Centenarians: Who They Are and What We've Learned

Centenarians are often considered a good model for healthy aging. However, Swedish centenarians face many health issues, polypharmacy, and to a high degree rely on geriatric long-term care.
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Centenarians: who are they? A description of the total Swedish centenarian population in terms of living arrangements, health, and care utilization - Aging Clinical and Experimental Research

Background The global centenarian population has doubled each decade and is expected to continue growing. However, information regarding how they live, their health status, and care needs is limited. Aims This study aims to describe the total Swedish centenarian population in terms of health status, living arrangements, and socio-demographic characteristics. Methods This nationwide register-based study included all Swedish people reaching age 100 between 2013 and 2018. We analyzed their socio-demographic characteristics, living arrangements, number of prescribed drugs, and health status. Moreover, their care transitions from age 100 and two years forward were described. Results Of 5,882 centenarians (80.7% women), only 15.0% lived at home without formal care and 24.5% cohabited on their 100th birthday. Men (22.7%) were more likely than women (13.2%) to live at home without care. Approximately half of the centenarians lived in care homes, with fewer men (41.0%) than women (54.0%). Around 66.6% had a child living within the 50 km range. Most (76.5%) had an income below the median for Swedish older adults. Almost none were free from drugs, and polypharmacy was common (65.3%). Over half had at least one morbidity. Two years later, only 4.3% lived at home without care, and 63.9% died. Conclusion Sweden’s centenarian population is highly dependent on home care and care homes. Among the ones still living at home, the vast majority live alone and have low incomes. Strategies to manage health and social care demands of this growing population group in the coming decade are important.

Question of This Study

Centenarians, who reach the remarkable age of 100, have become more common over the years, but we don't know much about them. This study sought to uncover the characteristics of Sweden's centenarian population, shedding light on their living arrangements, socio-demographic profiles, health, and geriatric care, meaning formal home care or residing in a care home.

Study Findings

  1. Who Are Sweden's Centenarians?
  • Mostly Women: Of the 5,882 centenarians studied, the majority (81%) were women, emphasizing the remarkable longevity of the female population.
  • Living Arrangements: Many centenarians (40%) lived alone, while a small proportion (8%) cohabited. The rest of the centenarians lived in care homes (52%). Male centenarians (18%) were more likely to cohabitate than female centenarians (6%).
  • Familial Proximity: About 67% had a child living within a 50 km radius.
  • Income: The majority (77%) had incomes below the median for older adults in Sweden, highlighting economic vulnerability.
  1. Health Status of Centenarians (Figure1)
  • Comorbidities: Over half of the centenarians had at least one chronic health condition, with 1 out of 3 experiencing multiple health issues. Heart failure was the most common diagnosis, followed by myocardial infarction and cerebrovascular disease.
  • Prescribed Medications: Almost none were free from drugs, with a high proportion of polypharmacy (Men, 62%; Women, 66%), indicating a substantial medication load.
  • Gender Difference: Women received more prescribed drugs than men, although men had more morbidities.
Figure 1. CCI, specific morbidity, drug information, hospitalizations, and death stratified by sex.
CCI Charlson comorbidity index, COPD Chronic obstructive pulmonary disease, RAS Renin-angiotensin system
  1. Geriatric Care Transitions (Figure2)
  • Care Homes: Roughly half of centenarians at the age of 100 resided in care homes, with a higher proportion of women (54%) than men (41%).
  • Care Needs: Two years later, only 4% continued to live at home without formal care, while 64% had passed away.
Figure 2. Two-year care transition in centenarians.

    Conclusion

    Sweden's centenarian population is not characterized by exceptional health or independence. Instead, they face many health issues, polypharmacy, and a heavy reliance on geriatric care. With most centenarians living alone and having limited incomes, they belong to a vulnerable demographic group. Strategies need to be devised and implemented to address the healthcare and social support demands of this growing population. Only 2% of the centenarians had no diagnosed morbidity, a maximum of 1 drug, and no geriatric care. This study provides valuable insights into the lives of centenarians, dispelling the myth that they are uniformly healthy and independent. As the number of centenarians continues to rise, understanding their unique needs and challenges becomes increasingly critical for healthcare and social services planning.

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