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Background/Objectives: To evaluate the prevalence of sarcopenia and osteoporosis in centenarians and its association with body composition and past physical activity (PPA). Subjects/Methods: We conducted an observational cross-sectional study in a representative nationwide population of 253 Portuguese centenarians. A clinically oriented questionnaire and anthropometric and body composition analysis by bioimpedance were executed. Sarcopenia was determined using a muscle mass (MM) index cutoff [[less-than or slanted equal to]16.7 kg/m.sup.2. Osteoporosis was defined through estimated bone mass (BM), according to gender and body weight. Inadequate physical performance was considered when the timed-up-and-go test was >12 s. Results: BM and MM were gender dependent, even after adjusting for multiple variables. We found a protective effect of intense PPA on sarcopenia risk (OR=0.41, 95% CI=0.20-0.82, P=0.013). Those with worse physical function status presented a significantly higher risk for osteoporosis (OR=8.9, 95% CI=1.94-40.08, P=0.005). Multivariate models showed that low MM, BM and fat mass (FM) were predictors of underweight in centenarians. Underweight, male gender, worst physical function, hypohydration and sarcopenia were associated with increased osteoporosis risk. The risk for sarcopenia was higher in women (P=0.002), in those underweight (P=0.005) and in osteoporotic individuals (P Conclusions: Gender was revealed to be a relevant factor influencing BM and MM in centenarians. MM and BM were better predictors of underweight than was dehydration. Healthy BM and MM were positively related with PPA intensity and determined physical performance, having a positive impact on the centenarian's independence. During aging, improving physical function might add to sarcopenia and osteoporosis prevention, besides prevention of femur neck fractures and cardiovascular diseases., Author(s): A P da Silva [sup.1] [sup.2] [sup.3] , A Matos [sup.2] [sup.4] , R Ribeiro [sup.2] , Â Gil [sup.2] [sup.4] , A Valente [sup.2] [sup.5] , M Bicho [...]

A study in humans indicates that certain bile acids that are produced by bacteria and commonly found in people over 100 boost gut health and protect against infection. These findings shed light on the contributors to healthy ageing. Analysis points to factors that contribute to healthy ageing of humans., Author(s): Bipin Rimal, Andrew D. Patterson Author Affiliations: Role of bile acids and gut bacteria in healthy ageing of centenarians As we age, we are more likely to develop ageing-related [...]

Blood levels of a protein hint at the survival prospects of people over 90 years old. Blood levels of a protein hint at the survival prospects of people over 90 years old., Author Affiliations: Damage to neurons (pictured; artist's impression) can lead to elevated levels of a protein called neurofilament light chain in the blood. Credit: Kateryna Kon/Science Photo Library Computer illustration [...]

Background. Most survival studies of the elderly population have set their baselines for first examinations between 60 and 80 years. The rapidly increasing numbers of exceptionally old persons call for knowledge about determinants of exceptional survival. Methods. The Swedish Centenarian Study followed 100 centenarians from the age of 100 to death of the entire cohort, by age 111 years. A biomedical, psychological, and social multivariate survival analysis was performed based on factors identified as important in earlier studies of older adults. Latent Variable Partial Least Square Estimation (LVPLS) Soft Modeling was used to test the hypothesized predictions of survival in centenarians. Results. Fewer predictors for survival were found in centenarians than were observed in studies of younger elderly persons. Survival after age 100 was dependent mainly on better baseline physical reserve, as measured by body mass index and body weight, and better baseline physical and cognitive function, as measured by activities of daily living and verbal ability/spatial orientation, respectively. Conclusions. Individual characteristics such as physiological reserve, present health and functional status, as well as chance appear important for centenarian survival. Hereditary factors, social relationships, marital status, and personality did not contribute to survival prediction in this exceptional age group. From a theoretical point of view, our data suggest that, in very old age, stochastic determinants may dominate over programmed factors (e.g., family longevity) in determining survival. More research is needed to assess survival factors at exceptional ages. Key Words: Centenarian--Longevity--Survival--Prediction--Risk factor.

Background. Observational studies have demonstrated similarities between the underpinning of frailty and biological features of centenarians, suggesting that adaptability to age-related multiple physiological decline may be a core component of successful aging. The aim of this study is to determine whether hormonal pathways potentially involved in energy homeostasis contribute to survival beyond 100 years of age. Methods. We assessed a total of 252 centenarians (mean [standard deviation (SD)] age, 101.5 (1.8) years, range 100-108 years) using a complete set of biomarkers of adipose endocrine function and the insulin-like growth factor-1 (IGF-1) axis. Conventional risk factors at baseline were also assessed. The participants were followed up for all-cause mortality every 12 months by telephone contact. Results. During 2253 days of follow-up, 208 centenarians (82.5%) died. The lowest tertile of leptin and the highest tertile of tumor necrosis factor-[alpha] were associated with higher mortality risk among centenarians after adjusting for age (per 6-month increase), sex, education, smoking, activities of daily living (ADL), cognitive function, and comorbidities (hazard ratio [HR] 1.6; 95% confidence interval [CI], 1.14-2.35; and HR 1.45; 95% CI, 1.00-2.08, respectively). The lowest tertiles of both IGF-1 and IGF binding protein 3 (IGFBP3) were also associated with increased mortality. The adipose risk score, indicating cumulative effects of adipokine dysregulation, was strongly associated with increased mortality risk; ADL; cognitive function; and levels of albumin, cholinesterase, high-density lipoprotein-cholesterol, C-reactive protein, inteleukin 6, and IGF-1 at baseline. Conclusions. The results suggested that preservation of adipose endocrine function and the IGF-1 axis may be potentially important for maintaining health and function and promoting survival at an extremely old age. Key Words: Centenarians--Leptin--Adiponectin--Tumor necrosis factor-alpha--Insulin-like growth factor 1--Mortality-- Frailty--Metabolic network.

Background. As elite representatives of the rapidly increasing 'oldest-old' population, centenarians have become an important model population for understanding human aging. However, as we are beginning to understand more about this important phenotype, another demographic group of even more elite survivors is emerging--so-called 'supercentenarians' or those who survive 110-plus years. Little is known about these exceptional survivors. Methods. We assessed the Okinawa Centenarian Study (OCS) database for all information on supercentenarians. The database includes dates of birth and year of death for all residents of Okinawa 99 years old or older and a yearly geriatric assessment of all centenarians who consented, enabling prospective study of age-related traits. Of 20 potential supercentenarians identified, 15 had agreed to participate in the OCS interview, physical examination, and blood draw. Of these 15, 12 (3 men and 9 women) met our age validation criteria and were accepted as supercentenarians. Phenotypic variables studied include medical and social history, activities of daily living (ADLs), and clinical phenotypes (physiology, hematology, biochemistry, and immunology). Results. Age at death ranged from 110 to 112 years. The majority of supercentenarians had minimal clinically apparent disease until late in life, with cataracts (42%) and fractures (33%) being common and coronary heart disease (8%), stroke (8%), cancer (0%), and diabetes (0%) rare or not evident on clinical examination. Functionally, most supercentenarians were independent in ADLs at age 100 years, and few were institutionalized before the age of 105 years. Most had normal clinical parameters at age 100 years, but by age 105 exhibited multiple clinical markers of frailty coincident with a rapid ADL decline. Conclusion. Supercentenarians displayed an exceptionally healthy aging phenotype where clinically apparent major chronic diseases and disabilities were markedly delayed, often beyond age 100. They had little clinical history of cardiovascular disease and reported no history of cancer or diabetes. This phenotype is consistent with a more elite phenotype than has been observed in prior studies of centenarians. The genetic and environmental antecedents of this exceptionally healthy aging phenotype deserve further study. Key Words: Supercentenarian--Longevity--Healthy aging--Phenotype--Okinawa--Japan.

Background. The number of centenarians has increased rapidly since the 1950s. In Denmark, 42% more of the 1905 birth cohort made it to 100 years of age compared to the 1895 cohort. We tested whether this increased survival proportion has resulted in an increased disability level in the more recent cohort of centenarians. Methods. The Longitudinal Study of Danish Centenarians (LSDC) included all persons who reached the age of 100 years in the period from April 1, 1995 through May 31, 1996 (a total of 276 persons). In total, 207 persons participated in the survey (75%). The Danish 1905 Cohort Survey included all individuals born in Denmark in 1905. At baseline in 1998, a total of 2262 persons participated in the intake survey (63%). In total, 225 of 364 persons (62%) who reached their 100th birthday in the cohort participated in the most recent 2005 wave. Basic Activities of Daily Living (BADLs) and Physical Activities of Daily Living (PADLs) were assessed in both cohorts. Results. The 1905 cohort displayed better self-reported ADLs than the 1895 cohort did. Stratified by gender, this apparent cohort advantage was due to women in the 1905 cohort performing significantly better than their female counterparts in the 1895 cohort. Conclusion. The increasing number of female centenarians does not entail increasing proportions of disabled individuals. In contrast, there is a lack of improvement in ADLs among male centenarians even though the number of male centenarians is stagnating. Key Words: Centenarians--Activities of Daily Living--Cohort comparisons.

Background. Given previous evidence of familial predisposition for longevity, we hypothesized that siblings and parents of supercentenarians (age [greater than or equal to] 110 years) were predisposed to survival to very old age and that, relative to their birth cohorts, their relative survival probabilities (RSPs) are even higher than what has been observed for the siblings of centenarians. Methods. Mean age at death conditional upon survival to ages 20 and 50 and survival probabilities from ages 20 and 50 to higher ages were determined for 50 male and 56 female siblings and 54 parents of 29 supercentenarians. These estimates were contrasted with comparable estimates based on birth cohort-specific mortality experience for the United States and Sweden. Results. Conditional on survival to age 20 years, mean age at death of supercentenarians' siblings was ~81 years for men and women. Compared with respective Swedish and U.S. birth cohorts, these estimates were 17%-20% (12-14 years) higher for the brothers and 11%-14% (8-10 years) higher for the sisters. Sisters had a 2.9 times greater probability and brothers had a 4.3 times greater probability of survival from age 20 to age 90. Mothers of supercentenarians had a 5.8 times greater probability of surviving from age 50 to age 90. Fathers also experienced an increased survival probability from age 50 to age 90 of 2.7, but it failed to attain statistical significance. Conclusions. The RSPs of siblings and mothers of supercentenarians revealed a substantial survival advantage and were most pronounced at the oldest ages. The RSP to age 90 for siblings of supercentenarians was approximately the same as that reported for siblings of centenarians. It is possible that greater RSPs are observed for reaching even higher ages such as 100 years, but a larger sample of supercentenarians and their siblings and parents is needed to investigate this possibility.

Background. Research in Western countries has shown most centenarians to be survivors with multiple comorbidities. However, Japanese centenarians' morbidity and its relationship to functional status has yet to be elucidated. The aim of this study is to clarity the association of morbidity with the physical and cognitive function of centenarians. We examined Tokyo-area centenarians to determine their kinds of morbidity profiles and how such morbidity related to their functional status. Methods. We studied 302 centenarians living in Tokyo (101.2 [+ or -] 1.8 years: 65 men, 237 women), and assessed their physical status, morbidity, and use of medication. Activities of daily living and cognitive function were also assessed using the Barthel Index and the Clinical Dementia Rating. Results. More than 95% of the centenarians had chronic diseases. Both the physical and cognitive functions were significantly higher in men. The present and previous illnesses most frequently included hypertension, heart disease, stroke, fractures, and cataracts. Fractures were observed significantly more frequently in women. Diabetes mellitus was uncommon. The physical and cognitive function of centenarians with a history of stroke or fracture were particularly poor. whereas those centenarians with hypertension tended to show a high level of physical and cognitive function. Conclusions. Almost all centenarians had chronic diseases. Stroke and fracture were correlated with poorer function; therefore, we hypothesize that prevention of stroke and fracture might improve functional status in the oldest-old.

Background. The 2000 U.S. census identified 50,454 Americans older than 100 years (18 per 100,000). Increased longevity is only of benefit if accompanied by the maintenance of physical, social, and cognitive function into advanced age. The goal of this review was to identify research describing centenarians to find the prevalence of dementia-free survival. Methods. We reviewed 650 publications to find studies that described the prevalence of dementia in centenarians, were community-based, had data that were specific to persons older than 100 years, and were published in peer-reviewed journals. For each study, we identified the prevalence of dementia, the completeness of the sample, the number of study participants, the method used to diagnose dementia, and the duration of the study. Results. We identified 20 research groups from 14 countries with publications meeting our search criteria. The studies showed substantial variation in methods of assessing cognitive status, assuring a complete cohort, and sample size. Few studies reported longitudinal data or attempted diagnosis of the cause of dementia. The prevalence of dementia-flee survival past 100 years of age varied between 0 and 50 percent. Conclusions. The methodology used in studies regarding dementia prevalence among centenarians is sufficiently varied that combination of existing studies into a meta-analysis is not possible. Suggestions for assuring quality in future centenarian research are presented.

Background. Information on the health status of centenarians provides a means for understanding the health care needs of this growing population. Therefore, we examined the health status of a national cohort of centenarian veteran enrollees. Methods. Ninety-three centenarian veteran enrollees returned a complete health history questionnaire, which included questions about sociodemographic information, age-associated conditions, health behaviors, health-related quality of life as measured by the Veterans SF-36, and change in health status. Results. Centenarian veteran enrollees are a group with major impairment across multiple dimensions of health-related quality of life despite having a relatively low prevalence of diseases. They had considerable physical limitations as reflected by their physical health summary scores (26.2 [+ or -] 8.3). However, their mental health was comparatively good (mental health summary score 44.1 [+ or -] 12.5). Compared to younger elderly veterans (ages 85-99), centenarians had a lower prevalence of hypertension, angina or myocardial infarction, diabetes, and chronic low back pain (p < .05). Centenarians had significantly worse physical functioning, role physical, vitality, and social functioning scores than did younger elderly veterans. The two groups did not differ in their general health, bodily pain, role emotional, and mental health scores. Centenarians did not perceive much decline in their physical or mental health during the preceding year. Conclusions. Centenarian veteran enrollees are a group with a low number of age-associated diseases and good mental health despite substantial physical limitations. These results support future studies of services directed toward improvement of function as opposed to those focused solely on the treatment of diseases.

Consistent with the compression-of-morbidity hypothesis, several studies have reported that a significant proportion of centenarians delay or escape age-related diseases. Of those who live with such diseases for a long time, many appear to do so with better functional status than do younger persons who do not achieve extreme old age. The authors describe the first autopsy in an Okinawan-Japanese centenarian who escaped many age-related illnesses and delayed frailty toward the end of her very long life. Her late-life morbidity pattern is contrasted with that of white centenarians.

Background. Previously, the authors have shown that an important component of the ability to survive to exceptionally old age is family health history. This study assessed the age at onset of age-related diseases in centenarian offspring. Methods. The health histories of 177 offspring of centenarians enrolled in the nationwide New England Centenarian Study, and 166 controls were assessed from 1997 to 2000. Controls were the offspring of parents born in the same years as the centenarians but at least one of whom died at average life expectancy. Ages at onset of heart disease, hypertension, diabetes, cancer, osteoporosis, cataracts, glaucoma, macular degeneration, depression, thyroid disease, and stroke were compared in the two groups. Results. The median ages of onset for coronary heart disease (p < .001), hypertension (p < .001), diabetes (p = .002), and stroke (p = .017) were significantly delayed in the centenarian offspring by 5.0, 2.0, 8.5, and 8.5 years, respectively, compared with the age-matched controls. Adjusted hazard ratios were 0.388 (p = .0004), 0.39 (p < .0001), 0.302 (p = .008), and 0.328 (p = .06). No differences were found in the ages of onset for the other diseases investigated. Conclusions. The offspring of centenarians show a marked delay in the age of onset for cardiovascular disease, diabetes, hypertension, and stroke but not for other age-related diseases such as cancer, osteoporosis, and thyroid disease. These results suggest that the children of centenarians may be following in their parents' footsteps, markedly delaying the onset of lethal diseases that commonly affect older persons.

Background. A significant component of the ability to survive to exceptional old age may be familial. This study assessed the prevalence of age-related diseases in the offspring of centenarians. Methods. The health histories of centenarian offspring (n = 177) and controls (n = 166) were assessed from 1997-2000 using a cross-sectional study design. The offspring of 192 centenarian subjects enrolled in the nationwide New England Centenarian Study were recruited and enrolled. Controls consisted of offspring whose parents were born in the same years as the centenarians but at least 1 of whom died at an average life expectancy. Prevalence of age-related diseases including heart disease, hypertension, diabetes, cancer, osteoporosis, stroke, dementia, cataracts, glaucoma, macular degeneration, depression, Parkinson's disease, thyroid disease, and chronic obstructive pulmonary disease were compared between the two groups. Results. Centenarian offspring had a 56% reduced relative prevalence of heart disease (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.24, 0.80), a 66% reduced relative prevalence of hypertension (OR 0.34, 95% CI 0.21, 0.55), and 59% reduced relative prevalence of diabetes (OR 0.41, 95% CI 0.15, 1.12) after multivariate adjusted analyses. Conclusions. The offspring of centenarians demonstrate a markedly reduced prevalence of diseases associated with aging, in particular for cardiovascular disease and cardiovascular risk factors. Along with their parents, the centenarian offspring, who are in their 70s and 80s, may prove to be a valuable cohort to study genetic and environmental factors conducive to the ability to live to very old age in good health.

Background. The compression of morbidity hypothesis predicts that, in order to achieve their extreme old age, centenarians markedly delay or even escape diseases that would otherwise be lethal at younger ages. Phenotypic studies have not adequately characterized the prevalence and timing of age-related illnesses among those who achieve exceptional old age. Thus, we conducted a retrospective cohort study of centenarians to explore the timing of such diseases among centenarians. Methods. Health history questionnaires were completed by 424 centenarians (aged 97-119 years) or their proxies. Lifetime (to-date) diagnoses of 10 major lethal illnesses (hypertension, heart disease, diabetes, stroke, nonskin cancer, skin cancer, osteoporosis, thyroid condition, Parkinson's disease, and chronic obstructive pulmonary disease) and one ocular disease (cataracts) that befall the elderly population, approximate age of diagnosis, level of alcohol and tobacco use, and presence or absence of cognitive impairment were assessed. Because of the retrospective nature of the study, the typically imprecise age of onset of cognitive impairment negated the ability to include age of onset of cognitive impairment in this aspect of the analyses. Results. Examining the ages of onset for the 10 age-associated diseases and excluding cognitive impairment, we found that the centenarians fit into three morbidity profiles--Survivors, Delayers, and Escapers. 24% of male subjects and 43% of female subjects fit the Survivor profile, or those who had a diagnosis of an age-associated illness prior to the age of 80. Delayers were individuals who delayed the onset of age-associated illness until at least the age of 80, and 44% of male and 42% of female subjects fit this profile. Escapers were individuals who attained their 100th year of life without the diagnosis of common age-associated illnesses, and 32% of male and 15% of female subjects fit the Escaper profile. When examining only the most lethal diseases of the elderly population, heart disease, nonskin cancer, and stroke, we found that 87% of male and 83% of female subjects delayed or escaped these diseases. Subjects with and without cognitive impairment did not differ in terms of the profile to which they belonged. Conclusions. These results suggest there may be multiple routes to achieving exceptional longevity and that there are sex differences according to which route is taken. These routes represent different phenotypes and thus likely different genotypes of centenarians. The identification of three types of centenarians, Survivors, Delayers, and Escapers, provides direction for future study into the factors that determine exceptional longevity.

Background. Genetic polymorphisms of angiotensin-converting enzyme (ACE) and apolipoprotein E (APOE) have been reported to be associated with human longevity and dementia in the elderly. However, whether such putative longevity genes exert the same effects on different ethnic groups living in different environments is not well known. Methods. We investigated the distributions of the ACE and APOE genotypes and their relations with dementia status in Korean centenarians by cross-sectional study. A total of 103 centenarians (13 men and 90 women, mean age 102.4 [+ or -] 2.6 years) were included in this study. The allele frequencies of the genes were compared with those of two control groups: 7232 apparently healthy adults (4100 men and 3132 women) of mean age 48.5 [+ or -] 9.6 years for the ACE genotyping, and 6435 adults (5008 men and 1427 women) of mean age 50.7 [+ or -] 7.9 years for the APOE genotyping. The dementia status of the centenarians was assessed by clinical psychologist using the Clinical Dementia Rating (CDR) score. Results. The frequencies of genotypes and alleles of the ACE and APOE genes of the centenarians were not significantly different from those of the control groups. There was a lack of association between presence of the D allele on the ACE gene and dementia status. However, the frequency of the [epsilon]4 allele of the APOE gene was significantly higher in centenarians with dementia than in centenarians without definitive dementia (9.1% versus 1.5%, p < .05). Conclusions. These results suggest that neither the ACE nor the APOE gene is significantly associated with longevity in the Korean population, but that the APOE [epsilon]4 allele is still related with dementia even at age 100 and older.

ABSTRACTS Unique data from a 1998 healthy longevity baseline survey provide demographic, socioeconomic, and health characteristics of the oldest old, aged 80-105, in China. This subpopulation is growing rapidly and [...]

BACKGROUND: Exceptional aging, defined as reaching age 85 years, shows geographic inequalities that may depend on local environmental conditions. Links between particulate pollution--a wellrecognized environmental risk factor--and exceptional aging have not been investigated. OBJECTIVES: We conducted a nationwide analysis of ~28 million adults in 3,034 United States counties to determine whether local [PM.sub.2.5] levels (particulate matter < 2.5 pm in aerodynamic diameter) affected the probability of becoming 85-to 94-year-olds or centenarians (100- to 104-year-olds) in 2010 for individuals who were 55-64 or 70-74 years old, respectively, in 1980. METHODS: We used population-weighted regression models including county-level [PM.sub.2.5] from hybrid land-use regression and geostatistical interpolation, smoking, obesity, sociodemographic, and age-specific migration variables. RESULTS: On average, 2,295 and 71.4 per 10,000 of the 55- to 64- and 70- to 74-year-olds in 1980, respectively, remained in the 85- to 94- and 100- to 104-year-old population in 2010. An interquartile range (4.19 µg/[m.sup.3]) increase in [PM.sub.2.5] was associated with 93.7 fewer 85- to 94-yearolds (p < 0.001) and 3.5 fewer centenarians (p < 0.05). These associations were nearly linear, were stable to model specification, and were detectable below the annual [PM.sub.2.5] national standard. Exceptional aging was strongly associated with smoking, with an interquartile range (4.77%) increase in population who smoked associated with 181.9 fewer 85- to 94-year-olds (p < 0.001) and 6.4 fewer centenarians (p < 0.001). Exceptional aging was also associated with obesity rates and median income. CONCLUSIONS: Communities with the most exceptional aging have low ambient air pollution and low rates of smoking, poverty, and obesity. Improvements in these determinants may contribute to increasing exceptional aging. http://dx.doi.org/10.1289/EHP197, Introduction Recent declines in mortality have resulted in a worldwide increase in exceptional aging, defined as reaching age 85 years or older [National Institute on Aging (NIA) 2013]. Persons ≥ [...]

Author(s): Michael Eisenstein [1] [illus. 1] On any weekday morning, you might catch Irving Kahn heading into his office in Manhattan, where he works as an investor and financial analyst [...]

We are currently experiencing a welcome boom in centenarians. More people than ever before are reaching the magic age of 100. This is a fairly recent phenomenon. Beginning their work [...]