Dellara F Terry1, Paola Sebastiani, Stacy L Andersen, Thomas T Perls. 1. New England Centenarian Study, Geriatrics Section of the Department of Medicine, Boston University School of Medicine and Boston Medical Center, MA 02118, USA. laterry@bu.edu
Abstract
BACKGROUND: Although it is commonly held that survival to age 100 years entails markedly delaying or escaping age-related morbidities, nearly one-third of centenarians have age-related morbidities for 15 or more years. Yet, we have previously observed that many centenarians compress disability toward the end of their lives. Therefore, we hypothesize that for some centenarians, compression of disability rather than morbidity is a key feature for survival to old age. METHODS: This cross-sectional, nationwide study included 523 women and 216 men 97 years or older. The participants were stratified by sex and age at onset (age <85 years [termed survivors] and age >or=85 years [termed delayers]) of chronic obstructive pulmonary disease, dementia, diabetes, heart disease, hypertension, osteoporosis, Parkinson disease, and stroke. Dependent variables were the Barthel Activities of Daily Living Index (Barthel Index) and the Information-Memory-Concentration test of the Blessed Dementia Scale. RESULTS: Thirty-two percent of the participants were survivors. For men with hypertension and/or heart disease for 15 or more years, the median Barthel Index score was 90 (independence range, 80-100). For female survivors with hypertension, heart disease, and/or osteoporosis, the median Barthel Index score was 65 (minimal assistance range, 60-79). Generally, men had better function than women: 60% of male survivors had Barthel Index scores of 90 or higher compared with 18% of female survivors (P < .001) and 50% of male delayers had Barthel Index scores of 90 or higher compared with 27% of females delayers (P < .001). CONCLUSIONS: Whereas the compression of both morbidity and disability are essential features of survival to old age for some centenarians, for others, the compression of disability alone may be the key prerequisite. Though far fewer in number, male centenarians tend to have significantly better cognition and physical function than their female counterparts.
BACKGROUND: Although it is commonly held that survival to age 100 years entails markedly delaying or escaping age-related morbidities, nearly one-third of centenarians have age-related morbidities for 15 or more years. Yet, we have previously observed that many centenarians compress disability toward the end of their lives. Therefore, we hypothesize that for some centenarians, compression of disability rather than morbidity is a key feature for survival to old age. METHODS: This cross-sectional, nationwide study included 523 women and 216 men 97 years or older. The participants were stratified by sex and age at onset (age <85 years [termed survivors] and age >or=85 years [termed delayers]) of chronic obstructive pulmonary disease, dementia, diabetes, heart disease, hypertension, osteoporosis, Parkinson disease, and stroke. Dependent variables were the Barthel Activities of Daily Living Index (Barthel Index) and the Information-Memory-Concentration test of the Blessed Dementia Scale. RESULTS: Thirty-two percent of the participants were survivors. For men with hypertension and/or heart disease for 15 or more years, the median Barthel Index score was 90 (independence range, 80-100). For female survivors with hypertension, heart disease, and/or osteoporosis, the median Barthel Index score was 65 (minimal assistance range, 60-79). Generally, men had better function than women: 60% of male survivors had Barthel Index scores of 90 or higher compared with 18% of female survivors (P < .001) and 50% of male delayers had Barthel Index scores of 90 or higher compared with 27% of females delayers (P < .001). CONCLUSIONS: Whereas the compression of both morbidity and disability are essential features of survival to old age for some centenarians, for others, the compression of disability alone may be the key prerequisite. Though far fewer in number, male centenarians tend to have significantly better cognition and physical function than their female counterparts.
Authors: Linda P Fried; Luigi Ferrucci; Jonathan Darer; Jeff D Williamson; Gerard Anderson Journal: J Gerontol A Biol Sci Med Sci Date: 2004-03 Impact factor: 6.053
Authors: Stacy L Andersen; Paola Sebastiani; Daniel A Dworkis; Lori Feldman; Thomas T Perls Journal: J Gerontol A Biol Sci Med Sci Date: 2012-01-04 Impact factor: 6.053
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Authors: Emily R Adams; Vikki G Nolan; Stacy L Andersen; Thomas T Perls; Dellara F Terry Journal: J Am Geriatr Soc Date: 2008-09-22 Impact factor: 5.562
Authors: Paola Sebastiani; Monty Montano; Annibale Puca; Nadia Solovieff; Toshio Kojima; Meng C Wang; Efthymia Melista; Micah Meltzer; Sylvia E J Fischer; Stacy Andersen; Stephen H Hartley; Amanda Sedgewick; Yasumichi Arai; Aviv Bergman; Nir Barzilai; Dellara F Terry; Alberto Riva; Chiara Viviani Anselmi; Alberto Malovini; Aya Kitamoto; Motoji Sawabe; Tomio Arai; Yasuyuki Gondo; Martin H Steinberg; Nobuyoshi Hirose; Gil Atzmon; Gary Ruvkun; Clinton T Baldwin; Thomas T Perls Journal: PLoS One Date: 2009-12-14 Impact factor: 3.240
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