Thomas Perls MD, MPHGeriatrics Section, Department of Medicine

Boston University School of Medicine, Boston Medical Center

Centenarians

National Institute On Aging

Promoting Health in Ageing (or Aging)Annual Joint Symposium September 26-27

• Demography• Age claims• Some characteristics• Compression of morbidity?• Centenarians as a “hook” for promoting healthy aging

OUTLINE

Our Study Populations

The 8 Hurlburt siblings, ages 79-96 years Agnes: "none of us have canes."

(http://www.time.com/time/photogallery)

79 88 93 80 96 89 84 91

National Institute On Aging

850 long lived families4,800 family members

1,600 centenarians (100-119 years)500 offspring (63-100 years)115 supercentenarians (110+ years)

New England Centenarian Study

Sakhan Dosova celebrated what she, her family and Kazakh officials all agree was her 130th birthday

10 categories of false claims

Our review of invalid age claims of 115 years or older resulted in the creation of ten categories of how these false claims emerge:

1. Religious Myth2. the Village Elder3. Fountain of Youth (substance)4. Shangri-La (geographic) 5. Nationalist Pride6. Spiritual Practice7. Familial Longevity8. Individual and/or Family Notoriety9. Military Service10.Pension Fraud

Robert Young, Bertrand Desjardins, Kirsten McGlaughlin, Michel Poulain, Thomas Perls. Typologies of Extreme Longevity Myths. Curr Gerontol Geriatr Res, 2010.

Based on the age of onset of heart disease, diabetes, cancer, skin cancer, osteoporosis, thyroid condition, hypertension, stroke, dementia, and COPD.

Evert J, Lawler E, Bogan H, Perls T. Morbidity profiles of centenarians: survivors, delayers, and escapers. J Gerontol A Biol Sci Med Sci.

2003;58: 232-237

The survivors: onset of disease before the age of 80 (42%)

The delayers: onset of disease at or beyond the age of 80 (45%)

The escapers: reaches 100 without the onset of disease

Three Types of Centenarians

Diseases included in this analysis were: cancer, cardiovascular disease, COPD, dementia, diabetes, and stroke.

The escapers: reach 100 without the onset of disease

The delayers: onset of disease at or beyond the age of 80

The survivors: onset of disease before the age of 80

Exceptional Health Span

10

11

85 Supercentenarians(age 110-119 yrs)

Medical History

n % n %

Myocardial Infarction 5 6 Osteoporosis 20 24

Cardiac Arrhythmia 8 9 Cataract 69 81

Pacemaker Inserted 4 5 Parkinson’s Disease 2 2

Angina Pectoris 2 2 Cancer 12 14

Stroke 11 13 Cancer Type:

Bladder1 1

Treated Hypertension 20 24 Breast 4 5

Adult Onset Diabetes 4 5 Colon 3 4

Chronic Obstructive Pulmonary Disease

1 1 Skin 10 12

Hypothyroidism 10 12 Other 3 4

Other Thyroid Condition 6 7 Unknown 1 1

(Sample of 30 supers: Perls et al, Journal American Geriatrics Society, August, 2006)

Personality Domains

Conscientiousness

Agreeableness

Openness Extraversion

Nature vs. Nurture

• 70% environmental, 30% genetic to reach mid to late 80’s• Evidence for an increasing genetic component for older ages:

• Familial clustering• Siblings with marked increased relative probabilities of living

to 100+ years• Offspring with marked decreased risks for age related

diseases such as heart disease, stroke, diabetes, cancer• Power to discover genetic variants associated with

exceptional longevity increases with age• What kind of genetic variants? Disease vs. Protective

AttitudeGeneticsExerciseInterestsNutritionGet rid of (smoking & anti-aging quackery)

<88 years>

AGEING

16www.livingto100.com

The Quacks Are Flocking

1994 U.S. congressional passage of the Dietary Supplements Health and Education Act (DSHEA)

The Internet 70 M

illion Baby Boomers

Ken B. Kathy T. Linda M.Alan D.

HGH