Living Beyond 100 A report on centenarians
One manifestation of our ageing population structure is the rapid growth of ‘centenarians’: the group of people who have reached 100 years of age. There are a number of explanations as to why this group of individuals manage to surpass average life expectancy by twenty or more years. Genetic variation has been identified as a key predictor of ‘exceptional longevity’ (for example, Perls, 2003), alongside lifestyle factors, such as nutrition, exercise, avoiding obesity and long-term heavy smoking (Poulain, 2011), in addition to the element of chance (Kirkwood et al, 2005). However, while advances have been made in researching antecedent factors that predict living to 100, less attention has been paid to life as a centenarian; becoming a centenarian has become one of the most celebrated, if least understood, events of our time.
In fact, until now, centenarians have rarely been considered as a separate group by researchers and, when they have, the focus has tended to be on the predictors of longevity or the size of the group. We know relatively little about the profile or quality of life of centenarians, or how their socioeconomic circumstances or health and care needs differ from those of younger cohorts of older people. Whilst there is considerable current debate about the policy implications of an ‘ageing society’, the specific implications for policy and service delivery of extreme longevity have not, to date, been drawn out. From an economic perspective, this group may be particularly significant in that they have generally spent longer in retirement than they have done in employment. This report aims to inform such debate by providing an overview of the literature on centenarians, and by presenting some of the policy implications of the key trends. We begin by outlining the demographic characteristics of centenarians before exploring in later chapters:
1. Health and Social Care Issues Affecting Centenarians: What is going to be the future impact of centenarians and the ‘oldest old’ on health and social care services?
Living longer does not necessarily mean living in good health. In fact, later life is often characterised by chronic conditions and disability, which may bring increased dependency. The chapter examining Health and Social Care Issues Affecting Centenarians aims to explore the health profile of centenarians and to highlight the implications of this for health and care policies.
2. Housing and Wealth Issues Affecting Centenarians: What is going to be the future impact of centenarians and the ‘oldest old’ on pensions, housing and the intergenerational transfer of wealth?
Evidence suggests that the oldest age groups tend to be the poorest within the pensioner population (National Equality Panel, 2010; Krach and Velkoff, 1999) and a rising population is likely to exacerbate this trend. Where individuals typically worked for 45 years up to the age of 65 and expected an average retirement of 15-20 years, in the case of centenarians, working lives and retirement can be equal in length. This poses serious implications for pensions systems, and may also have an impact on housing and intergenerational transfers of wealth. The chapter on Housing and Wealth Issues Affecting Centenarians provides more research on housing, income and wealth of the oldest old and centenarians.
3. Quality of Life of Centenarians: How can we promote quality of life for centenarians and the ‘oldest old’?
As we get older, we are more likely to report reductions in our quality of life. The oldest old and centenarians are more likely to experience social exclusion and loneliness, and appear to be significantly more isolated than other age cohorts (Barnes et al, 2006). The final chapter on the Quality of Life of Centenarians explores what we know about the well-being of centenarians and the oldest old.
Due to the limited body of UK literature focused specifically on centenarians, this report also draws inferences from research on the broader group of those who are aged 85+ (often labelled the ‘oldest old’ population). We have also reviewed a number of international studies and highlighted gaps in the current evidence base.