Ageing populations: The challenges ahead

Danish Ageing Research Centre, University of Southern Denmark, Odense, Denmark.
The Lancet (Impact Factor: 45.22). 10/2009; 374(9696):1196-208. DOI: 10.1016/S0140-6736(09)61460-4
Source: PubMed


If the pace of increase in life expectancy in developed countries over the past two centuries continues through the 21st century, most babies born since 2000 in France, Germany, Italy, the UK, the USA, Canada, Japan, and other countries with long life expectancies will celebrate their 100th birthdays. Although trends differ between countries, populations of nearly all such countries are ageing as a result of low fertility, low immigration, and long lives. A key question is: are increases in life expectancy accompanied by a concurrent postponement of functional limitations and disability? The answer is still open, but research suggests that ageing processes are modifiable and that people are living longer without severe disability. This finding, together with technological and medical development and redistribution of work, will be important for our chances to meet the challenges of ageing populations.

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    • "The population of Germany shows, like most developed countries, a steadily increasing life expectancy [11]. The increase in life expectancy, in conjunction with the birth rate which has been low for many years, led to a higher demographic ageing compared to other countries [6]. "
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    • "A perhaps more fundamental biological question is to what degree senescence is synchronous across physiological systems and phenotypic traits in a given species (Promislow, Fedorka & Burger 2006; Martin, Bergman & Barzilai 2007). Whilst influential evolutionary biologists have hypothesised that natural selection should shape senescence to be synchronous across physiological systems (Maynard-Smith 1962; Williams 1999), empirical data from humans and laboratory model organisms suggests asynchrony is commonplace and that health-and life-span are readily uncoupled (Herndon et al. 2002; Martin, Bergman & Barzilai 2007; Christensen et al. 2009; Bansal et al. 2015). However, the benign and protected conditions experienced by laboratory model organisms and modern human societies are associated with lifespans hugely in excess of those observed under natural conditions. "
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    ABSTRACT: The degree to which changes in lifespan are coupled to changes in senescence in different physiological systems and phenotypic traits is a central question in biogerontology. It is underpinned by a deeper biological question about whether or not senescence is a synchronised process, or whether levels of synchrony depend on species or environmental context. Understanding how natural selection shapes patterns of synchrony in senescence across physiological systems and phenotypic traits demands the longitudinal study of many phenotypes under natural conditions. Here, we examine the patterns of age-related variation in late adulthood in a wild population of Soay sheep (Ovis aries) that have been the subject of individual-based monitoring for thirty years. We examined twenty different phenotypic traits in both males and females, encompassing vital rates (survival and fecundity), maternal reproductive performance (offspring birth weight, birth date and survival), male rutting behaviour, home range measures, parasite burdens, and body mass. We initially quantified age-related variation in each trait having controlled for annual variation in the environment, among-individual variation and selective disappearance effects. We then standardised our age-specific trait means and tested whether age trajectories could be meaningfully grouped according to sex or the type of trait. Whilst most traits showed age-related declines in later life, we found striking levels of asynchrony both within and between the sexes. Of particular note, female fecundity and reproductive performance declined with age, but male annual reproductive success did not. We also discovered that while home range size and quality declines with age in females, home range size increases with age in males. Our findings highlight the complexity of phenotypic ageing under natural conditions and, along with emerging data from other wild populations and laboratory models, suggest that the long-standing hypothesis within evolutionary biology that fitness-related traits should senesce in a synchronous manner is seriously flawed. Copyright © 2015. Published by Elsevier Inc.
    Experimental gerontology 08/2015; DOI:10.1016/j.exger.2015.08.003 · 3.49 Impact Factor
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    • "In fact, people over the age of 85 years are the fastest growing population group in the USA and people above 65 years will soon constitute more than 20% of the population. Furthermore, a life expectancy of more than 100 years has been estimated for half of all girls born today in many western countries (Christensen et al., 2009). Already now, many women spend around 30– 40% of their lives in menopause and face sequelae such as demineralization of bones (i.e. "
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    ABSTRACT: Life expectancy has increased by more than 30 years during the last century and continues to increase. Many women already live decades in menopause deprived of naturally produced oestradiol and progesterone, leading to an increasing incidence of menopause-related disorders such as osteoporosis, cardiovascular diseases and lack of general well-being. Exogenous oestradiol has traditionally been used to alleviate menopause-related effects. This commentary discusses a radical new method to postpone menopause. Part of the enormous surplus of ovarian follicles can now be cryostored in youth for use after menopause. Excision of ovarian tissue will advance menopause marginally and will not reduce natural fertility. Grafted tissue restores ovarian function with circulating concentrations of sex steroids for years in post-menopausal cancer survivors. Future developments may further utilize the enormous store of ovarian follicles. Currently, the main goal of ovarian cryopreservation is fertility preservation, but grafting of ovarian tissue may also serve endocrine functions as a physiological solution to prevent the massive medical legacy of osteoporosis and menopause-related conditions in the ageing population. This intriguing solution is now technically available; the question is whether this method qualifies for postponing menopause, perhaps initially for those patients who already have cryostored tissue? Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 05/2015; 31(2). DOI:10.1016/j.rbmo.2015.05.002 · 3.02 Impact Factor
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