Articles - AI and pensions affecting life expectancy


Since the mid-1800s, U.K. life expectancy has consistently increased despite the occasional shocks from major global pandemics or wars. Since the early 2000s, there has been excellent progress in reducing rates of death attributable to cardiovascular diseases and certain cancers. However, these improvements slowed in the decade leading up to the COVID-19 pandemic and only last year did mortality rates return to the relatively low levels achieved in 2019, just before that pandemic.

 By Adam Boyes, Head of Trustee Consulting, Stephen Caine, Senior Mortality Consultant and Alison Fisher, Director, Retirement at WTW

 With such significant progress and some of the more obvious gains in hindsight having been made (e.g. reduction in smoking prevalence), it is less clear what will drive significant further extensions in life expectancy. Furthermore, the NHS currently faces several significant challenges that appear to present a headwind to further gains.

 In theory, the application of AI has the potential to bring about significant positive change in a great number of health-related areas that could lead to improvements in life expectancy.

 Where could AI have an impact on lifespan?
 Click on the sections below to explore some areas where AI may affect lifespan.

 Disease detection
 Being able to detect the potential onset of a disease before it takes effect can drastically improve health outcomes and is why certain existing screening programs are the norm in the U.K.. AI presents the possibility of reduced costs through automation, identifying new and less-invasive signatures for the early detection of diseases, and improved accuracy in pinpointing issues.
 Some examples of disease detection include:
 The U.K. has launched a world-leading trial involving almost 700,000 women to catch breast cancer cases earlier through the use of AI to review mammograms
 A pilot project, supported by NHS England, uses an AI model to detect heart inflammation and can identify people at risk of a heart attack in the next decade
 There are a number of areas where AI is being applied to assist to spot cancers and other disease markers in blood tests before they become critical
 Software involving AI has been found to be twice as accurate as visual assessments by medical professionals in analysing brain scans of patients who have had a stroke

 Accelerated drug discovery
 New drugs provide the hope of curing previously untreatable diseases or improving the effectiveness or patients' experiences of current treatments. AI could accelerate the discovery process significantly, potentially resulting in a ten-fold increase in the rate of drug discovery (which currently takes 5-10 years).
 Some examples of accelerated drug discovery include:
 At the World Economic Forum in early 2025, Demis Hassabis of Google's DeepMind, which developed AlphaFold, explained that he expected that the first drug discovered by AI would happen by the end of this year
 In the search for treatments for Parkinson's disease, researchers from the University of Cambridge have been able to speed up the initial screening process for new drugs ten-fold and reduce cost by a thousand-fold

 Enhancing precision (P4) medicine
 Coined in the early 2000s, 'P4' medicine is Predictive, Preventive, Personalised and Participatory medicine – moving from one-size-fits-all medicine to an approach that is personalised to the individual in order to determine the optimal treatment. AI offers the ability to accelerate and enhance the art of the possible, predicting a patient's responses to medical interventions by using AI models that combine many large data sources (e.g. genomics, biometrics and historical medical records) to develop the treatment plan and medicine itself.
 Some examples of enhancing precision (P4) medicine include:
 At the launch of the Stargate Project, Larry Ellison (chairman of Oracle) highlighted that AI may enable the development of customised vaccines that could be created within 48 hours of the potential cancer being identified through an early detection test. AI would be applied both in identifying small tumour fragments in bloodstreams, which are then gene-sequenced in order for a robotic system to produce a customised mRNA vaccine tailored to that individual
 Beyond vaccines, AI is enabling 'digital twins' of human organs to be modelled on computers enabling more rapid testing of medical devices and disease treatments, accelerating the time to reach human trials and potentially reducing mortality rates associated with medical interventions due to the ability to test procedures in a more fine-tuned way. AI and machine learning have had a significant effect on microbiome research leading to personalised microbiome treatments

 Robot-assisted surgery
 The amount of surgery undertaken with robotic assistance has been growing fast in the last few years. Advances in robotics have enabled the performance of more intricate, complex operations less invasively and with enhanced precision. This can improve patient outcomes, with fewer complications, faster recoveries and less time in hospital, and can be particularly beneficial for elderly or frail patients who may not tolerate surgery as well. AI could expand the breadth of capabilities of robotic assistance in surgery environments, including the monitoring of and reaction to visual information and other data from patient monitoring systems.
 Some examples of robot-assisted surgery include:
 Researchers at the University of Yokohama have developed a deep-learning model to assist surgeons with recognising safe areas for dissection without blood vessels and nerves
 The latest model of the da Vinci surgical system (currently the most widely used robotic surgical system) has force-sensing technology, which will provide data for bringing future analytical insights supported through AI

 Chronic disease management
 The combination of continual monitoring devices, AI and internet connectivity could enable improved management and long-term care in relation to a number of chronic diseases. For example, providing round-the-clock detection of subtle signs of deterioration in their condition would alert the individual, their caregivers or their medical professionals to act.
 Better management of chronic diseases could lead to fewer (or the later onset of) severe complications, reducing co-morbidities and leading to longer, healthier lives.
 Some examples of Chronic disease management include:
 Phillips reported that an AI-powered wearable ECG sensor could reduce readmissions for stroke patients as well as significantly lower A&E usage
 A continuous glucose monitoring (CGM) system uses AI to continually analyse how an individual's glucose levels respond to food, insulin, and other contextual data, providing personalised insights for more effective diabetes management

 Lifestyle improvements
 Smartphones, smartwatches and other wearables have been tracking all manner of metrics about us over the last decade and are now being enhanced with an array of AI features. These devices can provide targeted behavioural nudges that guide us towards improved physical and mental health as well as tailored plans to improve fitness and diet. The incorporation of large language models may lead to increased interaction with our devices due to the more natural human-like communication. Additionally, it offers a new channel for providing mental health support.
 Google has tested a large language model to allow users to ask questions about their Fitbit data and receive personalised insights in natural language
 Researchers have used deep learning models to use Fitbit data to detect depression and anxiety
 AI-powered CBT support allows personalised mental health treatments to reach the masses

 NHS efficiency and healthcare availability
 One of the pervasive AI opportunities across the economy is to improve efficiency. In the NHS, the potential areas that might benefit are broad, including:
 Automating the creation, collation and sharing of patient notes
 Reducing the number of medical professionals required to review scans and test results
 Optimising resource management, patient flow and general administration.
 Some examples of NHS efficiency and healthcare availability include:
 An AI tool that can analyse brain tumour image scans more rapidly than experienced neuroradiologists and with greater detail.
 Streamlining pathology workflow with AI to determine which prostate cancer biopsies require additional processing with immunohistochemistry
 Managing the flow of patients through hospital using AI to estimate how many hospital beds will be needed in the future
 Transcribing consultations to alleviate GP workloads
 One of the pervasive AI opportunities across the economy is to improve efficiency. In the NHS, the potential areas that might benefit are broad, including:
 Automating the creation, collation and sharing of patient notes
 Reducing the number of medical professionals required to review scans and test results
 Optimising resource management, patient flow and general administration.
 Some examples of NHS efficiency and healthcare availability include:
 An AI tool that can analyse brain tumour image scans more rapidly than experienced neuroradiologists and with greater detail.
 Streamlining pathology workflow with AI to determine which prostate cancer biopsies require additional processing with immunohistochemistry
 Managing the flow of patients through hospital using AI to estimate how many hospital beds will be needed in the future
 Transcribing consultations to alleviate GP workloads
  
 What might this mean in theory?
 Dario Amodei (CEO of Anthropic) suggested last October that we might see a century's worth of medical progress in just the next decade (which shares the same "10x" grounding in the comments from others in the technology and medical fields quoted earlier in this article).

 The latest model for improvements in mortality rates would see life expectancy for a 65-year-old increase from around 23 years to around 30 years over the next 100 years. If we really saw that much medical progress in a decade, then the resulting 7-year increase to life expectancy over the decade could lead to a jump of c. 25% in the value of the liabilities of a 'typical' DB scheme. While such an extreme outcome might be theoretically possible, this would seem to require everything to go in the right direction rapidly and so perhaps in practice a smaller improvement is more probable.

 And what is plausible in practice?
 Ascertaining what might happen in practice is fiendishly difficult and speculative. Additionally, improvements in areas might overlap, counteract or be offset in another area. Therefore, any estimates need to be taken with an unhealthy dose of salt. Nevertheless, the table below provides some high-level subjective illustrations of potential population-wide life expectancy increases, with a focus on scenarios in each area touched on above that could play out in the next decade.

 
 * Please note that these crude illustrations do not provide a view about the likelihood of such changes materialising nor cover all scenarios that could arise.

 These plausible scenarios for the potential impact of AI show that, over the next decade, life expectancy improvements in the region of a couple of years of life expectancy are feasible, which could translate into an increase in the value of typical DB liabilities in the ballpark of 10%.

 We are, of course, unlikely to see one-way traffic and AI could also present downsides to life expectancy prospects such as through job displacement, increases in sedentary lifestyles and exacerbated health inequalities. Additionally (though beyond the scope of this article), there are many factors, positive and negative, that will influence life expectancy beyond what is achieved through the application of AI.

 So, what does all this mean?
 In the light of the many areas where AI could have a positive impact on human lifespan and acknowledging the considerable momentum behind current investments in AI, it is hard not to be optimistic about the role AI might play in improving population-wide life expectancy and the nation's health over the next decade. Whether advancements are equivalent to a century's progress in a decade or just a substantial improvement, the potential benefits could well be significant.

 Those in the pensions industry should keep a watching brief on developments in this area and consider carrying out scenario analysis to understand the potential risks for their schemes and appropriate risk-mitigation strategies.

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