05Mar14 - Missing 90 year olds

Missing 90 year olds
An ILC-UK debate supported by
Partnership as part of the Population
Patterns Series
Wednesday 5th March 2014
This event is kindly supported by Partnership

#missing90s

#populationpatterns

Baroness Sally Greengross
Chief Executive
ILC-UK


#missing90s

#populationpatterns

Richard Willets
Director of Longevity
Partnership


#missing90s

#populationpatterns

‘Missing’ 90 year olds
An Introduction

Richard Willets
International Longevity Centre – 5 March 2014

Introduction
• Population estimates for England & Wales based on the 2011 Census
were published in July 2012

• Prior to this our population estimates were based on the 2001 Census
with adjustments made to allow for subsequent migration and deaths

•

Source: Wall Street Journal

March 14

5

Impact of the 2011 Census on population
estimates

6

Revision to England & Wales population estimates for mid-year 2011 following 2011 Census,
by age
5%

Females

0%
40-44

45-49

50-54

-5%

-10%

-15%

-20%

•

Source: own calculations using ONS data

March 14

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90-94

95-99

100+

Impact of the 2011 Census on population
estimates

7

Revision to England & Wales population estimates for mid-year 2011 following 2011 Census,
by age
5%

Females
Males

0%
40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90-94

95-99

100+

-5%

-10%

-15%

-20%

•


March 14

Approx 30,000 fewer
individuals

More significant revisions in the US
• In 2004 the US Census Bureau projected there would be:•
•

114,000 Americans aged 100 plus in 2010
1.1 million centenarians in 2050

• Following the 2010 Census, figures revised to:•
•

•

53,364 Americans aged 100 plus in 2010
0.59 million centenarians in 2050

Source: Wall Street Journal

March 14

8

Impact on apparent mortality improvement rates
Average annual rate of mortality improvement, males in England & Wales,
2001-2011, by age group, before and after publication of the 2011 Census
results
2010-based

3.0%

2.5%

2.0%

1.5%

1.0%

0.5%

0.0%
80-84
•


March 14

85-89

90-94

95-99

9

results
2010-based

3.0%

revised
2.5%

2.0%

1.5%

1.0%

0.5%

0.0%
80-84
•


March 14

85-89

90-94

95-99

10

results
2010-based

3.0%

revised
2001 to 2013

2.5%

2.0%

1.5%

1.0%

0.5%

0.0%
80-84
•


March 14

85-89

90-94

95-99

11

Impact on projected mortality rates

12

0.40

Average mortality rate
for males in the 90-99
age range, England &
Wales, actual and
projected figures

Actual
Simple
extrapolation

0.35

0.30

0.25

0.20

0.15

0.10

0.05

0.00
1990
•


March 14

1995

2000

2005

2010

2015

2020

2025

2030

Impact on projected mortality rates

13

0.40

Average mortality rate
for males in the 90-99
age range, England &
Wales, actual and
projected figures

Actual

0.35

Simple
extrapolation
2010-based
projection

0.30

+50%

0.25

0.20

0.15

0.10

0.05

0.00
1990
•


March 14

1995

2000

2005

2010

2015

2020

2025

2030

Consequences

14

• Greater appreciation of the challenges in producing accurate data
for the highest age groups

• Small but material reductions in the projected lifespans of
pensioners/annuitants

• Significant revisions in the projected number of elderly individuals
The ONS publication “What are the chances of reaching age 100?” published in Spring
2012 projected that 9.5% (37,000) of men aged 65 in the UK in 2012 would reach age
100*
The equivalent publication in 2013 had a principal projection of 8% (31,000) of men aged
65 in 2013 reaching age 100*
Arguably, a more realistic survival probability could be 5-6%**

• Raises more fundamental questions (e.g. why is rate of mortality
improvement so much lower at high ages?)
•

*Source: ONS

March 14

•

**Source: own calculation

Thank you

Partnership is a trading style of the Partnership group of Companies, which includes; Partnership Life Assurance Company Limited
(registered in England and Wales No. 05465261), and Partnership Home Loans Limited (registered in England and Wales No.
05108846).
Partnership Life Assurance Company Limited is authorised by the Prudential Regulation Authority and regulated by the Financial
Conduct Authority and the Prudential Regulation Authority. Partnership Home Loans Limited is authorised and regulated by the
Financial Conduct Authority. The registered office for both companies is Sackville House, 143-149 Fenchurch Street, London EC3M
6BN.
March 14

15

Dave Grimshaw FIA
Partner
Barnett Waddingham LLP


#missing90s

#populationpatterns

UK Actuarial Advisory Firm of the Year

Understanding mortality at 90+ years
ILC-UK Population Patterns Series event: ‘Missing 90 year olds’
Dave Grimshaw, Partner, Barnett Waddingham LLP
dave.grimshaw@bwllp.co.uk

05 March 2014

Why are actuaries interested in
mortality?
Where a payment is contingent on survival
• Valuing liabilities for pension schemes
• Pricing and valuing insurance products:
• Where a benefit is payable on death, and
• Where a benefit is payable throughout life

We are interested in current mortality and how
it might change in future

19

Mortality rates and mortality improvements
Mortality rate

Deaths ÷ Exposure

• Example:
• Age 83 in 2005

9,227 ÷ 92,381 = 9.99%

• Age 83 in 2006

8,779 ÷ 89,958 = 9.76%

Mortality improvement
• Percentage reduction in mortality rate compared to
the same age one year earlier
• Example:
• Mortality reduction: 0.23%
• Mortality improvement: 0.23% ÷ 9.99% = 2.3%
20

What data do actuaries use?
• Specific portfolio
• Data for the (pension scheme or insurance company)

• Pooled studies
• e.g. the CMI produces analyses of pension schemes and
various insurance products

• Population data

21

Why is population data useful?
Preference for similar data i.e. the specific group of
pensioners or insured lives but…
• Pension schemes can be small and heterogeneous
• CMI pensioners dataset is approximately 24% of the
population for Males and only 8% for Females
• Population data adds credibility, especially where
data is sparse (e.g. oldest or youngest ages)
• Insurance/pensioner data may be unreliable
• Mortality tends to converge at older ages
• Mortality improvements need especially large
datasets
22

Unreliability of insured and
pensioner data at older ages?
1.00

Mortality Rate (log m)

S1PML

PCML00

Low Gate
Crude Rate

0.10

High Gate
S1PML
PCML00

0.01
65

75

85

95

105
65
Age

75

85

95

105

Comparison of observed experience with graduations
Source: CMI Working Paper 35 (for S1PML) and CMI Report 23 (for PCML00).

23

Convergence of mortality rates at
older ages?
200%

% of mortality rate for all classes combined

180%
I - Professional
160%
II - Managerial
140%
IIIN - Skilled non-manual
120%
IIIM - Skilled manual
100%
IV - Partly skilled
80%
V - Unskilled
60%
All classes combined
40%
20%
0%
40−44

45−49

50−54

55−59

60−64

65−69

70−74

75−79

80−84

85−89

90+

Age band

Relative crude mortality rates by age band and socio-economic class
for males in England and Wales, 1982-2005.
Source: BW calculations using data from ONS Longitudinal Study 1982-2005 classified by RGSC

24

UNDERSTANDING POPULATION
MORTALITY AT AGES 90+
25

Change in population estimate (%)

2011 Census and E&W population
estimates
10%

Males
Females

5%
0%
-5%

-10%
-15%
-20%

Age Band

2011 Census count compared with roll-forward estimate
Source: ONS supplemented by BW calculations for ages 90+; estimates as at mid-2011

26

Population estimates for older ages
between Censuses
• ONS use Census roll-forward method to estimate population at
individual ages to age 89, plus a total for ages 90+

• Use Kannisto-Thatcher survivor ratio method to allocate 90+
total to individual ages
• Extinct cohort method
• Reconstruct population working back along cohort’s path, starting
from last survivor and adding back deaths, assuming no migration

• Non-extinct cohorts
• Estimate current population using survivor ratio
• Survivor ratio = Survivors ÷ deaths in cohort in last 5 years
• Assume stability or predictability of survivor ratio across cohorts

• Then work back along cohort’s path as above

27

between Censuses
• As ONS apply a constraint on the K-T method, the
total 90+ estimates are determined by the rollforward method
• These roll-forward estimates are highly sensitive at
older ages to accuracy of initial estimate

• 1% error in estimates for ages 80-89 results in:
• 4% error for females at ages 90-99 at next census;
and
• 7% error for males at ages 90-99 at next census.
28

– an alternative approach
• ONS use Kannisto-Thatcher method to allocate 90+
total to individual ages (but 90+ total based on rollforward estimates)
• But can also apply K-T methodology without
constraint to 90+ total

• Key assumptions:
• Death registration data is accurate
• No net migration
• Survivor ratio is stable / predictable.
29

Alternative estimates compared with
roll-forward estimate
% reduction to the roll-forward
estimate from the 2001 Census

0%

-5%

-10%

-15%
2011 Census (M)
-20%

BW (M)
2011 Census (F)

-25%

BW (F)
80-84

85-89

90-94
Age Band

95-99

100+

Comparison of estimates of mid-2011 population for E&W
Source: BW calculations using population estimates and death registrations data to 2011 published by ONS.

30

K-T estimate using 2012 deaths
compared with roll-forward estimate
350,000

Females

300,000

250,000

200,000

ONS

150,000

Barnett Waddingham (K-T)
100,000

50,000

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

0

Comparison of estimates of female population for E&W

31

K-T estimate using 2012 deaths
compared with roll-forward estimate
150,000

Males

120,000

90,000

ONS

60,000

Barnett Waddingham (K-T)
30,000

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

0

Comparison of estimates of male population for E&W

32

Summary
• Census estimates at older ages appear
reasonably accurate…
• But some doubt regarding 2001 for males

• Inter-Censal estimates may become less
reliable, as any inaccuracy in the previous
Census is amplified in the current approach

33

Regulatory Information
•

The information in this presentation is based on our understanding of
current taxation law, proposed legislation and HM Revenue & Customs
practice, which may be subject to future variation.

•

This presentation is not intended to provide and must not be
construed as regulated investment advice. Returns are not
guaranteed and the value of investments may go down as well as up.

•

Barnett Waddingham LLP is a limited liability partnership registered in
England and Wales.
Registered Number OC307678.
Registered Office: Cheapside House, 138 Cheapside, London, EC2V
6BW

•
•
•

34

Barnett Waddingham LLP is authorised and regulated by the Financial
Conduct Authority and is licensed by the Institute and Faculty of
Actuaries for a range of investment business activities.

Angele Storey
Demographic Analysis Unit
ONS


#missing90s

#populationpatterns

How accurate are official high age
population estimates?

Angele Storey, Demographic Analysis Unit,
Population Statistics Division, Office for National Statistics

Official high age estimates
• Annual mid-year population estimates by single year of
age and sex up to age 89 and 90 and over population
- component cohort method
• Life tables and population projections require population
estimates at single year of age for the 90 and over
population
- Kannisto-Thatcher method (form of survivor ratio
methodology)

.

Kannisto -Thatcher method
• Age at death data is used to build profiles of the
distribution of older people in back years
• Average of the last 5 years ‘age at death’ data for each
cohort is used to produce an estimate of the number of
survivors for the current year.
• KT estimates constrained to the official 90+ total in final
stage of the method
• Back years are recalculated annually as more recent
deaths data becomes available

KT 90+ totals as percentage of official MYE 90+
totals
105
Sum of deaths
100

95

90

85

80

75
1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011
Males

Females

1991, 2001 and 2012 based KT 90+ totals as a
percentage of official 90+ totals - Males
100

98
96
94
92
90
88
86
84
82
80
1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011
2012 based KT estimates



1991, 2001 and 2012 based KT 90+ totals as a
percentage of official 90+ totals - Females
105

100

95

90

85

80
1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011



Comparison of 90+ totals across data sources
- Males

130,000

120,000

110,000

100,000

90,000

80,000

70,000
2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

90+ on Patient Register

DWP 90+ claimants

Official 90+ MYE

90+ KT estimate (unconstrained)

2012

Comparison of 90+ totals across data sources
- Females
360,000

340,000

320,000

300,000

280,000

260,000

240,000
2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

90+ on Patient Register

DWP 90+ Claimants

Official 90+ MYE

90+ KT estimate (unconstrained)

2012

Possible sources of error in data
sources
• Census estimates:
- D.o.b. exaggeration and mis-reporting
- Proxy responses
- Some incorrect recording of year of birth / processing issues

• Inter-censal estimates: (Annual Mid-Year Estimates)
- Any errors in 90+ age group at Census are rolled forward
- Any over-count in those in their 80s comprises a larger
proportion as these non-existent people are aged on

• Patient Register and DWP claimants
- People not removed / time lag in removing?
- People not on registers
-

KT method assumptions

1) Deaths data is accurate and complete
- No validation of d.o.b on death certificate
- Occurrences recorded in the correct year but those not captured at
time are not added back
- Registrations capture all deaths but not necessarily in correct year

2) No migration at oldest ages
- Internal to E & W (around 2.1% of people aged 90+ in 2005)
- international migration – in and out flows too small to measure

What would be the impact of lower
estimates of the very old on life expectancy?

2012 BASED
MALES

KT estimates
constrained
to official
90+ total

KT estimates KT estimates
constrained to unconstrained
92% of official
90+ total

Life expectancy
at age 0

79.2

79.2

79.1

Life expectancy
at age 65

18.4

18.4

18.3

Life expectancy
at age 90

4.0

3.8

3.5

What would be the impact of lower
estimates of the very old on life expectancy?

2012 BASED
FEMALES

KT estimates
constrained
to official
90+ total

KT estimates KT estimates
constrained to unconstrained
95% of official
90+ total

Life expectancy
at age 0

82.9

82.8

82.7

Life expectancy
at age 65

20.9

20.8

20.7

Life expectancy
at age 90

4.7

4.5

4.1

Review of 90+ totals and age
distributions
• Investigate effects of ‘tweaking the method’
- optimum survivor ratios; death registrations v. death
occurrences; calendar year to mid-year

• Investigate effect of no allowance being made for
improvements to the mortality rate in KT method
• Produce UK set of 90+ estimates on basis of
combined constituent countries deaths data (to
eliminate any internal migration factor)
• Assess optimum age to ‘join’ KT estimates to official
90+ estimates

Review of 90+ totals and age
distributions cont….
• Investigate extent of inaccuracies in reporting of d.o.b.
in the Census ,
- validate a sample of 90+ deaths by matching to birth
certificates
- use ONS LS to trace those aged 90 to 115 back thorough the 5
available Censuses
- quantify imputation rates at oldest ages

• Detailed investigation of comparative data sources- age
distributions
• Discussion – Your ideas – what else could we do?

For further information…
For information or queries on…..
- population ageing, contact:

ageing@ons.gov.uk

- national life expectancy, contact:

lifetables@ons.gov.uk;

- sub-national life expectancy ,contact:
- population projections ,contact:
- 2011 Census, contact:

mortality@ons.gov.uk

projections@ons.gov.uk

Census.customerservices@ons.gov.uk

David Sinclair
Assistant Director, Policy and Communications
ILC-UK


#missing90s

#populationpatterns

The oldest old

David Sinclair, International Longevity
Centre – UK @ilcuk @sinclairda

The International Longevity Centre-UK is an independent, non-partisan think-tank

dedicated to addressing issues of longevity, ageing and population change.

 Life is pretty tough.
(frailty/isolation/health/income)
 Dependency is not inevitable
 Irrespective on the exact numbers. There will be
more.
 We don’t actually know a lot about the oldest
old.

 Today’s oldest old are not necessarily
representative of tomorrows
(genetics/environment/poor health = withdrawal
from longitudinal studies)


Life is not easy for the oldest old
 Three quarters of the oldest old
suffer from limiting longstanding
illnesses, and one out of three
perceive themselves as being in
poor health. (Tomassini C, 2005)

 “almost 50% of men and women

http://www.flickr.com/photos/pondspider/4170
990903/sizes/m/in/photostream/

aged 80-84 report severe
limitations in activities” (IFS,

2010)


Falls
 60% of interviewees aged over
90 had had a fall and that of
these, 4 in five were unable to
get up after at least one fall and
almost a third had lain on the
ground for an hour or more.

 Call alarms were widely
available but not used.(Fleming
and Brayne, 2008; Cambridge
City over 75-Cohor. BMJ)


And many find it difficult to do day to day
tasks
Sixty per-cent of over 90s
report difficulties shopping for
groceries, almost a quarter

report difficulties making
telephone calls and 35% report

http://www.flickr.com/photos/pinkcho
colate/3039589789/sizes/m/in/photos
tream/

difficulties managing money.

(Sinclair, 2010/ELSA)



A relatively high proportion live alone

Of those living in
private households,
four in ten very old
men and seven out of
ten very old women
live alone. One out of
five very old people
live in communal
establishments.
(Tomassini C, 2005).

http://www.flickr.com/photos/sbeebe/51541697



Living together is good for us
 Those who moved from living alone to living
as part of a couple (with no children)
exhibited a 68% fall in the odds of becoming
multiply excluded between 2002 and 2008
compared to those who stayed living alone;

 Those who moved from being resident in a
couple household to living alone were over
three times more likely to become multiply
excluded. For this age group (50+),
becoming a widow is one of the most
common reasons for starting to live alone.


http://www.flickr.co
m/photos/anabadili/
2963913137/sizes/
m/in/photostream/

The oldest old remain the most excluded
 Almost 38% of those aged 85 or
older faced some kind of social
exclusion, an encouraging decline
of 10% from the 2002 levels
 As people age, they are more
likely to become more socially
excluded than less

http://www.flickr.com/photos/pinkcho
colate/3039589789/sizes/m/in/photos
tream/

 Almost two-fifths (38%) of those
aged 85 and older were excluded
from two or more domains of
exclusion in 2008


Quality of Life falls with age



Depression
 “23% of those aged 85 and over
had levels of depressive
symptoms indicative of clinical
relevance”

 “Almost 13% of men and women
aged 80 and over had high
levels of depressive symptoms
in 2008-09 but not in 2002-03”
(IFS, 2010) ELSA

http://www.flickr.com/photos/junglearctic/



Most centenarians consult their GP
98% of centenarians
and near
centenarians
consulted a GP and
received prescription
medicine during
follow up. (Roughead,
Kalisch et al, 2010)
http://www.flickr.com/photos/rwjensen/2288339230/sizes/m/in/photostre
am/



Centenarians do use drugs heavily
A study of 602 centenarians in
Italy found that a very high
proportion of this age group
were users of drugs.







5% no drugs.
13% one drug a day
16% took 2 drugs per day
65% took three drugs a day
5.5% more than 3 drugs a
day.



Some evidence of longer hospital stays
Centenarians who had suffered from a hip
fracture between 2000 and 2007 compared to a
randomly selected control group of 50 hip
fracture patients aged between 75 and 85. “the
mean stay in acute orthopaedic wards for
centenarians was 20.7 days and for the control
group was 14.9 days”.
The longer acute hospital stay in the centenarian
cohort would amount to a mean extra cost of £
2511 per patient. (Verma et al)


Dementia among centenarians
The prevalence of
dementia-free
survival past 100

years of age varied
between 0 and 50
percent.
http://www.flickr.com/photos/thousandshipz/4679235/sizes/m/in/photostream/



Poverty is a very real challenge
 There is evidence that the
oldest old (aged 85 and over)
are, as a group, at greater risk
of poverty than younger older
people (aged 65-85)

 Up to 10% of the oldest old
have total net wealth of £3,000
or less.



Britons ageing quicker than their parents



Dependency is not inevitable
Dependency is not
inevitable and a
”considerable proportion of
the centenarians maintain a
good level of auto
sufficiency for the basic
performance of the
everyday life”. (Antonini et
al, 2008)

http://www.flickr.com/photos/driever/5525684658/si
zes/m/in/photostream/



Some of the oldest old become more active



A move to prevention is vital
 Prevention of ill health

 Physical Activity
 Smoking and alcohol consumption

 Nutrition
 Immunisation



We need to get housing right
1. Extra care housing is a
home for life
2. Extra care translates
into fewer falls
3. Extra care is
associated with a lower
uptake of inpatient
hospital beds



Many thanks

David Sinclair
Head of Policy and Research
International Longevity Centre
Davidsinclair@ilcuk.org.uk
02073400440
Twitter: @ilcuk and @sinclairda


Andrew Latto
Deputy Director, State Pensions Directorate
Department for Work and Pensions


#missing90s

#populationpatterns

05Mar14 - Missing 90 year olds

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