Purpose: The moving rectangle method is used to disentangle the contributions of rectangularization and life span extension to the increase in life expectancy. It requires the choice of an endpoint... Show morePurpose: The moving rectangle method is used to disentangle the contributions of rectangularization and life span extension to the increase in life expectancy. It requires the choice of an endpoint of the survival curve that approaches the maximum age at death. We examined the effect of choosing different end points on the outcomes of this method. Methods: For five developed countries, survival curves from age 50 years were constructed per calendar year from 1922 onward. Survival values of 0.1, 0.01, and 0.001 were chosen as end points of the survival curve, and the contributions of rectangularization and life span extension to the increase in life expectancy were calculated using the moving rectangle method. Results: The choice of different survival values as end points profoundly influenced the estimated contributions of rectangularization and life span extension to the increase in life expectancy. When choosing 0.001, rectangularization contributed most years, whereas when choosing 0.1, life span extension contributed most years. Conclusions: When the moving rectangle method is used to estimate the contributions of rectangularization and life span extension to the increase in life expectancy, its outcomes depend on the choice of the endpoint of the survival curve. Show less
In this thesis we first studied the start of the epidemiologic transition in rural Ghana and describe the changes in mortality. This is followed by studies on the compression of mortality and... Show moreIn this thesis we first studied the start of the epidemiologic transition in rural Ghana and describe the changes in mortality. This is followed by studies on the compression of mortality and morbidity during the transition in Japan and the Netherlands. Finally, we examined the plasticity of mortality at old age. Studying old-age mortality during the epidemiologic transition is of great importance now that an increasing number of people reach old-age. The main findings from this thesis are that overall, when countries shift from a pre- to a post-transitional stage, mortality decreases and an increasing number of people live up to old age. In addition, mortality is compressed to a narrower age interval in which most of the annual deaths occur. This compression of mortality reaches a limit as soon as countries enter the post-transitional era. Furthermore, during the last stage of the epidemiologic transition we have observed that life expectancy without disability is increasing parallel to the increase in life expectancy, indicating a compression of disability. Finally we found that, mortality remains highly plastic up to old age, as indicated by the continuous rise in life expectancy and the shift of the age-at-death distribution towards higher ages. Show less
Engelaer, F.M.; Bodegom, D. van; Westendorp, R.G.J. 2013
Life expectancy has steadily increased with around 2.5 years per decade over the past 150 years and continuous to do so at a similar rate [1]. Before 1950, the increase in life expectancy was... Show moreLife expectancy has steadily increased with around 2.5 years per decade over the past 150 years and continuous to do so at a similar rate [1]. Before 1950, the increase in life expectancy was primarily driven by reductions in child mortality. During the last decades, however, the increase in life expectancy is mainly the result of mortality reductions at old age [2]. Better living conditions and hygiëne have saved us from an early death, while incremental health care innovations have brought us an old age Show less
