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Life Expectancy
Life expectancy is considered to be the length of survival of a person or a patient. On one hand, this length of survival can be calculated as life expectancy at birth, which represents the number of years an infant is supposed to live throughout his or her life. This information is of importance for political, administrative, and insurance purposes but has less meaning in daily practice for a physician. On the other hand, life expectancy can also be calculated as life expectancy at any time point in the life of a person; this then represents the number of years a person is supposed to live throughout the rest of his or her life. A physician is especially interested in this latter life expectancy, as for medical decision making it can be important to know, at a certain time point, how much longer a patient will have to live.
In the following, life expectancy in general, defined as life expectancy at birth and its changes over the decades, will be briefly discussed, as this information is relevant for present and future health systems as well as for prevalence and incidence of certain diseases. This will be followed by a more specific discussion of life expectancy at a given time point in life and about tools that can be used to make predictions of life expectancy accurate and reliable and therefore useful for medical decision making.
Life Expectancy in General
Life expectancies are assessed by considering the age-specific death rates of a population. These age-specific death rates are calculated by dividing the number of deaths in a given age-group by the total population of that age-group. They are expressed as an average annual rate in a 100,000-person population. These values represent the base to develop life tables which then can be used to estimate the probability of surviving from one age to the next. Based on that, the life expectancy at birth represents the average number of years infants are supposed to live if they were to experience the death rates present in the year of birth throughout their life. Moreover, life tables can be used to calculate the number of remaining life years at a certain age, if one considers the age-specific death rates for each year a person will age in the future.
Improvements in sanitation, nutrition, and medical knowledge have resulted in a constant increase of life expectancy during the past decades throughout the world. The greatest improvements have been observed in the most developed parts, such as North America, Europe, and Japan. For example, life expectancy at birth in the United States in 1900 was 47 years and reached 78 years in 2005. Life expectancy in India in the middle of the 20th century was around 39 years and reached 64 years in 2005. It is of note that the calculations of life tables do not consider any expected changes of life expectancy in the future. This means that the calculations of life expectancy are rather hypothetical, as they effectively assume that current death rates are “frozen” and will not change in the future.
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