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Human Longevity, Individual
Life Duration, and the Growth
of the Oldest-Old Population

Edited by

JEAN-MARIE ROBINE
University of Montpellier, France

EILEEN M. CRIMMINS
University of Southern California,
Los Angeles, U.S.A.

SHIRO HORIUCHI
Rockefeller University,
New York, U.S.A.

and

ZENG YI
Duke University, Durham, U.S.A.
and Peking University, China
A C.I.P. Catalogue record for this book is available from the Library of Congress.

ISBN 978-1-4020-4847-0 (PB)

ISBN 978-1-4020-4846-3 (HB)
ISBN 978-1-4020-4848-7 (e-book)

Published by Springer,
P.O. Box 17, 3300 AA Dordrecht, The Netherlands.

www.springer.com

Printed on acid-free paper

All Rights Reserved

C 2007 Springer

No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or
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CONTENTS

In Memoriam: Väinö Kannisto ix

Preface xiii

Acknowledgements xv

Introduction 1
Jean-Marie Robine, Eileen Crimmins, Shiro Horiuchi, and Zeng Yi

Section 1. Theoretical and Comparative Biological Concepts

1. Research Issues on Human Longevity 7

Jean-Marie Robine

2. Patterns in Mammalian Ageing: Demography and Evolution 43

Steven N. Austad

3. Life Span Extension in Humans is Self-Reinforcing:

A General Theory of Longevity 57
James R. Carey and Debra S. Judge

Section 2. Empirical and Analytical Studies of Ageing and

Oldest-Old Populations

4. Oldest-Old Mortality in China 87

Zeng Yi and James W. Vaupel

5. Central and Dispersion Indicators of Individual Life Duration:

New Methods 111
Väinö Kannisto

6. Recent Trends in Life Expectancy and Rectangularisation of the Survival

Curve at Advanced Ages in the Netherlands 131
Wilma J. Nusselder

v
vi CONTENTS

7. The Validation of Exceptional Male Longevity in Sardinia 147

Michel Poulain, Giovanni M. Pes, Ciriaco Carru, Luiggi Ferrucci,
Giovanella Baggio, Claudio Franceschi, and Luca Deiana

8. Mortality at Extreme Ages and Data Quality: The Canadian Experience 167
Robert Bourbeau and Bertrand Desjardins

Section 3. Causes of Death and Biological Frailty

9. Causes of Death among the Oldest-Old: Validity and Comparability 191

France Meslé

10. Causes of Death among the Oldest-Old: Age-Related Changes in the

Causes-of-Death Distribution 215
Shiro Horiuchi

11. Genetic Factors Associated with Individual Life Duration: Heritability 237
Kaare Christensen and Anne Maria Herskind

12. Mortality among the Least Frail: Lessons from Research

on the APOE Gene 251
Douglas C. Ewbank

Section 4. Sex, Gender, and Social Determinants and Consequences of Mortality

13. Social Determinants of Mortality in the Oldest-Old: Social Class and

Individual Way-of-Life 271
Marja Jylhä and Tiina Luukkaala

14. Social Differences in Older Adult Mortality in the United States:

Questions, Data, Methods, and Results 297
John R. Wilmoth and Mike Dennis

15. Mortality Differences by Sex among the Oldest-Old 333

Jacques Vallin

Section 5. Causes of the Trend in Mortality and Morbidity

16. Explanation of the Decline in Mortality among the Oldest-Old: The Impact
of Circulatory Diseases 357
Bernard Jeune
 CONTENTS vii

17. Explanation of the Decline in Mortality among the Oldest-Old:

A Demographic Point of View 395
Graziella Caselli, James W. Vaupel, and Anatoli I. Yashin

18. Marital Status and Family Support for the Oldest-Old in Great Britain 415
Emily Grundy and Michael Murphy

Index 437
IN MEMORIAM: VÄINÖ KANNISTO (1916–2002)

After a long and distinguished career as a demographer and statistician with the United
Nations (1957–1981), Väinö Kannisto illustrated the concept of active ageing through
outstanding research accomplishments in his old age. While continuing on several missions
for the United Nations up until 1990,1 he pioneered modern research in the demography
of the oldest-old. He started this research around age 70 and his work between age 72 and
85 became a monument in old-age mortality research.

He was one of the first to study mortality above the age of 100 years, publishing as early
as 1988 a paper on the survival of centenarians in Population Studies. In the 1990s, with
the help of Roger Thatcher, he developed the Oldest-Old Mortality Database, known today
as the Kannisto-Thatcher Database on Old Age Mortality (http://www.demogr.mpg.de).
Three books, which laid the foundation of our current knowledge on mortality of the
oldest-old, were published by Odense University Press from this database: Development
of Oldest-Old Mortality, 1950–1990: Evidence from 28 developed countries in 1994; The
Advancing Frontier of Survival in 1996; and The Force of Mortality at Ages 80 to 120 in
1998. Through these studies, he and his collaborators have found that significant declines in
oldest-old mortality started in many industrialized countries during the third quarter of the
twentieth century. This is widely considered as one of the major findings in demographic
research on ageing.

He made important contributions to the methodology of old-age mortality research as

well. Again with Thatcher, in 2002, Kannisto proposed a simple procedure to extend
the method of extinct generations developed by Vincent in 1951 in order to accurately
compute the mortality rates at extreme ages. He also proposed the two-parameter logistic
model (Kannisto model), which effectively summarizes age variations in old-age mortality
with the minimal number of parameters.

Väinö Kannisto was also deeply interested in the relationship between the mortality level
and the population health status. In 1991, he published a major paper in Genus where he
explored the possible impact of the change in mortality selection on the individual level
of frailty among survivors. Kannisto returned to this topic in 1997 when he published a
paper on the impact of the Finnish famine on mortality.

1 More information on the career of Kannisto is available in Vaupel, J.W. (2002) “Dr Väinö Kannisto: A reflec-
tion”, Demographic Research, 6 (Article 5) http://www.demographic-research.org/Volumes/Vol6/5/

ix
x IN MEMORIAM

In the last years of his life, as a member of the IUSSP committee on Longevity and
Health, Väinö Kannisto pushed us to go deeply into two phenomena accompanying the
increase in life expectancy, i.e. the ‘compression of mortality’ and the ‘rectangularisation
of the survival curves’. He proposed a number of indicators to monitor these phenomena,
including the C family indicators to measure the concentration of deaths and the R family
indicators to measure the rectangularisation of the survival curve. He built on Lexis’ work
on the normal life duration and underlined the importance of the modal age at death as an
indicator of longevity as well as the standard deviation of deaths above the modal age.

Kannisto’s work was mainly published in demographic journals such as Population Studies;
Genus; Population and Development Review; Population; and Demographic Research.
His primary co-authors were Roger Thatcher and James Vaupel. Kannisto was the first
demographer awarded the Longevity Prize of the Ipsen Foundation in 1997.

Väinö Kannisto was born on September 24, 1916 in Helsinki and he died unexpectedly
on 16 February 2002 in Lisbon, interrupting his ongoing work. He was 85 years old.
Several times during our committee meetings, he stressed that active life is much more
important than long life. His life, including the extraordinarily creative years after age 70,
was exemplarily active, productive, and fruitful.

Jean-Marie Robine

References

Kannisto, V. (1988) “On the survival of centenarians and the span of life”, Population Studies, 42:389–406.

Kannisto, V. (1991) “Frailty and survival”, Genus, 47(3–4):101–118.

Kannisto, V. (1994) Development of Oldest-Old Mortality, 1950–1990: Evidence from 28 Developed Countries.
Odense: Odense University Press (Odense Monographs on Population Aging 1).

Kannisto, V. (1996) The Advancing Frontier of Survival. Odense: Odense University Press.

Kannisto, V. (1999) Measuring the Compression of Mortality. Paper distributed at the European Population
Conference, EAPS.

Kannisto, V. (2000a) Central and Dispersion Indicators of Individual Life Duration: New Methods. International
Union for the Scientific Study of Population, Seminar on: Human Longevity, Individual Life Durations and
Growth of the Oldest–Old, Montpellier, 23–26 October.

Kannisto, V. (2000b) “Measuring the compression of mortality”, Demographic Research 3 (Article 6).
http://www.demographic-research.org/Volumes/Vol3/6/

Kannisto, V. (2001) “Mode and dispersion of the length of life”, Population, 13(1):159–171.

Kannisto, V., Christensen, K., and Vaupel, J. W. (1997) “No increased mortality in later life for cohorts born
during famine”, American Journal of Epidemiology, 145(11):987–994.

Kannisto, V., Lauristen, J., Thatcher, A. R., et al (1994) “Reductions in mortality at advanced ages: several decades
of evidence from 27 countries”, Population and Development Review, 20:793–809.
 IN MEMORIAM xi

Kannisto, V., Turpeinen, O., and Nieminen, M. (1999) “Finnish life tables since 1751” Demographic Research,
1(1):1–27. (Available online at www.demographic-research.org).

Lexis, W. (1878) Sur la Durée Normale de la Vie Humaine et sur la Théorie de la Stabilité des Rapports Statistiques.
Annales de Démographie Internationale, 2(5):447–460.

Thatcher, A. R., Kannisto, V., and Vaupel, J. W. (1998) The Force of Mortality at Ages 80 to 120. Odense: Odense
University Press.

Thatcher, R. V., Kannisto, V., and Andreev, K. (2002) “The survivor ratio method for estimating numbers at high
ages”, Demographic Research, 6(1):1–18. (Available online at www.demographic-research.org).

Vincent, P. (1951) La mortalité des vieillards. Population, 6:181–204.

Vaupel, J. W., Carey, J. R., Christensen, K., Johnson, T. E., Yashin. A. I., Holm. N. V., Iachine, I. A., Kannisto, V.,
Khazaeli, A. A., Liedo, P., Longo, V. D., Zeng, Y., Manton, K. G., and Curtsinger, J. W. (1998) “Biodemographic
trajectories of longevity”, Science, 280:855–860.
PREFACE

JEAN-MARIE ROBINE1 , EILEEN CRIMMINS2 ,

SHIRO HORIUCHI3 , AND ZENG YI4
1
INSERM, University of Montpellier; 2 University of Southern
California; 3 Rockefeller University; 4 Duke University
and Peking University

What do we know about human longevity? The scientific community regularly meets
to examine and re-examine this question, which persists in intriguing us. We all keep
proceedings of such meetings on our shelves, such as the CIBA Foundation Colloquia on
Ageing held in 1959, the world conference Ageing: A challenge to Science and Society
held in Vichy in 1975; Between Zeus and the Salmon, gathering the contributions to the US
National Research Council Committee on Population presented in Washington in 1996;
and the proceedings of the series Research and Perspectives in Longevity, convened by the
Foundation IPSEN.

Such books gathering current knowledge from several perspectives—biology, demography,

medicine, sociology—form a crossroads for the diffusion of new ideas and hypotheses.
Thus, in October 1977 the Council of the International Union for the Scientific Study of
Population (IUSSP) created a new scientific committee on ‘factors affecting mortality and
the length of life’. The reason was the necessity for demographers and actuaries to develop
closer links with other social and biomedical disciplines. The first seminar, held at Fiuggi
Terme (Italy) in May 1980, gathered among others, John Pollard, Antonio Golini, Samuel
Preston and Jacques Vallin with Leonard Hayflick, Roy Walford, Albert Jacquard, Jean-
Noel Biraben and Bernard Benjamin. The resulting book, Biological and Social Aspects
of Mortality and the Length of Life, became a reference work for many years and remains
a model for our committee.

Twenty years later, in 1999, the International Union for the Scientific Study of Population
convened a new scientific committee on ‘longevity and health’, to update our knowledge
on the length of life. The scientific objectives were to study human longevity, the dy-
namics of health transitions, the emergence and proliferation of centenarians, and demo-
epidemiological projections, together with the forecast of future health status.

To provide answers to these different questions, it was decided to arrange three seminars,
each of them dealing with one of the main objectives: (i) a critical assessment of our
knowledge about human longevity, mortality at older ages and the distribution of individual

xiii
xiv PREFACE

life durations, held in Montpellier, France in 2000; (ii) the definition(s) of the different
health concepts and the relations which link them together, held in Beijing in 2001; and
(iii) the evolution of the diverse socioeconomic factors that may be linked with a positive
evolution of functional abilities, and that may positively or negatively influence older
people’s living conditions and quality of life in general, held in New York in 2003.

Two books have resulted from these three seminars: this one focusing on longevity—Human
Longevity, Individual Life Duration, and the Growth of the Oldest-Old Population; and the
other one focusing on healthy ageing—Longer Life and Healthy Ageing. In addition, a
special issue of Genus (2005) focuses on the causes and prospects of increasing longevity.

In addition, the committee organized in 2004 an international conference in Beijing on the

‘demographic window’ which brought together demographers and population economists
from Western and Asian countries, to exchange the latest scientific knowledge on popu-
lation dynamics, the change in population age structure, and its impact on economic and
social development. This conference led to a special issue of Asian Population Studies
(2005).

An editorial committee selected a subset of the many excellent papers presented at the
Montpellier meeting in 2000 for publication in this volume. They have been reviewed by
the editorial committee and by an external reviewer and appropriate revisions and updating
to 2005 have been made. The final revised papers are presented here.
ACKNOWLEDGEMENTS

The committee (Jean-Marie Robine, Yves Carrière, Eileen Crimmins, Shiro Horiuchi,
Vaı̈nö Kannisto† , Zeng Yi) thanks all those agencies and people that made this work pos-
sible. First, the International Union for the Scientific Study of Population, for sponsorship
of the Seminar held in Montpellier (France) on October 23–25, 2000. We also thank the
Centre de Lutte Contre le Cancer (CRLC) and the School of Medicine of the University of
Montpellier, the Centre for Healthy Ageing and Family Studies at Peking University, the
Laboratory of Populations at the Rockefeller University, the Asian Metacentre at the Singa-
pore National University, and the U.S. National Institute on Ageing (grants 7P01AG08761
and R13 AG021466-01). The committee is much indebted to Isabelle Romieu for assisting
the committee, organizing the seminar in Montpellier, and for editorial assistance.

xv
INTRODUCTION

JEAN-MARIE ROBINE1 , EILEEN CRIMMINS2 ,

SHIRO HORIUCHI3 , AND ZENG YI4
1
INSERM, University of Montpellier; 2 University of Southern
California; 3 Rockefeller University; 4 Duke University and
Peking University

This book is intended to assess our current knowledge on human longevity and on the
relationships linking longevity and health. Research in this area—demographic, epidemi-
ological, genetic and evolutionary—has developed at an accelerating pace in recent years,
revealing many radical and unexpected findings. Throughout most of the Western world,
expectation of life has increased to a much greater degree than most actuaries ever ex-
pected, potentially threatening the solvency of pension systems and upsetting population
projections. Record life expectations have been reliably recorded and their trend mea-
sured with new databases. The rapid growth of the ‘oldest-old’ population—90 and over,
and especially of centenarians and super-centenarians—has attracted much attention. A
completely unexpected deceleration of the increase in the force of mortality among the
oldest-old has challenged accepted opinion about the form of the human mortality curve,
and thus fuelled speculation about the expansion of the human life-span.

Argument continues about whether the human survival curve, as well as the curve of
morbidity onset, is becoming rectangularised or whether the tail of its distribution will
simply be extended to older and older ages. The causes of death of the oldest-old, now
known to be different in many important ways from those of the younger old, have raised
questions about frailty, the selection of survivors, the morbidity, the health and medical
needs of the very elderly. In trying to resolve these questions, biology and demography
often come together. Important biodemographic issues include the impact of early-life
events on the future longevity of individuals, the heritability of longevity between parents
and children, the existence of long-lived families and the relationship between longevity
and fertility and the optimum ages for procreation.

Comparisons of physiological processes and life-cycle strategies of different species (yeast,

worms, flies, mice and even large monkeys) have been essential for the development of
higher-level theories of ageing from an evolutionary viewpoint. Other biological work has
developed markers of ageing in persons of good health and, on a different track, begun to
isolate “longevity” genes. A great variety of biological findings, on the effects upon ageing
of caloric restriction, antioxidants, inflammation, telomere length, growth hormones, and

1
J.-M. Robine et al. (eds.), Human Longevity, Individual Life Duration, and the Growth of the Oldest-Old Population, 1–2

C 2007 Springer.
2 JEAN-MARIE ROBINE ET AL.

genes such as ApoE, and of numerous changes in environmental conditions, all await
location in a coherent overall model. This complexity in relationship between the biological
and environmental factors makes it clearer that the expression of longevity is a complex,
multifactorial, phenotypic trait, largely governed by environment (Robine 2003; Vaupel
et al. 2003), and less and less a fixed species characteristic (Buffon 1749; Cutler 1985;
Walford 1985; Hayflick 1996).

This first volume from the IUSSP Committee on Longevity and Health deals with the
limits of human longevity, the distribution of individual life duration, and the growth of the
oldest-old population. It discusses the availability and reliability of data—the biological,
environmental and social factors affecting length of life and the oldest-old and some of
the demographic effects of recent and future changes in survival upon human social struc-
ture. In the chapters that follow, experts in biology, demography, epidemiology, medical
gerontology, and sociology attempt to answer many questions related to human longevity.

The book is organized in 5 sections. In the first section dealing with theoretical and compar-
ative biological concepts, research questions related to human longevity are summarized
by Jean-Marie Robine and put in the broader context of species diversity by Steven Austad
and of biodemography by James Carey and Debra Judge. In the second section dealing
with empirical and analytical studies of ageing and of oldest-old population, empirical data
on the mortality trajectory for the oldest-old in China are introduced by Zeng Yi and James
Vaupel. New indicators of individual life duration are presented by Väinö Kannisto, and
Wilma Nusselder examines the rectangularisation of the survival curve at advanced ages in
the Netherlands. Evidence for exceptional male longevity in Sardinia is shown by Michel
Poulain and his colleagues and the quality of data on reported age among the elderly in
Quebec is examined by Robert Bourbeau and Bertrand Desjardins. In the third section,
dealing with the causes of death and biological frailty, France Meslé studies in detail the
quality and the comparability of the data and Shiro Horiuchi examines the distribution of
the causes of death of the oldest old. Kaare Christensen and Anne Maria Herskind analyse
the heritability of longevity and Douglas Ewbank examines the genetic factors associated
with human life span. In the fourth section dealing with gender and social determinants,
Marja Jylha and Tiina Luukkaala investigate the social determinants in mortality in the
oldest old and John Wilmoth and Mike Dennis examine the social determinants in older
adult mortality in the United States. The gender differences in mortality among the oldest-
old are examined by Jacques Vallin. In a final section, dealing with causes of the trend
in mortality and morbidity, possible explanations of the decline in mortality among the
oldest-old are explored from a medical point of view by Bernard Jeune and from a de-
mographic perspective by Graziella Caselli, James Vaupel, and Anatoli Yashin. Lastly, the
marital status and family support of the oldest-old in Great Britain are presented by Emily
Grundy and Michael Murphy. The diversity of these 18 chapters underlines the resolutely
multidisciplinary approach adopted by the committee to carry out a critical assessment of
our knowledge about human longevity.