Health and Survival in the Elderly
This chapter provides an overview of global trends in longevity and survival at older ages, with a special focus on global and regional disparities. In particular, existing evidence regarding potential data and estimation challenges will be critically assessed. The chapter also aims at summarizing the mixed evidence on the determinants of longevity at older ages. Our insights into global longevity trends suggest that longevity improvements have been highly uneven between and within the global regions. The reported results highlight the growing divergence in survival at age 65 and at age 80 among the most advanced high-income countries. Meanwhile, model-based estimates indicate that the majority of developing countries have probably not reached the phase in which systematic improvements in survival at older ages are occurring. The evidence is even more complex and problematic for global changes in the prevalence of diseases, risk factors, and disability. Epidemiological studies indicate that the burden of cardiovascular and other noncommunicable diseases is increasing in developing countries. It also appears that in many developed countries, smoking rates are decreasing and the obesity epidemic is stabilizing. Yet even the elderly in some high-income countries have unfavorable longevity profiles, as a substantial proportion of their remaining life expectancy is spent with chronic conditions or disability. More efforts are needed to obtain reliable and internationally comparable data on health and survival at old age in all global regions.