Top row: Ronnie Klein, Special Advisor Health & Ageing, The Geneva Association (Moderator); Richard Jackson, President of the Global Aging Institute. Bottom row: Andrew Cairns, Heriot-Watt University
Richard Jackson, President of the Global Aging Institute, opened with the question, “Are healthspans rising along with lifespans?” Pessimists suggest that there is generally a maximum age (commonly referred to as omega – w) and that more people will reach this in the future, optimists feel that w will continue to rise, while visionaries contend that breakthroughs in medical science will cause w to increase dramatically in the near future. Whatever the case, life expectancies are clearly projected to increase.
He explained that the compression of morbidity and the failure of success models are commonly used to measure the correlation between life and health expectancy. The former postulates that healthspans are rising as fast as or faster than lifespans and that disease will be limited to a short period at the very end of life, and the latter posits that advancements in science will increase the number of ‘marginal survivors’.
Extending productive work years to improve financial security requires continued good health; however, achieving this could strain health systems globally as complex comorbidities add to existing disease priorities. While disability among the elderly has decreased, lifestyle diseases in the middle-aged increase the risk of disability later in life.
David Blake of the Pensions Institute and Andrew Cairns of Heriot-Watt University discussed the effect of COVID-19 on higher-age mortality. The importance of the relationship between COVID-19 mortality and all-cause mortality was underscored, as many deaths ascribed to COVID-19 were accelerated rather than caused by the disease. Their model looked not only at accelerated deaths, but also at the longevity of survivors.
The results suggest that COVID-19 deaths by age are proportional to all-cause mortality, an important point often missed by the media. However, age is not the only factor and their model introduced others based on groupings such as the health of individuals within an age group (comorbidities) and living conditions. The relative frailty rate remained constant, so mortality rates were not materially different from all-cause mortality rates following infection.
The key takeaway was that COVID-19 has highlighted existing biases, such as geographical location, ethnicity and income level, that affect all-cause mortality.