Theories about biological limits to life span and evolutionary shaping of human longevity depend on facts about mortality at extreme ages, but these facts have remained a matter of debate. Do hazard curves typically level out into high plateaus eventually, as seen in other species, or do exponential increases persist? In this study, we estimated hazard rates from data on all inhabitants of Italy aged 105 and older between 2009 and 2015 (born 1896-1910), a total of 3836 documented cases. We observed level hazard curves, which were essentially constant beyond age 105. Our estimates are free from artifacts of aggregation that limited earlier studies and provide the best evidence to date for the existence of extreme-age mortality plateaus in humans.

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Two cases of focal occipital epilepsy with cerebral calcifications poorly responsive to antiepileptic treatment are described. In both cases coeliac disease was diagnosed and folic acid deficiency documented. A gluten-free diet and a brief supplementation with folic acid lead to a complete EEG and clinical normalization in one case and to a significant improvement of EEG and seizure control in the other.

This paper considers the issue of actuarial fairness of the new Italian public pension system in view of the recent trends in old-age mortality and the survival differences by gender, birth cohort and region of residence. After reviewing the secular trends in elderly mortality in Italy, and the evolution of regional differences in survival over the last three decades, we evaluate the impact, on the conversion factors introduced by the Dini reform, of a further decline in elderly mortality over the next few decades. We compute the conversion factors using a close approximation to the unknown formula employed in the Dini reform but allowing for gender-and region-specific survival probabilities. Our results leave no doubt about the importance of frequently updating the conversion factors in the light of the rapid increase in elderly survival. The paper also quantifies to what extent gender-and region-specific conversion factors may differ from their currently legislated values, that only vary by age. Finally, we recognize that the actuarial fairness of the system introduced by the recent reform can only be guaranteed on average and that, in the presence of a heterogeneous population of individuals that differ considerably in their mortality prospects, the current system implies a substantial degree of redistribution from high-mortality groups (typically characterized by low income and low wealth) to low-mortality groups (typically characterized by high income and high wealth).LABOUR 17 (Special Issue) 45-78 (2003) JEL J11, J14, N33, N34Note: Some differences in life expectancy are generated by inevitable approximations in applying Pollard's formula (1982) adapted to estimate the contributions made. Figure 2.Ratio of male to female mortality probabilities by age and calendar year from 1887-88 to 1994-95

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Gender-specific mortality surfaces are panels of time series of mortality rates that allow to examine the temporal evolution of male and female mortality across ages. The analysis of these surfaces is often complicated by time-varying effects that reflect the association of age and gender with mortality under unobserved time-varying conditions of the population under study. We propose a hidden Markov model as a simple tool to estimate time-varying effects in mortality surfaces. Under this model, age and gender effects depend on the evolution of an unobserved (hidden) Markov chain, which segments each time series of rates according to time-varying latent classes. We describe the details of an efficient EM algorithm for maximum likelihood estimation of the parameters and suggest a straightforward parametric bootstrap routine to compute standard errors. These methods are illustrated on cardiovascular and cancer mortality rates, observed in Italy during the period 1980–2014.