Daily Papers

A growing literature argues that progress in human longevity is slowing, and that this slowdown may signal an approaching biological limit to lifespan. The argument rests on visible flattening of cumulative life expectancy records, evaluated through linear regressions or through comparisons of average gains across decades. These summaries, however, provide only weak evidence for slowing improvements, because they cannot distinguish a true from an apparent slowdown. An apparent slowdown may arise due to periods of low variance around unchanged mean annual gains. Applying a Bayesian change-point framework to annual gains, both at the best-practice frontier and separately for each record-holding country, we find no evidence that the expected annual gain has changed across nearly two centuries, but strong evidence that its variance has moved through distinct historical regimes, with progress most regular in recent decades. The recent flattening is consistent with a low-variance regime and provides little evidence for a decline in the underlying mean pace of improvement. Claims that the best-practice frontier signals a biological ceiling should therefore not rest on the recent bend in the cumulative record alone. The frontier is better read as an empirical benchmark, the highest country-specific survival achieved under observed historical conditions.

Human aging is marked by a steady rise in the risk of dying with age-a process demographers call senescence. Over the past century, life expectancy has risen dramatically, but is this because we are aging slower, or simply starting it later? Vaupel hypothesizes that the pace at which individuals age may be constant, with gains in longevity coming from the delayed onset of senescence rather than its slowing down. We test this idea using a new framework that decomposes the pace of senescence into three components: a biological baseline, a long-term trend, and the cumulative impact of period shocks. Applying this to cohort mortality data above age 80 from 12 countries, we find that once period shocks are accounted for, there is no statistical evidence of a long-term trend, consistent with Vaupel's hypothesis. Analyses using lower starting ages yield the same qualitative conclusion. Rather than indicating a change in the process that drives senescence, these variations are consistent with echoes of shared historical events. These results suggest that while longevity has shifted, the rhythm of human aging may be conserved.

Age-specific mortality improvements are non-uniform, neither across ages nor across time. We propose a two-step procedure to estimate the rates of mortality improvement (RMI) in age-specific death rates (ASDR) at ages 85 and above for ten European countries from 1950 to 2019. In the first step, we smooth the raw death counts and estimate ASDR using four different methods: one parametric (gamma-Gompertz-Makeham), two non-parametric (P-splines and PCLM), and a novel Bayesian procedure to handle fluctuations resulting from ages with zero death counts. We compare the goodness of fit of the four smoothing methods and calculate the year-to-year ASDR differences according to the best-fitting one. We fit a piecewise linear function to these differences in the second step. The slope in each linear segment captures the average RMI in the respective year range. For each age, we calculate the goodness of fit in the last linear segment to assess how informative the estimated RMI of current mortality change is. The estimated rates of mortality improvement or deterioration (RMI) can be used to make short-term social, health, and social planning, as well as more precise mortality forecasts.

This paper presents a novel approach for modeling mortality rates above age 70 by proposing a mixture-based model. This model is compared to four other widely used models: the Beard, Gompertz, Makeham, and Perks models. Our model can capture the complex behavior of mortality rates at all ages, providing a more accurate representation of the data. To evaluate the performance of our model, we applied it to two countries with different data quality: Japan and Brazil. Our results show that the proposed model outperforms the other models in both countries, particularly in Japan where it obtained an absolute mean percentage error of less than 7%, while the other models presented values greater than 30%. This highlights the ability of our model to adapt to different data quality and country-specific mortality patterns. In summary, this paper presents a mixture-based model that captures the behavior of mortality rates at all ages and outperforms other widely used models in both high- and low-quality data settings. This model can improve mortality prediction and inform public health policy.

The face is a rich source of information that can be utilized to infer a person's biological age, sex, phenotype, genetic defects, and health status. All of these factors are relevant for predicting an individual's remaining lifespan. In this study, we collected a dataset of over 24,000 images (from Wikidata/Wikipedia) of individuals who died of natural causes, along with the number of years between when the image was taken and when the person passed away. We made this dataset publicly available. We fine-tuned multiple Convolutional Neural Network (CNN) models on this data, at best achieving a mean absolute error of 8.3 years in the validation data using VGGFace. However, the model's performance diminishes when the person was younger at the time of the image. To demonstrate the potential applications of our remaining lifespan model, we present examples of using it to estimate the average loss of life (in years) due to the COVID-19 pandemic and to predict the increase in life expectancy that might result from a health intervention such as weight loss. Additionally, we discuss the ethical considerations associated with such models.

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

Whether the risk of death keeps climbing at extreme ages or levels off has divided researchers for a century. We show this conflict reflects a moving target. Using cohort data from twelve low-mortality populations, we find that mortality deceleration and plateau onset shift steadily later across cohorts born from the mid-19th to the early-20th century. The data support a plateau across the full cohort range, though evidence weakens for the youngest, incompletely observed cohorts. In these younger cohorts, deceleration begins near age 100, and the fitted plateau begins beyond age 108. Because past studies focused on different cohorts and fixed age ranges, they sampled different phases of the exact same shift. The mortality plateau has no fixed age: it has been rescheduled.

In this paper, we suggest a novel method for detecting mortality deceleration. We focus on the gamma-Gompertz frailty model and suggest the subtraction of a penalty in the log-likelihood function as an alternative to traditional likelihood inference and hypothesis testing. Over existing methods, our method offers advantages, such as avoiding the use of a p-value, hypothesis testing, and asymptotic distributions. We evaluate the performance of our approach by comparing it with traditional likelihood inference on both simulated and real mortality data. Results have shown that our approach is more accurate in detecting mortality deceleration and provides more reliable estimates of the underlying parameters. The proposed method is a significant contribution to the literature as it offers a powerful tool for analyzing mortality patterns.

\noindent The modal age at death is an increasingly used measure for understanding longevity and mortality patterns. However, existing estimation methods focus on point estimates, overlooking the inherent variability and uncertainty in mortality data. This study addresses this gap by introducing a probabilistic framework for estimating the probability distribution of the modal age at death. Using a multinomial model for age-specific death counts and leveraging a Gaussian approximation, our methodology captures variability while aligning with the discrete nature of mortality data. Empirical examples are based on mortality data from six different countries. By quantifying uncertainty around the modal age at death and improving robustness to data fluctuations, this approach offers valuable insights for demographic research and policy planning.

Automatic Adjustment Mechanisms (AAM) are legal instruments that help social security systems respond to demographic and economic changes. In Brazil, the Social Security Factor (SSF) was introduced in the late 1990s as an AAM to link retirement benefits to life expectancy at the retirement age, with the hope of promoting contributory justice and discouraging early retirement. Recent research has highlighted the limitations of right-censored life tables, such as those used in Brazil. It has recommended using the gamma-Gompertz-Makeham (GGM) model to estimate adult and old-age mortality. This study investigated the impact of right-censoring on the SSF by comparing the official SSF and other social security metrics with a counterfactual scenario computed based on fitted GGM models. The results indicate that from 2004 to 2012, official life tables may have negatively impacted retirees' income, particularly for those who delayed their retirement. Furthermore, the GGM-fitted models' life expectancies had more stable paths over time, which could have helped with long-term planning. This study's findings are significant for policymakers as they highlight the importance of using appropriate mortality metrics in AAMs to ensure accurate retirement benefit payments. They also underscore the need to consider the potential impacts of seemingly innocuous hypotheses on public action outcomes. Overall, this study provides valuable insights for public planners and policymakers looking to enhance the effectiveness and fairness of social security systems.

The Makeham term is a crucial element in mortality modeling, representing a constant additive hazard that addresses background mortality factors unrelated to aging. Widely used in mortality analysis, this term enables the capture of risks not linked to age-related decline. This paper aims to explore the relationship between Makeham mortality models and competing risk frameworks, investigating how Makeham models can be analyzed within the context of competing risks. It provides insights into the mathematical properties, interpretation, and applicability of Makeham models in modeling mortality risks associated with various causes of death. Additionally, it demonstrates that competing risk models can be represented as mixture models, enhancing understanding of mortality dynamics. The contribution lies in showing that Makeham mortality models, when represented as mixtures, offer a straightforward specification that can accommodate unobserved heterogeneity and distinguish between senescent and extrinsic mortality. By expressing Makeham models as a convex combination of probability distributions, the paper allows the estimation of premature mortality profiles, particularly at older ages, where most deaths are assumed to be senescent. It also facilitates the estimation of senescent mortality, which is crucial for studying the aging process.

Predicting mortality-related outcomes from images offers the prospect of accessible, noninvasive, and scalable health screening. We present a method that leverages pretrained vision transformer foundation models to estimate remaining lifespan from facial and whole-body images, alongside robust uncertainty quantification. We show that predictive uncertainty varies systematically with the true remaining lifespan, and that this uncertainty can be effectively modeled by learning a Gaussian distribution for each sample. Our approach achieves state-of-the-art mean absolute error (MAE) of 7.48 years on an established Dataset, and further improves to 4.79 and 5.07 years MAE on two new, higher-quality datasets curated and published in this work. Importantly, our models provide well-calibrated uncertainty estimates, as demonstrated by a bucketed expected calibration error of 0.62 years. While not intended for clinical deployment, these results highlight the potential of extracting medically relevant signals from images. We make all code and datasets available to facilitate further research.

Life satisfaction is a crucial facet of human well-being. Hence, research on life satisfaction is incumbent for understanding how individuals experience their lives and influencing interventions targeted at enhancing mental health and well-being. Life satisfaction has traditionally been measured using analog, complicated, and frequently error-prone methods. These methods raise questions concerning validation and propagation. However, this study demonstrates the potential for machine learning algorithms to predict life satisfaction with a high accuracy of 93.80% and a 73.00% macro F1-score. The dataset comes from a government survey of 19000 people aged 16-64 years in Denmark. Using feature learning techniques, 27 significant questions for assessing contentment were extracted, making the study highly reproducible, simple, and easily interpretable. Furthermore, clinical and biomedical large language models (LLMs) were explored for predicting life satisfaction by converting tabular data into natural language sentences through mapping and adding meaningful counterparts, achieving an accuracy of 93.74% and macro F1-score of 73.21%. It was found that life satisfaction prediction is more closely related to the biomedical domain than the clinical domain. Ablation studies were also conducted to understand the impact of data resampling and feature selection techniques on model performance. Moreover, the correlation between primary determinants with different age brackets was analyzed, and it was found that health condition is the most important determinant across all ages. This study demonstrates how machine learning, large language models and XAI can jointly contribute to building trust and understanding in using AI to investigate human behavior, with significant ramifications for academics and professionals working to quantify and comprehend subjective well-being.

We introduce a general, flexible, parametric survival modelling framework which encompasses key shapes of hazard function (constant, increasing, decreasing, up-then-down, down-then-up), various common survival distributions (log-logistic, Burr type XII, Weibull, Gompertz), and includes defective distributions (i.e., cure models). This generality is achieved using four basic distributional parameters: two scale-type parameters and two shape parameters. Generalising to covariate dependence, the scale-type regression components correspond to accelerated failure time (AFT) and proportional hazards (PH) models. Therefore, this general formulation unifies the most popular survival models which allows us to consider the practical value of possible modelling choices for survival data. Furthermore, in line with our proposed flexible baseline distribution, we advocate the use of multi-parameter regression in which more than one distributional parameter depends on covariates - rather than the usual convention of having a single covariate-dependent (scale) parameter. While many choices are available, we suggest introducing covariates through just one or other of the two scale parameters, which covers AFT and PH models, in combination with a `power' shape parameter, which allows for more complex non-AFT/non-PH effects, while the other shape parameter remains covariate-independent, and handles automatic selection of the baseline distribution. We explore inferential issues in simulations, both with and without a covariate, with particular focus on evidence concerning the need, or otherwise, to include both AFT and PH parameters. We illustrate the efficacy of our modelling framework by investigating differences between treatment groups using data from a lung cancer study and a melanoma study. Censoring is accommodated throughout.

We propose a neural-network based survival model (SurvSurf) specifically designed for direct and simultaneous probabilistic prediction of the first hitting time of sequential events from baseline. Unlike existing models, SurvSurf is theoretically guaranteed to never violate the monotonic relationship between the cumulative incidence functions of sequential events, while allowing nonlinear influence from predictors. It also incorporates implicit truths for unobserved intermediate events in model fitting, and supports both discrete and continuous time and events. We also identified a variant of the Integrated Brier Score (IBS) that showed robust correlation with the mean squared error (MSE) between the true and predicted probabilities by accounting for implied truths about the missing intermediate events. We demonstrated the superiority of SurvSurf compared to modern and traditional predictive survival models in two simulated datasets and two real-world datasets, using MSE, the more robust IBS and by measuring the extent of monotonicity violation.

The probabilistic reading of the cumulative accuracy profile (CAP) has a long industry lineage. Falkenstein, Boral and Carty (2000) state, in discrete form, that the default rate at a score percentile equals the portfolio average rate times the local slope of the power curve; van der Burgt (2008, 2019) formalizes this as the continuous identity p(Dmid x) = p_D, dy/dx and imports the continuous form as a working fact; Tasche (2009) analyzes the resulting calibration method; Voloshyn and Voloshyn (2023) substitute Bayes' theorem, f(xmid D)=p(Dmid x) f(x)/p_D, into the area integral and write the Gini as a functional of the calibration curve. The slope itself is already in the lineage (van der Burgt's dy/dx is the ratio of the two cumulative differentials), but it enters as a cited working fact, never as Bayes' theorem. We make that identification explicit and draw out its consequences. First, the CAP slope is Bayes' theorem in cumulative coordinates: the standardized PD it recovers is the posterior probability rescaled by the prior. The weight of the paper then falls on two results this reading unlocks. The odds form places the weight of evidence (the log of the likelihood ratio, i.e. the Bayes factor) and the information value inside one geometry (the weight of evidence at a point is the log of the ratio of the "bad" and "good" CAP slopes). The accuracy ratio, Somers' D_{xy}, and the Gini (2A-1)/(1-p_D) are revealed as one number computed three ways. Run in comparison mode (realized outcomes against model claims), the same identity recovers the reliability diagram in cumulative coordinates, with the sign of the gap between the empirical and model-implied Gini coefficients as a calibration diagnostic. A worked five-band example carries every identity in discrete form, and a kernel-density example extends them to the continuous case.

A wide range of statistical and machine learning methods have been proposed for survival analysis with competing risks, where the occurrence of one event (i.e., cancer death) precludes the occurrence of other events (i.e., cardiovascular disease death). Despite these methodological advances, their systematic evaluation and adoption are limited by the lack of comprehensive, reproducible and extensible benchmarking frameworks. We developed an open-source benchmarking framework for competing risks models that enables their systematic comparison across multiple datasets under different aspects of performance; calibration, discrimination, overall prediction error and clinical utility. We additionally introduce an extension of SHAP for competing risks, allowing model-agnostic interpretability of covariates contributions over time. All our code is publicly available via GitHub:https://github.com/BBolosSierra/CompRisksBenchmark

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.