5 Things I Learned at the SOA LT100 Symposium
At the Living to 100 Symposium, I enjoyed the Orlando, Florida January weather but, more importantly, the fellowship that makes this symposium extra special for everyone, not just for actuaries. Now the organizing committee is busy reading reviews and generating ideas to help disseminate the information and make the next symposium even better.
I come out of each symposium with a mood that encapsulates the essence of all the presentations I attended and discussions I had. It is not a feeling that the organizing committee plans for, and it is probably a little different for each participant depending on their angle of interest in old age issues, but it is largely shared by the attendees. I will do my best to share that feeling by focusing on the five following points.
Life expectancy of 100 is not happening.
As we see with the increase in Alzheimer’s deaths, it is not sufficient to survive heart disease and cancer because aging bodies are subject to a whole series of threats. According to Jay Siegel, a life expectancy of 100 would require a huge proportion of supercentenarians that reach age 105+. This is one of the flaws of using life expectancy at birth to understand what is happening to mortality at the older ages: Life expectancy is hardly moved by improvements at the older ages but is quite sensitive to improvement at very young ages.
An important caveat to keep in mind is that this sensitivity is true in the current state of medical research. Another important point to remember is that the life expectancy in the U.S. is quite the outlier (in a negative way) compared to most other developed countries apart from some countries in Eastern Europe. That means we have room for improvement, if some actions are taken. This ranking, however, may also be due in part to significantly different patterns of mortality for different socio-economic classes around the world, which was explored by several of the papers presented at the Symposium.
We are starting to measure aging itself.
Scientific progress relies on objective definitions and precise methodology for measurement. I can recognize someone who aged well, but I can’t define it. Aging is not cancer and it is not Alzheimer’s or hip fractures. Yet those are, without a doubt, strongly correlated with aging. Aging is not just decay; it is decay that overwhelms the repair tools our bodies acquired through evolution. When Dr. Sofiya Milman presented the TAME study, she mentioned measuring many of those correlates of aging because that’s all we have now.
Dr. Steve Horvath presented an alternative - measuring methylation of the genome to derive his cellular epigenetic clock. It is statistically derived, and it remains unclear whether the clock measures a causal effect or is just correlated with aging. Its importance is in opening the door for the immediate measurement of aging intervention. Whether his clock or another will prevail is still unknown as there is no certainty when you are at the edge of research, but the avenue is promising. Imagine the potential of a treatment that affects an accurate clock: No need to wait for a decade to see if it really worked or not.
“Three stages of life” is not useful for planning.
We think the three stages of life are learning, working, retiring. Three hundred years ago if you were a born a peasant, then you worked and died a peasant; if you were a noble, you never worked. In today’s world, we are always learning and blurring the distinction between learning and working stages, and I would add even blurring into the third stage. Today, people who can afford it have two stages of retirement - a more active stage followed by a more sedentary one as disabilities start taking their toll. Careers after retirement are no longer an advantage after a civil service or military career; they are quite common, even if not driven by need. The future of work automation and an extended work period past an artificial “retirement age” will confuse the retirement issue even more. How can our financial security products, commercial or societal, address our needs in such an environment?
Solutions don’t have to be high-tech.
There is no denying that with aging comes a heavier burden of disabilities or “lesser abilities.” But just as the ADA established standards for the workplace that enabled many with disabilities to work, we need to actively pursue ways to facilitate inclusion of our elderly population in all aspects of life. Financial necessity may require us to work into old age or perhaps you just would like to be productive in other ways. Designing thoughtful structures of support has demonstrated a longevity dividend and an emotional dividend as well. A simple structure like the Whiteley village in the UK can have an impact if we can reproduce the model.
We know that successful aging is facilitated by purpose: people that stay socially engaged - e.g., through work or community as a volunteer - live longer. What can we do, as a society and as individuals with our own biases, to make it a more purposeful world? Dr. Jacquelyn James discussed the importance of building a “social nest egg” as well as a financial one.
We can apply lateral thinking to study aging.
We often stereotype older people as set in their ways when we, ourselves, are often set in our own ways, too. I heard two points that emphasize the need to change our lens to stay, if not young, at least intellectually fresh.
- Sam Gutterman, a great role model for the importance of asking questions and looking for answers, explored the role of multiple comorbidities in aging. We know, and his paper reminded us, that multiple medical conditions are common in older people. Yet our thinking, often reinforced by the desire to study “one thing at a time” in scientific research, is linear and additive. Good underwriters, on the other hand, are adept at looking at the multi-dimensions of an individual. To adjust our thinking, we should embrace the promise of predictive modeling in the actuarial field to answer these kinds of questions.
- The research presented by Jean-Marie Robine focused on noticing changes in extreme population life spans. Until now, people studied extreme life span using, for each year and for each region, the age of the oldest person alive that year in that region. (As a parenthetical comment, Jeanne Calment’s 122 years old still stand to this day - her age having been validated by Dr. Robine among others.) Dr. Robine showed that a better measure of the extreme population life spans, and therefore of life extension progress, may be revealed by studying the age of the 30th oldest person. Dr. Robine observed that, in the French population, the age of the 30th oldest person had been stable at around 99 years, plus or minus one year, for centuries of demographic data. Remarkably, that age has experienced a linear increase since World War II. Same old data but a new angle could be key to better measure of progress.
So, let’s all think outside the proverbial box, and in that way stay forever young…at heart.