1. At each period of the history of mankind, since the most primitive times, a small number of individuals were able to live up to 100 years and to thus carry out the potential maximum longevity of the species. Biology of aging and longevity R Cutler, 1985

2. There is no evidence that the maximum human life span has changed from what it was about a hundred thousand years ago… … If the human life span is really increasing, then, for example we might find that the oldest humans were reaching the age of 100 years in 1850, 115 years in 1900, and 120 years in 1950. This would be good evidence that maximum life span is increasing, especially if large numbers of people in each period reached these very old ages. Hayflick, 1996

3. European Health Forum Gastein, October 5th 2005 Perspectives for extending healthy life expectancy Jean-Marie Robine INSERM, Health and Demography, CRLC, University of Montpellier, France

4. During the 18th century… The first limits for the human life span Alexandre de Moivre (1724) : 86 ans Alexandre de Moivre (1724) : 86 ans Isaac de Graaf (1729) : 92 ans Isaac de Graaf (1729) : 92 ans As for what is alleged, that by some observations of late years, it appears, that life is carried to 90, 95, and even to 100 years ; I am not more moved by it, than by the example of Parr, or Jenkins, the first of which lived 152 years, and the other 167. de Moivre, 1724

5. Increase in life expectancy

6. Female life expectancy in the record- holding country since 1840… Oeppen & Vaupel, 2002

7. Increase in life expectancy in Switzerland Robine & Paccaud, 2005

8. … fall of mortality among the oldest-old

9. Mortality decline at age 80 Thatcher, 1999 England & Wales

10. Mortality rates at ages100-104 and 105 and over in Japan since 1975, female Robine & al, 2003

11. Mortality trajectories?

12. Modelisation… Thatcher-Kannisto, database, 1998

13. Robine & Vaupel, 2005

14. … emergence of the oldest-old

15. Emergence of the oldest-old in France during the 20th century France 1901-1999, females

16. 23,000 centenarians in Japan in 2003 Robine & Saito, 2003

17. More than 800 persons aged 105 and over in Japan in 2002 Robine & Saito, 2003

18. Emergence of super-centenarians: more than 20 cases in Japan in 2002 Robine & Saito, 2003

19. Lenghening of life

20. Distribution of deaths in Switzerland 1876-1880, 1929-1932, 1988-1993

21. Increase in the modal length of life and decrease in the standard deviation, males and females, Switzerland,1876-1880 to 2001-2002 Cheung, Robine, Paccaud, 2005

22. Maximum age reported at death, Switzerland Robine & Paccaud, 2005

23. Frail population…

24. Frail persons… Robine & Vaupel, 2001

25. In this context… To give a priority to the quality of life even if this probably will lengthen it more.

26. Trends in LE and DFLE at age 65 in the European Union, 1995-2003, for women Jagger and the EHEMU team, 2005

27. Trends in proportion of life spent disability-free at age 65 in the European Union, Women = gain of 5% + = loss of 5% + = gain or loss of less than 5% Jagger and the EHEMU team, 2005

28. Who will care for the oldest old?

29. Rapport entre le nombre des personnes de 85 ans et plus et les femmes âgées de 50 à 75 ans en France de 1900 à 2050; rapport ajusté selon les taux de dépendance du NLTCS et divers scénarios

30. Keeping the share between informal, informal + formal and formal LTC? More oldest old? More oldest old? More oldest old with LTC needs? More oldest old with LTC needs? Disability decline Disability decline Use of technical equipment Use of technical equipment More families with oldest old (actual numbers / proportion)? More families with oldest old (actual numbers / proportion)? More available children? More available children? Childless Childless Number of living children Number of living children Same willingness to care for? Same willingness to care for? Impact of divorce (father/daughter)… Impact of divorce (father/daughter)… Son participation in caring Son participation in caring Same demand / same expectation Same demand / same expectation Ability to afford paid services Ability to afford paid services Level of education (SES differentials) Level of education (SES differentials) Same level of disability for the oldest old with LTC needs? Same level of disability for the oldest old with LTC needs? Ability to care for Ability to care for Informal use only Informal use only Informal and formal Informal and formal Formal only Formal only

31. Thank you

32. Horizontalization of the survival curve, women, Switzerland, from 1876-80 to 2001-02 Cheung, Robine, Paccaud, 2005

33. Verticalization of the survival curves, women in Switzerland, 1876- 80 and 2001-02 Cheung, Robine, Paccaud, 2005