Jeanne Calment February 21, 1875 August 4, 1997

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Mortality Experts Meeting
Staple Inn Hall
3 March 2008 Living Ever Longer?
Tom Kirkwood Director, Institute for Ageing
and HealthNewcastle University
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(No Transcript)
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The Continuing Increase in Life Expectancy
Oeppen Vaupel Science 2002
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The Challenges for Mortality Research

• Life is getting longer already do we understand
  why?
• What is the likelihood of further increases in
  life span?
• What is likely to happen to age-related health,
  quality of life and capacity for independent
  living?

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Key Questions about Ageing

• Why does ageing occur?
• Is there a limit to the human life span?
• Do longer lives mean more diseases?

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Progress Through the Stages of Life
Then
Now
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DISPOSABLE SOMA THEORY
Kirkwood Nature 1977
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The Ageing Process Kirkwood Cell 2005

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Human Ageing is Malleable

• By decreasing exposure to damage
• Improved nutrition
• Healthy lifestyle
• Supportive environment
• By enhancing natural mechanisms for protection
  and repair
• Enhanced nutrition
• Novel drugs, stem cell therapies, etc

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Factors Influencing Longevity and Health Span

• Genes
• Nutrition
• Lifestyle
• Environment
• Socioeconomic status
• Attitude
• Chance
• These factors and their interactions are being
  studied in the Newcastle 85 Study a 5-year
  prospective study of biological, clinical and
  psychosocial factors associated with healthy
  ageing funded by MRC/BBSRC.

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Genetic Heritability of Human LifespanCournil
Kirkwood Trends in Genetics 2001

• Twin Studies
• McGue et al (1993) 0.22
• Herskind et al (1996) 0.25
• Ljungquist et al (1998) lt0.33
• Traditional Family Studies
• Philippe (1978) 0-0.24
• Bocquet-Appel Jakobi (1990) 0.10-0.30
• Mayer (1990) 0.10-0.33
• Gavrilova et al (1998) 0.18-0.58
• Cournil et al (2000) 0.27

Genes account for 25 of what determines longevity
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• High intakes of vegetables, fruits and cereals.
• Moderate to high intake of fish.
• Low intake of meat.
• Low intake of saturated fatty acids.
• High intake of monounsaturated fatty acids
  (olive oil).
• Low to moderate intake of dairy products,
  principally cheese and yoghurt.
• Modest intake of alcohol (mostly wine).

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EPIC-elderly Study Protocol
76,707 men and women aged 60 No CHD, stroke or
cancer at enrolment Median follow up 89 months
(4047 deaths) Adherence to Mediterranean diet
assessed on 10-point scale 0 (poor)9 (high)
2 unit increment results in 8 reduction of
overall mortality
Trichopoulou A et al. (2005) BMJ 330, 991-997
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Do longer lives mean more diseases?

• For many important diseases, age is the largest
  single risk factor.
• Understanding why aged cells and organs are more
  vulnerable to pathology will open new paths to
  prevention and cure.
• At present, we have many medical research
  institutes but very few of these include research
  on the science of intrinsic ageing.

The coming decades are likely to see greatly
expanded research on the mechanisms underpinning
both normal ageing and age-related diseases.
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Pathways to Age-Related Disease
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Targeting for Healthy Ageing
Target Population for Nutrition/Lifestyle
Future
Now
Target Population for Drugs, etc
Population numbers
Unhealthy condition
Healthy
Adapted from Green and van der Ouderaa Nature
Pharmacogenomics 2003
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Beating the Biological Clock

• Wrong lifestyle
• Excess calorie intake
• High saturated fats
• Low micro-nutrients
• Too little exercise
• Poor glucose tolerance
• Stress
• Smoking

Biological Ageing

• Right lifestyle
• Energy balance
• Maintain glucose sensitivity
• Low saturated fats
• Rich micro-nutrient diet
• High exercise level
• Low to moderate stress

Chronological Ageing

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• If Id known I was going to live this long, Id
  have taken better care of myself
• US comedian Eubie Blake on his 100th birthday

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Today and Beyond
Understanding the future of mortality patterns
calls for an multi-disciplinary approaches.
Other disciplines have much to learn from the
actuarial profession, and vice versa. How to
take forward the building of further bridges?