Ageing populations: the challenges ahead

Abstract

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.

Figure 1. Best-practice life expectancy and life expectancy for women in selected countries from 1840 to 2007

Linear regression trend depicted by solid grey line with a slope of 0·24 per year. Data from supplementary material of reference and the Human Mortality Database.

Figure 2. Probability of dying for elderly men and women in selected countries from 1950 to 2003

(A) Women aged 80 years. (B) Men aged 80 years. (C) Women aged 90 years. (D) Men aged 90 years. Data from reference .

Figure 3. Population pyramids for Germany in 1956, 2006, and 2050

Horizontal bars are proportional to number of men (blue) and women (red). Data for 2050 are based on the German Federal Statistical Office’s 1-W1 scenario, which assumes a roughly constant total fertility rate of 1·4, yearly net migration of 100 000 and life expectancy in 2050 reaching 83·5 years for men and 88·0 years for women. Data from reference and the Human Mortality Database.