Life Expectancy and Longevity

So you want to go to a nursing home

If you want to increase your chances of going to a nursing home, you should

Happiness and health

What are the major factors that might make you happy or unhappy?  A combination of several studies all boil happiness down to the following six characteristics:

Three ways to become a centenarian

Tom Perls of the New England Centenarian Study has studied more centenarians than anyone else.  He divides centenarians into three groups:

1. The escapers, the people who reach age 100 with no signs of disease.
2. The survivors, the people who have beaten a heart attack or cancer and survived anyway. 
3. The delayers, the people who postpone serious disease until sometime after age 85.  I posit that our current focus on preventive medicine will increase this pool of people substantially in the near future.  For example, the 55-year old who treats their high cholesterol and high blood pressure may not ever suffer a heart attack--that is why we are taking those pills, isn't it?

All of this matters because, according to the Society of Actuaries Living to 100 Conference in 2005, the group of centenarians is growing 4.1% per year right now.   

Tom also notes "The only you are, the healthier you have been." 

 

Age 65? Write a personal business plan

Thoughts worth contemplating:

Why do we give special significance to "age 65?"   How old would you be if calendars had not been invented?  Are you suddenly "old" because the calendar says you are 65?  Or are you "old" when you become too old to do the things you want to do--which may not occur until age 80 or 85?   Or, as the baseball great, Satchel Paige, is reported to have said, "How old would you be if you didn't know how old you wus?"

Does our Social Security and corporate retire-at-65 mentality push people to a "benign obsolescence?"  If it does, should it or, more importantly must it?   

The statement "if you don't control your own destiny, someone else will" applies equally to how we age.  A good plan and hard work are required to avoid the fickle mutabilities or vicissitudes of age.   You need to control your aging destiny:  Do you have a plan to stay physically fit and active, to prevent disease and disability, to engage socially and mentally, and to live well as long as you alive? 

If you are what you do, who are you when you don't?   Neither a mandatory nor an involuntary retirement means that you are obligated to disengage from life.   Jack LaLane's famous statement, "We do not get old from doing too much; we get old from doing too little," applies as much to social, mental, and meaningful activities as it does to physical fitness.

Five years before you retire, write a five-year business plan for yourself--and then update it every year thereafter.  Write three sentences: Who you want to be and where you want to be and what you want to be doing in five years.  Identify the road blocks and plan how you will get around them, identify new skills you need or want to learn.  Yes, it sounds exactly like the reasons that you quit the corporate world, but writing a personal five-year is essential. 

       

   

The future of 65-year olds is not homogenous

The future of 65-year olds is not homogeneous.  The health of 65-year olds is more divergent than at any prior age.

• The energizer bunnies live healthful lives and have a low risk of future disease.  They also have the greatest chances of living an active and very long life.
• Some have average health with some disease or untreated risk factors for disease, poor fitness, and a mediocre diet. This group will likely experience what we all think of as "normal aging."
• The Dearly Departed (actually the "too-soon departed" but I prefer alliteration), a frankly unhealthy group with either current disease or high risk factors for future disease. They either have type-2 diabetes, obesity, are smokers, or were unlucky enough to get a bad disease despite their best efforts. This group will have the worst future life with the most disability, require the most medical resources, and die the soonest. 

We need to understand these three groups because their futures, health care needs, definitions of satisfaction are widely different.  I believe that looking only at the "normal" and the "successful" misses the important (and disastrous) "much-less-than-healthy group." Dr. Robert Butler of the International Longevity Center uses the phrase "shortgevity" to describe this group.  In future blogs, I will start to define and differentiate these three groups, their life expectancy, heath problems, risk factors, outcomes, and costs.  We should all understand the health care and social costs of all of our society.

Only some will find their aging to be successful.  Stay tuned, this blog will help guide us to the success part of the equation.  Dr. Bob

What is successful aging?

Successful aging may be a goal of every 65-year old, but, realistically, will be achieved by only some.   We need to define and understand what we mean by "successful aging" and how it is different than "normal aging."  Clearly, aging is more than just health

Look at this article in the the British Medical Journal, the book Successful Aging by Rowe and Kahn and The Berlin Ageing Study by Baltes and Mayer.  Rowe and Kahn distinguish between "normal aging" and "successful aging" with minimal loss of age-related function for a prolonged time until a compressed period of age-related decline.

My list or requirements for successful aging is below.  I will look at each of these in some detail in future blogs.  Successful aging requires ongoing:

1. Good physical and mental health   
2. Physical fitness
3. The ability to live independently
4. Having meaning or significance or purpose to your life
5. An active and meaningful social life with family and friends
6. A balance between who you think you are and who you actually are
7. The ability and willingness to enjoy life
8. Happiness and a sense of humor
9. Ongoing learning
10. Financial security   

What is the most interesting thing that you notice about my list?  To me, the most interesting detail is that the medical piece is only one of ten items; all of the others are psycho-social-community. 

Our historical focus on the medical-illness side of old age has fostered a focus on the sick elderly in contrast to the many who age successfully.   

Stay tuned, this is going to get interesting as we start to differentiate success from normal or worse than normal. 

Dr. Bob   

How long will you live?

A successful retirement has three legs: knowing your personal financial picture, your personal life expectancy, and a personal plan on what will give you meaning in retirement. 

You can start with this simple personal and classic financial statement.  In a future blog, I will write to remind you of things that you might not have thought of including like the annuitized value of social security payments.  but for now, it is a start. 

To get a quick look at your life expectancy, go to the simple but accurate Northwestern Mutual Longevity Game (and yes, I am a primary author) or the MSN calculator.  There are many others if your search for "life expectancy calculator" but some of them link to sites selling product and others take 30 minutes, too long as far as I am concerned.  The first two linked above will give you a very good estimate. 

And, lastly, I can not find a website to help you figure out what will give your  life meaning when you retire.  If you know of one let me know.  But you should as much or more attention on this third component as the first two. 

Stay well, spend less than you earn, and find meaning.

Dr. Bob   

A Mediterranean Diet and Healthy Lifestyle Help the Elderly

A recent ten-year study of 2339 Europeans between ages 70 and 90 strongly supports the benefits of a health promoting diet and lifestyle. There were 935 deaths in the group so it was statistically significant.

The table below summarizes the health benefit of a healthy lifestyle choice compared to the less healthy alternative:

Those who:		Lowered their risk of death compared to		Those who
Ate a Mediterranean diet		Had a 23% lower risk of death		Ate a Western diet
Had any alcohol intake		Had a 22% lower risk of death		Did not drink
Did moderate physical activity		Had a 37% lower risk of death		Were sedentary
Did not smoke		Had a 35% lower risk of death		Smoked
Did all of the above		Had a 65% lower risk of death

The proof is in the living, even the elderly living.

Reference: Knoops KTB Mediterranean diet, lifestyle, factors, and 10-year mortality in elderly European men and women: the HALE project, Journal of the American Medical Association, September 2004, p. 1433.

Living to 100 - Will Life Expectancy Continue to Improve?

Life expectancy from birth for the average American has increased 120 days every single year since 1870.  The American life expectancy has skyrocketed from 47 years in 1900 to 78 years in 2004.

The real question is whether these gains will continue? And, if so, will we continue to see fewer deaths at young ages or fewer deaths at middle or older ages. One pattern will give us more people about the same age as today and the other will give us more exceptionally old people.

The improvement in life expectancy can be broken into two major historical segments. From 1900 to 1950, most of the gain in life expectancy was due to a sharp drop in deaths in the first few decades of life due to the public health improvements such as sanitation, better housing, refrigeration, vaccines. Since 1950, most of the improvements in life expectancy have occurred in people over age 50 due to substantial improvements in health care, newer medications, less smoking, and more preventive health measures.

The question is whether these improvements will continue or flatten? This is no small matter: both the social security payment calculations and your pension or 401K withdrawal are based on knowing the answer to this question.

Some experts look at the data and the trend line and conclude that the improvement in life expectancy will continue because the pace of preventive medicine and medical discovery is continuing. Others look at the same data and say that the improvements will slow because we are at the limit of new medical therapies. And some, look at the obesity epidemic and see a reversal of life expectancy.

I believe life expectancies America will be divided into two distinct groups. The first group will have a distinctly shorter life expectancy. This group includes primarily those people, including tragically the children, in the new obesity, sedentary, and diabetes epidemic. The obesity epidemic will be followed by a shocking diabetes and cardiovascular disease epidemic in about 20 years.

On the other hand, the people who know what healthy people know, will have a long life span. These people will have less disease even when they are old or old-old. These healthy, take-care-of-themselves people will continue to push the frontiers of life expectancy. And in this group are those will live to exceptional old age in good health. Live well to live long.

Dr. Bob says: The longer you live, the healthier you have been.

How long will a 65-year old live?

I recently presented at the Society of Actuaries Living to 100 Symposium. The symposium was about the fastest-growing age group in America: centenarians.

The conference focused my thinking on the idea that many of us will live longer, much longer, than we think. Anna Rappaport, FSA, one of the lead presenters at the conference, showed a slide which caught my attention.

Her slide indicated that many of us will stay together for a long time. A 65-year-old couple today has:

• 43% chance that will both people will be alive at age 80
• 6% chance that both will still be alive at age 90,
• 89% chance that one of the two will live at age 80,
• 48% chance that one of the two will live to age 90, and
• 6% chance that one of the two will live to age 100.

This does not mean that we each have a 6% chance of living to 100. It means only that one of two people both age 65, has a 6% chance of living to 100. But that is still a big number in my book.

We all need to start to think about living longer. This information is vital to understand as we all begin to plan the rest of your life.