 4757 adult patients were awaiting renal transplant as of 2018. Meanwhile, 3272 transplant procedures were performed that year and 1200 patients died whilst awaiting transplant. To address the deficiency in donor organs, novel organ donor sources have been suggested and trialled - including transplantation of kidneys with small renal tumours (cT1) after ex-vivo tumour excision and histopathology confirming benign or low grade disease with clear margins. According to the British Association of urological Surgeon’s (BAUS) national audit, up to 7700 nephrectomy operations are performed each year in the UK, 2900 of which are for cT1 renal cancer. In existing studies which have trialled this concept, reported outcomes were positive, with neglible tumor recurrence and a high graft and patient survival. We explored the acceptability amongst UK clinicians of the consideration of utilising cT1 tumour-bearing kidneys as potential organ donors after ex-vivo tumour excision with pathology confirming benign or low grade disease and clear margins. METHODS: An online survey of UK urologists with an interest in renal surgery, transplant surgeons and transplant nephrologists was carried out between November and December 2018 to establish clinician attitude towards accepting such kidneys for transplantation in a carefully-selected group of dialysis-dependent patients which includes elderly patients, those in whom dialysis is poorly tolerated, those having difficulties finding a match or those with significant comorbidity. Reported outcomes were positive, with a high graft and patient survival. RESULTS: In all, 110 urologists, 50 transplant surgeons and 70 nephrologists were approach, with a response rate of 57%, 66% and 63% respectively. We identified six centres within the UK currently performing this procedure.Forty five (73%), 20(55%) and 30(91%) of the urologists, nephrologists and transplant surgeons respectively supported the concept of using these kidneys for selected transplant recipients. However, questions were raised – with some respondents with some expressing concern regarding the potential for higher recurrence risk in immunosuppressed post-transplant patients. CONCLUSIONS: This survey has demonstrated an interest for this concept amongst clinicians directly involved with renal cancer surgery or renal transplantation throughout the UK. Whilst associated ethical and logistical challenges must be carefully considered, widespread adoption of this concept may have potential to reduce waiting list burden and increase life expectancy in a specific cohort of patients awaiting renal transplantation. In light of the responses to this survey and existing studies which have demonstrated positive outcomes, there may be potential to establish a national clinical trial to investigate this concept further. Source of Funding: Nil © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e886-e886 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Trail* More articles by this author Ali Thwaini More articles by this author Wesam Elbaroni More articles by this author Aisling Courtney More articles by this author Tim Brown More articles by this author Ghulam Nabi More articles by this author David Cranston More articles by this author David Nicol More articles by this author Zeeshan Aslam More articles by this author Expand All Advertisement PDF downloadLoading ...

Reflection on modern methods: cause of death decomposition of cohort survival comparisons.

Life expectancy is most commonly measured for a period (corresponding to mortality within a given year) or for a specific birth cohort. Although widely used, period and cohort life expectancy have limitations as their time-trends often show disparities and can mask the historical mortality experience of all cohorts present at a given time. The truncated cross-sectional average length of life, or TCAL, is a period measure including all available cohort mortality information, irrespective of whether all cohort members have died. It is particularly useful for comparing cohort mortality between populations. This study extends TCAL by disentangling causes of death contributions. The strength of the approach is that it allows identification of mortality differences in cohorts with members still alive, as well as identification of which ages and causes of death contribute to mortality differentials between populations. Application of the method to Japan shows that over the period 1950-2014 a major contributor to TCAL differences with other high-longevity countries was its lower cardiovascular disease mortality.

Adolescence and Gender Equality in Health

Adolescence and Gender Equality in Health

Reproductive suppression and longevity in human birth cohorts.

Reproductive suppression refers to, among other phenomena, the termination of pregnancies in populations exposed to signals of death among young conspecifics. Extending the logic of reproduction suppression to humans has implications for health including that populations exposed to it should exhibit relatively great longevity. No research, however, has tested this prediction. We apply time-series methods to vital statistics from Sweden for the years 1751 through 1800 to test if birth cohorts exposed in utero to reproductive suppression exhibited lifespan different from expected. We use the odds of death among Swedes age 1 to 9 years to gauge exposure. As the dependent variable, we use cohort life expectancy. Our methods ensure autocorrelation cannot spuriously induce associations nor reduce the efficiency of our estimates. Our findings imply that reproductive suppression increased the lifespan of 24 annual birth cohorts by at least 1.3 years over the 50-year test period, and that 12 of those cohorts exhibited increases of at least 1.7 years above expected. The best available data in which to search for evidence of reproductive suppression in humans support the argument that populations subjected to environments dangerous for children yield birth cohorts that exhibit unexpectedly great longevity.

Age and cohort trajectories of gender inequality in health among elderly people in China

ABSTRACT Using a multistate model, this article examines gender gap and its trend in health transition, life expectancy (LE), and active life expectancy (ALE) in different age groups and birth cohorts. The transition rate from life independence/disability to death for elderly women is lower than for elderly men. However, their disability rate is higher. The gender gap in LE, ALE, and DLE (disabled life expectancy) declines as age increases. In successive birth cohorts, men’s LE increases more, and gender gaps in LE and ALE decrease over time. In the future, gender issues should be considered for health-care policy to provide nursing care for elderly women in China.

Tracking progress in mean longevity: The Lagged Cohort Life Expectancy (LCLE) approach

Cohort life expectancy is an important but rarely used indicator of mean longevity. In this paper, we show that there are specific advantages in lagging this indicator in time by its own value, an approach termed Lagged Cohort Life Expectancy (LCLE). We discuss the usefulness of LCLE as an indicator for tracking progress in mean longevity and introduce a new interpretation of LCLE as a reference age separating ‘early’ deaths from ‘late’ deaths, or, equivalently, as the age above which individuals in a population can be considered ‘above-average’ survivors. Using data from 15 countries in the Human Mortality Database, we show that current LCLE can be estimated with a relatively high degree of certainty, at least in these low-mortality populations. Results shed new light on levels and trends in mean longevity in these populations.

NDC Schemes and Heterogeneity in Longevity: Proposals for Redesign

A positive relationship between lifetime income and life expectancy leads to a redistribution mechanism when the average cohort life expectancy is applied for annuity calculation. Such a distortion puts into doubt the main features of the NDC (nonfinancial defined contribution) scheme and calls for alternative designs to compensate for the heterogeneity. This paper explores five key mechanisms of compensation: individualized annuities; individualized contribution rates; a two-tier contribution structure with socialized and individual rates; and two supplementary two-tier approaches to deal with the income distribution tails. Using unique American and British data, the analysis indicates that both individualized annuities and two-tier contribution schemes are feasible and effective and thus promising policy options. A de-pooling by gender will be required, however.

Early clinical and hemodynamic results of transcatheter aortic valve implantation using the “MedLab-KT” prosthesis

Background. The obvious expansion of mini-invasive technologies is looming large in surgical treatment of heart diseases. Hundreds of thousands of transcatheter aortic valve replacement procedures have been performed in the world today. The improvement in quality and the increase in life expectancy in cohorts of patients who until recently have been considered inoperable are now routinely achievable. A significant limitation of this method for Russian clinics is the absence of domestic transcatheter implantable prosthetic heart valves on the market. During the last five years, such devices have been developed at “MedEng” (Penza, Russia) scientific and production enterprise. We present the first Russian transcatheter aortic valve prosthesis, its leaflets made of polytetrafluoroethylene, components of the delivery system and implantation, as well as the hospital outcomes of clinical trials. Aim. To evaluate the clinical and hemodynamic results of transcatheter aortic valve implantation using a “MedLab-KT” prosthesis during hospital stay.Methods. A prospective study included 54 patients who underwent transcatheter repair of the aortic valve using a “MedLab-KT” prosthesis. To evaluate the frequency of complications, myocardial infarction, strokes, bleeding, deaths during hospital stay and gradient indices on the prosthesis, postoperative ultrasound examination data were obtained and analyzed. Results. The results are comparable with those achieved by using the foreign models known from literature. Conclusion. The clinical and hemodynamic results of using the “MedLab-KT” aortic valve prosthesis can be considered as satisfactory. Funding: The study had no sponsorship. Conflict of interest: The authors declare no conflict of interest. Authors’ contributionConception and study design: V.V. Bazylev, E.V. Rosseykin, A.B. VoevodinData collection and analysis: A.B. Voevodin, A.S. ZakharovaStatistical analysis: A.B. VoevodinDrafting the article: A.B. VoevodinCritical revision of the article: A.B. VoevodinFinal approval of the version to be published: V.V. Bazylev, A.B. Voevodin, A.S. Zakharova, E.V. Rosseykin ORCID IDV.V. Bazylev, https://orcid.org/0000-0001-6089-9722A.B. Voevodin, https://orcid.org/0000-0002-7078-1274A.S. Zakharova, https://orcid.org/0000-0001-7239-2945E.V. Rosseykin, https://orcid.org/0000-0003-0784-2246

Evaluation of the BASIL Survival Prediction Model in Patients Undergoing Infrapopliteal Interventions for Critical Limb Ischemia

Survival prediction models are clinical tools that help professionals make the best treatment decisions. In the treatment of critical limb ischemia, several scoring methods have emerged; however, many are limited because they are not reproducible in different populations. This study analyze the Bypass versus Angioplasty in Severe Ischemia of the Leg survival prediction model (BASIL SPM), exclusively in patients who underwent infrapopliteal (InfraPo) revascularization for the treatment of critical limb ischemia. In this retrospective cohort, patients who underwent InfraPo interventions during a 4-year period (2009-2013) were consecutively included, according to the primary intervention (endovascular or open repair), irrespective of combined treatment in the femoropopliteal and InfraPo segments. Performance of the BASIL SPM was determined using the area under the curve of the receiver-operating characteristic curve. Additionally, secondary patency, limb salvage, and overall survival were analyzed by the Kaplan-Meier method. The mean follow-up duration was 32.7±23.8months. In the total patient group (n=134), the mean age was 72±8.6years (range, 46-91years), and the main associated comorbidities were hypertension (85.8%) and diabetes mellitus (76.8%). Regarding differences between the groups, patients in the endovascular group (n=100) were older (73 vs. 69.5; P=0.033) and more frequently stratified as high risk (61% vs. 38.2%; P=0.030) than the open repair group (n=34). The area under the curve (95% confidence interval [CI]) using the BASIL SPM at 6, 12, and 24months was 0.499 (95% CI: 0.344-0.657), 0.508 (95% CI: 0.353-0.629), and 0.549 (95% CI: 0.420-0.678), respectively. In the total patient group, the 36-month secondary patency, limb salvage, and overall survival were 31.5%, 81.1%, and 65.9%, respectively. The BASIL SPM was a poor predictor of life expectancy in this patient cohort.

The Effects of Rosmarinus officinalis L. and Salvia officinalis L. (Lamiaceae) Essential Oils on Demographic Parameters of Habrobracon hebetor Say (Hym.: Braconidae) on Ephestia kuehniella Zeller (Lep.: Pyralidae) Larvae

Essential oils are volatile botanical compounds with strong odor that are characterized as plant secondary metabolites. In this research, the effects of Rosmarinus officinalis L. and Salvia officinalis L. (Lamiaceae) essential oils are investigated on demographic parameters of H. hebetor. The gas chromatography-mass spectroscopy (GC-MS) analysis indicates that α-pinene (9.99%) and β-thujone (25.63%) are major constituents of mentioned essential oils, respectively. The bioassay results show that LC50 values for R. officinalis and S. officinalis essential oils are 4.15 and 18.36 μl/liter air, respectively; that, R. officinalis essential oil show high acute toxicity on the female wasps of H. hebetor compared with S. officinalis essential oil. Then, the demographic parameters of this parasitoid wasp are investigated by LC30 treatment of essential oils that are 2.48 and 6.30 μl/liter air for mentioned essential oils, respectively. The sublethal results show that adult longevity, daily and total fecundity and fertility, gross and net reproductive rates, intrinsic rate of increase, finite rate of increase, mean generation time, doubling time, survival rate, probabilities of survival and death in one age to next age, death rate, cohort survival rate and life expectancy are affected negatively by the tested essential oils. Finally, the rm values in the control, R. officinalis and S. officinalis essential oils are obtained 0.274, 0.133 and 0.217 day-1, respectively. This research indicate that S. officinalis essential oil has less toxicity on H. hebetor and recommends as a compatible botanical compound with this biocontrol agent in integrated pest management programs.

Do Japanese and Italian Women Live Longer than Women in Scandinavia?

Life expectancies at birth are routinely computed from period life tables. When mortality is falling, such period life expectancies will typically underestimate real life expectancies, that is, life expectancies for birth cohorts. Hence, it becomes problematic to compare period life expectancies between countries when they have different historical mortality developments. For instance, life expectancies for countries in which the longevity improved early (like Norway and Sweden) are difficult to compare with those in countries where it improved later (like Italy and Japan). To get a fair comparison between the countries, one should consider cohort data. Since cohort life expectancies can only be computed for cohorts that were born more than a hundred years ago, in this paper we suggest that for younger cohorts one may consider the expected number of years lost up to a given age. Contrary to the results based on period data, our cohort results then indicate that Italian women may expect to lose more years than women in Norway and Sweden, while there are no indications that Japanese women will lose fewer years than women in Scandinavia. The large differences seen for period data may just be an artefact due to the distortion that period life tables imply in times of changing mortality.

Getting Life Expectancy Estimates Right for Pension Policy: Period Versus Cohort Approach

In many policy areas it is essential to use the best estimates of life expectancy, but such estimates are vital to most areas of pension policy – from indexed access age and the calculation of initial benefits to the financial sustainability of pension schemes and the operation of their balancing mechanism. This paper presents the conceptual differences between static period and dynamic cohort mortality tables, estimates the differences in life expectancy between both tables using data from Portugal and Spain, and compares official estimates of both life expectancy estimates for Australia, the United Kingdom, and the United States for 1981, 2010 and 2060. This comparison reveals major differences between period and cohort life expectancy in and between countries and across years. Using measures of period instead of cohort life expectancy creates an implicit subsidy for individuals of 30 percent or more, with potentially stark consequences on the financial sustainability of pension schemes. These and other implications for pension policy are explored and next steps suggested.

Potential support ratios: Cohort versus period perspectives

The ‘prospective potential support ratio’ has been proposed by researchers as a measure that accurately quantifies the burden of ageing, by identifying the fraction of a population that has passed a certain measure of longevity, for example, 17 years of life expectancy. Nevertheless, the prospective potential support ratio usually focuses on the current mortality schedule, or period life expectancy. Instead, in this paper we look at the actual mortality experienced by cohorts in a population, using cohort life tables. We analyse differences between the two perspectives using mortality models, historical data, and forecasted data. Cohort life expectancy takes future mortality improvements into account, unlike period life expectancy, leading to a higher prospective potential support ratio. Our results indicate that using cohort instead of period life expectancy returns around 0.5 extra younger people per older person among the analysed countries. We discuss the policy implications implied by our cohort measures.

Beyond three score years and ten: prospects for longevity in Australia

Most estimates and proj ections of life expec tancy are based on period measures. This paper presen tsforecasts of cohort life expectancy for older generations derived using the Lee-Carter method offorecasting mortality. These cohort measures point to more years of life expectancy than thecommonly-cited current period measures. The new forecasts also indicate a more rapid increase infuture life expectancy than official projections assum e. Policy-maker s and those planning re tirementshould take into account that Australians are likely to live longer than currently envisaged