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DEMOGRAPHY AND LONGEVITY

DEMOGRAPHY AND LONGEVITY. Stefania Maggi CNR – National Research Council of Italy Institute of Neuroscience, Padova. Secular trend of life expectancy. DEMOGRAPHY AND AGING.

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DEMOGRAPHY AND LONGEVITY

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  1. DEMOGRAPHYAND LONGEVITY Stefania Maggi CNR – National Research Council of Italy Institute of Neuroscience, Padova

  2. Secular trend of life expectancy

  3. DEMOGRAPHY AND AGING “Population aging is unquestionably the most important demographic force of the first half of the twenty-first century”. (Schoeni FR, Ofstedal MB. “Key Themes in research on the Demography aging” Demography, 47, 2010: S5-S15)

  4. POPULATION AGING • The global population aging is a stage of a process known as the demographic transition. • The demographic transition is a model that describes population change over time. It is based on a study of changes, or transitions, in birth rates and death rates (Thomson W, 1929).

  5. THE DEMOGRAPHIC TRANSITION (www.marathon.uwc.edu)

  6. WORLD POPULATION AGING During the last decades there has been a global decline of mortality and fertility from higher to lower levels.

  7. WORLD POPULATION The world population is rapidly growing:

  8. WORLD POPULATION AGING • World population is especially growing older: • the share of the population aged 65+ is expected to double between 2010 and 2040, from 7.8% to 14.7% • the number of older people will increase from 530 million in 2010, to 1.3 billion by 2040. (U.S. Census Bureau, International Data Base)

  9. WORLD POPULATION AGING • Another aspect of world population aging is the aging of the older population; the share of the older at ages 80+ (the “oldest-old”) is growing more rapidly than the older population itself. • This growth will translate into a large increase of oldest-old within the world’s older population, from 16% in 2000 to 24% in 2040. (U.S. Census Bureau, International Data Base)

  10. TOTAL POPULATIONIN EUROPE • The 2008-based national population projections show that the EU27 population will rise from 495 million in 2008, to 521 million in 2035, and thereafter decline to 506 million in 2060.

  11. POPULATION AGING IN EUROPE • The percentage of people aged 65+ in the total population will increase from 17% to 30%. • The number of over65 will rise from 84.6 million in 2008 to 151.5 in 2060. • The number of over80 will rise from 21.8 million in 2008 to 61.4 in 2060.

  12. POPULATION AGING IN EUROPE • The population is projected to become older in all States. • The median age of the population will increase, due to the combining effects of: • existing structure of the population • persistently low fertility • increasing number of survivors to higher ages.

  13. MEDIAN AGE OF THE TOTAL EU POPULATION

  14. POPULATION PYRAMID EU27 • The 2008 population showed the effect of baby boomer cohorts (1960s); in coming decades, the high number of aging baby boomers will swell the number of elderly.

  15. VITAL EVENTS EU27 • Smaller cohorts of women reaching the reproductive age result in fewer birth. • The annual number of birth is projected to decrease, while the absolute number of death will rise. • From 2015 onwards births will not outnumber deaths: the natural increase of the population will cease.

  16. MIGRATION EU27 • Migration will be the only population growth factor. However, it will not be possible for a long period to counterbalance the negative natural change.

  17. EPIDEMIOLOGY OF AGING • Going beyond the demographic focus, epidemiology has made additional contribution to the understanding of health status and functional trajectory of older individuals. • Geriatric epidemiology study health, functional status, quality of life and mortality of representative populations of elderly, also in order to generate intervention to improve life of millions of older individuals.

  18. EPIDEMIOLOGY OF AGING: MORTALITY • The increase in life expectancy has been driven in part by reduced mortality at older ages: the first half of the 20th century saw large decline in child mortality, whereas in the second half of the century unprecedented declines in mortality occured in the older segment of the population • The 5 leading cause of death among elderly: • heart disease • cancer • stroke • chronic lower respiratory tract disease • Alzheimer’s disease (Minino et al. National Vital Statistics Reports 2007; 55(9):1-120)

  19. EPIDEMIOLOGY OF AGING: DISEASES • Among people aged 65+, the most commonly reported condition are hypertension, followed by CHD and stroke. • Arthritis and chronic joint symptoms are reported by a large proportion of older persons, may have large impact on health and quality of life but do no appear on the list of most common conditions causing death.

  20. EPIDEMIOLOGY OF AGING: DISABILITY • A large body of epidemiologic studies allowed a greater understanding of occurence, determinants, and consequences of disability in the older population. • Epidemiologic studies have clearly identified disability as the most powerful markers in predicting adverse outcomes. Disability measures are able to capture the presence and the severity of multiple pathologies, including physical, cognitive, psychological conditions.

  21. EPIDEMIOLOGY OF AGING • Martin et al, considering data from the NHANES and the NHIS, conclude that health and disability of elderly improved during the last two decades of 20th century. At the same time, population aged 40-64 years has not shown a consistent improvement and there is some evidence of increase in disability in this age group. (Martin LG, Schoeni RF, Andreski PM. Demography 2010; 47:S41-S64)

  22. RESEARCH ON AGING • The demographic causes of aging of the population, in terms of fertility rates and mortality rates, are generally predictable. A variety of population projections are available, prepared by UN, EU and National Statistic Institutes. • What is less predictable is the interaction of these forces with social context, health status, economic changes, cultural influences and hence international migrations.

  23. RESEARCH ON AGING • For this reason further research on biodemography, dynamic of health, epidemiology, economics, psychology, social sciences and aging are needed. • Longitudinal data are essential in order to sort causal relationships among demographic, biological, psychosocial and economic factors, and health. • Cross-national comparison are important, considering variability across societies, in terms of status and well-being of older persons, experiences of health and mortality, family and social support.

  24. Biological Rationale - Mortality Co 14/38 37% CR 0 5/38 13% p=0.03 HR=3.0 p=0.16

  25. Biological Rationale – Age Related Diseases

  26. Biological Rationale – Age Related Diseases P=0.008 HR=2.9

  27. Compounds in / for clinical development • Resveratrol, Fisiten • Rapamycin • Metformin • 2-deoxy-D-glucose (2DG) • Antiossidants (vitamins C and E, b-carotene) • Synthetic ROS scavengers • Phenyl tert-butyl-nitrone (PBN) • Thiazolium halide alagebrium

  28. Biological Rationale and Molecular Targets

  29. CONCLUSIONS • The implications of the change in the age structure are very important. • A new vision of public health that embraces aging research and education is needed. • Scientists of today and tomorrow have to generate new knowledge to address health, social and economic issues facing our aging society.

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