Mortality improvements at older ages

Mortality improvements at older ages

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Speaker: Sam Gutterman
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Speaker(s): Sam Gutterman

The large majority of deaths occur at older ages (in this case defined as beginning at age 70). For this reason, to understand the trend over time of mortality rates, a focus on changes in mortality at older ages is important. The overall trend in decreasing old-age mortality in low-mortality countries has been well-documented.

However, exceptions have occurred recently, such as in several Scandinavian countries and a general tendency in high-income countries to experience a smaller rate of mortality improvement in the 2010s. In other countries, such as the United States, these trends have been cyclical in nature, e.g., by decade. The effect of several significant sources of mortality improvement at middle ages appear to wear off at older ages. For example, in several countries mortality of the obese at older ages have been better than those of standard weight.

In others, the observed differences by income level or educational attainment appears to wear off as cohorts have aged. A further discussion of the aging process and drivers of mortality at these ages is included. A case study has been developed covering recent trends in experience of participants in the U.S. Military Pension Plan at older ages. These are compared with those of overall population, as reported by the U.S. Social Security Administration. Trends in causes of death for countries in which such data is available are provided through a series of charts comparing mortality improvement by quinquennial ages and gender.

The concepts of mortality and morbidity compression by age (i.e., differences between life expectancy and healthy life expectancy) are discussed. Also, the question of whether an age gradient (a smaller mortality improvement measured by percent change at older ages compared to that at younger ages) has been observed and should be expected is illustrated.

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