By the year 2060, almost 24% of the US population will be age 65 or older. Biomedical and public health advances have led to great increases in longevity and a shift in disease burden to multiple chronic diseases with aging. In On the Risk, RGA's experts discuss frailty as an underwriting challenge. Explore the definition and prevalence rates of frailty and one of the most widely used frailty scales in geriatric research.
older age underwriting
Could air pollution contribute to the risk of developing Alzheimer’s disease? Can mental stimulation and social connection protect against the cognitive decline? RGA's Hilary Henly explores lifestyle and environmental risk factors, explores genetic insights and testing advances and more.
How can medical advancements extend a healthy lifespan and combat the diseases of old age?
Cognitive testing in life insurance is becoming more and more prevalent, particularly as the number of older age applicants grows. You can expect testing now as a routine at age 70 or older, and although the platform isn’t rigorous, it can derail an application almost irreversibly if performance is poor.
When one looks at a curve of the mortality rates by age in developed countries, we notice a very regular pattern. Especially the middle-age groups - age 30 to 70+, for example - seem to have close to an exponential curve in mortality rates.
The frailty index (FI) holds a robust and consistent correlation with mortality and morbidity and is a stronger predictor of mortality than chronological age. Frailty status may be a promising risk factor to add into the underwriting mix, particularly for disability products.
For a long time, Alzheimer’s could only be definitively diagnosed after a patient’s death based on neuropathological findings in the brain. Positron emission tomography (PET) scanning and spinal fluid technologies can improve on purely clinical diagnosis, but their cost and a lack of any cure means they are hardly used.
Many of today’s older-age evaluations include additional screenings to measure cognitive and frailty risks: clock drawing, delayed word recall and walking speed. These assessments may add time to the application process and increased cost for the insurer. However, recent studies indicate they could be replaced with a simple blood test: Cystatin C.
While wearables and apps are most closely associated with promoting physical fitness, technology is increasingly being put to use in lifestyle monitoring of the elderly and others in need of care.
Hilary Henly, Head of Underwriting, Ireland and Director, Divisional Underwriting Research, presents an innovative review of some non-traditional predictors of mortality and morbidity. She discusses the impact of loneliness, social engagement, and social activity. Given the aging population and newer approaches to older age underwriting, this topic will be of significant interest to the reader.