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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Research

Stratification in health and survival after age 100: evidence from Danish centenarians

Authors: Jesús-Adrián Alvarez, Anthony Medford, Cosmo Strozza, Mikael Thinggaard, Kaare Christensen

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

The existence of a super-select group of centenarians that demonstrates increased survivorship has been hypothesized. However, it is unknown if this super-select group possesses similar characteristics apart from extreme longevity.

Methods

In this study, we analyse high-quality health and survival data of Danish centenarians born in 1895, 1905 and 1910. We use Latent Class Analysis to identify unobserved health classes and to test whether these super-select lives share similar health characteristics.

Results

We find that, even after age 100, a clear and distinct gradient in health exists and that this gradient is remarkably similar across different birth cohorts of centenarians. Based on the level of health, we identify three clusters of centenarians - robust, frail and intermediate - and show that these groups have different survival prospects. The most distinctive characteristic of the robust centenarians is the outperformance in different health dimensions (physical, functional and cognitive). Finally, we show that our health class categorizations are good predictors of the survival prospects of centenarians.

Conclusions

There is a clear stratification in health and functioning among those over 100 years of age and these differences are associated with survival beyond age 100.
Appendix
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Footnotes
1
In Denmark in 2019 around 60% of female and 66% of male centenarians die by the age of 102 (Human Mortality Database, 2020).
 
2
The use of statistical imputation techniques like mean substitution or multiple imputation was avoided because these procedures might bias the results of the Latent Class Analysis and make comparisons among cohorts more uncertain. Therefore, we performed the analysis considering only the individuals that have complete values.
 
3
Following Thinggaard et al (2016) approach, we categorise those that can stand up with and without hands from their chair and having a MMSE > 24 as robust. Under this approach, the AUC ranged between 0.60 and 0.72 for the cohort 1905 and between 0.61 and 0.66 for the cohort 1910. See Table A14 in the Supplemental Material.
 
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Metadata
Title
Stratification in health and survival after age 100: evidence from Danish centenarians
Authors
Jesús-Adrián Alvarez
Anthony Medford
Cosmo Strozza
Mikael Thinggaard
Kaare Christensen
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02326-3

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