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Successful Aging, Lessens from the Oldest Old

Updated: Mar 13

Advances in medical science and technology have led to an increase in life expectancy, and projections indicate that more and more people will live past 100 years of age. Here are some projections for aging past 100:

1. Increase in centenarians: The number of people living past 100 is expected to increase significantly in the coming decades. According to the United Nations, the global population of people aged 80 and over is projected to triple by 2050, with a significant increase in the number of centenarians.

2. Health span extension: While lifespan extension is the goal of many scientific and medical interventions, the focus is increasingly shifting towards extending health span, or the period of time in which a person is healthy and active. This means that people who live past 100 are expected to maintain good health for longer.

3. Opportunities for scientific research: The increase in the number of people living past 100 presents opportunities for scientific research to better understand the aging process and develop interventions to improve health and well-being in later life.

Among individuals who live to be centenarians, there is much to be learned about those factors that contribute not only to longevity but to successful cognitive aging. Two of the larger studies of this group of individuals are the Leisure World Cohort Study, which began in 1981, and more recently the Oldest Old 90+ Study, which began in 2003.

This study followed members of the original LWCS study as they aged past 90. Numerous research papers have been published on these cohorts, and below are some of the major findings of the oldest old cohort on what contributes to living a long happy and healthy life.

Modifiable Lifestyle Practices, What Works and What Doesn’t Work?

Negative effect

  • Smoking (leading cause of death 18%)

  • Artificial Sweeteners

Neutral or no effect:

  • Antioxidant Vitamins (A,C,E); (high vitamin C actually associated with higher rates of dementia)

Positive effect on longevity:

  • Caffeinated Beverages

  • Alcoholic Beverages

  • Body Mass Index

  • Physical Activity

  • Leisure Activity


  • Moderate consumers (100-399mg/day) had a significantly reduced risk of death (5-10%).

  • Heavy consumption (400+mg/day) and low consumption (<50mg/day) both associated with an increased risk of mortality.

  • Regular coffee: beneficial in moderation (1-3 drinks/day) lowered risk of death by 5-10% compared to nondrinkers.

  • Decaf coffee or tea: had a 6-9% reduction.

  • Soft drinks: 1 or less cans of cola/wk reduced mortality by 8% compared to those not drinking soda.

  • However artificially sweetened soft drinks had the opposite effect. Individuals who drank >1 can of artificially sweetened (but not sugar-sweetened) soft drinks had an 11-24% increased risk of mortality.

  • Infrequent chocolate (a few times/month) also decreased risk.


• Those who drank 2 or more drinks per day had a 15% reduced risk of death.

• The decreased risk was not limited to one type of alcohol.

• Stable drinkers (those who reported drinking both at baseline and follow up) had a significantly decreased risk of death compared with stable non-drinkers.

• Those who started drinking at follow up had a significantly lower risk.

• For women, those who quit drinking were at increased risk of death. (quitting may have been due to other health reasons that affect mortality.

• In elderly men and women, moderate alcohol intake exhibits a beneficial effect on mortality.

BMI in the Elderly

• Underweight-BMI<18.5 Normal-BMI 18.5-24.9

• Overweight-BMI 25-29.9 Obese-BMI>30

• Being overweight or obese at 21 increased risk of mortality later in life.

• Being underweight or obese in later life increased risk of mortality.

• Take home message: being overweight in old age did not increase mortality but being underweight or obese puts you at increased risk.

Physical Activity

• Declines in motor ability (speed, power, and dexterity) associated with declines in cognition and an increased risk for dementia, disability, and death.

• Mortality was incrementally reduced with amount of time spent in physical activities. 45 minutes/day a 10 to 25% reduction after which a constant benefit was observed: a 21% to 25% reduction.

• Individuals who are physically active for 2 or more hours per week were 50% less likely to die compared with those with lower physical activity levels.

• 15 minutes or more in active activities is better than none.

Leisure Activity

• Findings: Time spent in activities, even ½ hour/day resulted in significantly lower mortality risks compared to no activities.

• A reduction in mortality of 15-35%

• The magnitude of the reduction continually increased with additional time spent in nonphysical activities.

• Greater than or equal to 3 hours/day associated with lower rates of dementia.

• 6 hours or more a day associated with lower mortality rates of all causes versus those with less than 2 hours.

• Leisure time activities are an important health promoter in aging populations for both quality and quantity of life.

• Watching TV- generally had no significant effect on mortality.

• Taking a nap- small but significant risk factor for death in the youngest women and the oldest men; increasing risk by about 10-20%.

• Sleeping 9+ hours/night increased risks in men less than 75: risk was 40% higher than those who slept less than 7 hours/night.

• Greatest risk in those who cut down or stop their activities due to illness or injury.

• The positive effects of participating in leisure activities was the greatest in those who reported this limitation.

• (30-35% decreased risk of death)

Overall, research on the oldest old has provided valuable insights into the factors that promote healthy aging and longevity, which can inform interventions aimed at improving health outcomes for older adults.

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