You May Be Younger Than You Think
For: Wellness
Made Easy, April 2003
The U.S. probably has the highest proportion of centenarians in the world. It's expected that the number of American 100-year-olds will have doubled during the 1990s, from about 37,000 to 72,000 (more than 80% of them women). And the number will keep doubling every decade, according to conservative estimates, with at least one million centenarians by 2050. This, of course, is a small fraction of our population, but it points out an important trend: there is a boom in very old Americans. And much of the conventional wisdom about them is wrong.
This century has seen life expectancy in the U.S. go from 47 to nearly 77 years—an increase of 30 years. People in about a dozen industrialized countries live longer than Ameri-cans, based on life expectancy at birth. But once Americans reach age 80, they live longer, on average, than their counterparts in other countries. According to a 1996 study, the average white American 80-year-old woman lives an additional 9 years, and her male counterpart, 7 years—about a year longer than 80-year-olds in Sweden, France, Japan, and England. Death rates actually slow down after age 80 in the U.S.
Why do older Americans live longer than European or Japanese people the same age? American life expectancy at birth is lowered by a relatively high infant mortality rate and higher death rates until middle age. After that Americans do better—for reasons that remain unclear—especially over age 80. That helps explain the boom in 100-year-olds.
Will increasing survival rates at advanced ages mean increased disability and frailty and perhaps a bankrupt Medicare system? Not necessarily, according to some demographers, who point out that rates of disability and illness among those over 65 have dropped significantly since the 1980s. Most people in their eighties report no serious disabilities, and in fact are far more vigorous and healthier than their parents and grandparents were at the same age. Annual health costs actually drop among the oldest old. Recent studies suggest that people who live to be over 90 or 95 tend to stay relatively healthy nearly until the end of their lives, and have a rapid decline toward death.
More years: for better and worse
The task of estimating current and future life expectancy (see box at right) is politically charged and of great interest to a range of policy makers, along with the rest of us. It will affect how we, as individuals and as an aging nation, plan for the future and allocate our resources. If huge numbers of people live to 90 or 100, how will they pay for their health care? How will Social Security survive? Will there be enough nursing homes? How will families be affected by the additional caregiving responsibilities? What will happen to the employment prospects of younger adults?
As life expectancy grows, there may be added decades of healthy, productive life, and many people may wish, or need, to work way past 65. If so, they will probably need some form of ongoing education so they can keep up with the advances and changes that have occurred since they got out of school. It's the beginning of another lifetime.
Last words: These facts may
encourage you to think differently about your future possibilities. Having
a long-lived sibling or parent improves your odds of reaching 90. But
while living to a ripe old age undoubtedly depends in part on "good"
genes and other forms of luck, life-style choices over the decades also
play an important role. It's never too late to improve your diet and exercise
habits and to quit smoking.Monitor your cardio-vascular health, especially
your blood pressure. Stimulate your mind, too: being involved with people
and the world around you can help keep your mind and body healthy.
This could be a self-fulfilling prophecy: if people think they have a
good chance to live longer and in better health, they are likely to take
measures to achieve it—that is, take better care of themselves.
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Is life expectancy today really 96? Forecasting life expectancy has always been as much guesswork as
science. There are alternative ways to compute it, each depending
on a range of assumptions (for instance, about progress in medicine
and public health). In recent decades the official estimates for
Americans have consistently turned out to
be low. For instance, if you were born in 1935, your expected
life-span was about 60, and here you are at 65, with an official
expectancy of at least 17 more years! Part of this is due to the
large, unpredicted drops in deaths from heart disease, stroke, many
infectious diseases, and accidents in this country. The Census Bureau now estimates life expectancy at birth to be
79 for a girl and 74 for a boy. The Bureau does speculate about
future trends (for instance, it projects that life expectancy will
increase about seven years by the year 2050). But it assumes that
it will be hard for recent declines in mortality rates to continue. Some leading longevity experts believe that the Bureau's estimates
for the future are too low. Mortality rates here have declined 1%
to 2% per year for the past 30 years, and the average life expectancy
has increased about two years each decade. If such trends continued,
a girl born today in the U.S. would live, on average, to 96, and
a boy, to 90. One out of every three newborn girls and one out of
every ten boys would live to be 100. About 40 million Americans
would be 85 or older by the year 2050 (compared to about 4 million
today). Such estimates are admittedly among the rosiest and may well be overly optimistic. No one knows, for one thing, if the scientific advances of the past decades will continue. No one knows what the maximum attainable human life span is and whether we will soon reach a plateau in life span. Moreover, some kind of natural or political disaster or war could dramatically increase death rates, as in Russia today. |
UC Berkeley Wellness Letter, January 2000