LONGECITY

This study was posted in the news section before, but it seems to offer a nice starting point for a separate discussion in Medicine section. 

Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010

 

'Old age' was the most common cause of certifying death (28%), followed by pneumonia (18%) and other respiratory diseases (6%); stroke (10%); heart disease (9%) and other circulatory diseases (10%);dementia and Alzheimer's disease (6%); and cancer (4%). Pneumonia accounted for the largest group of hospital deaths, while across non-hospital settings 'old age' formed the largest category followed by pneumonia. Overall, three-quarters of centenarian death certificates stated 'old age' as either an underlying cause (28%) or contributing cause (47%). The main causes of death changed with increasing age. In the group aged 80-85 years, heart disease was stated on 19% of death certificates, with 'old age' on only one per cent of certificates.

 

http://journals.plos...al.pmed.1001653

 

For summarized CoD frequencies per age group, see attached image.

It seems that CVD remains a high cause for mortality even in the centenarians at 28%. Two classes of CoD that noticeably increase in oldest age groups are 'old age' and pneumonia.   

I assume 'old age' covers general physical and mental frailty, so it might be that some of the brain disorders are categorised as 'old age' instead of AD/dementia. 

Your thoughts? 

I wonder how many deaths were ultimately due to frailty, i.e. hip fracture requiring hospitalization and leading to pneumonia and such..

Difficult to say, but probably frailty plays a large part, especially considering how lack of physical activity is a serious risk factor to many diseases. 

I have 2013 CoD statistics from Finland, which doesn't accept 'old age' as a reason: 

In people aged 90-94 (total 6400), 49% died from CVD, 30% from dementia and neurological disorders, 10% from cancer. Death from pneumonia was 2,5%. 

 

In people aged 95+ (total 2500), death from CVD was 50%, neurological issues 35%, cancer 5% and pneumonia 3%.

 

Personally, I'm wondering how much increasing frailty and lack of exercise affects these numbers. We know that regular vigorous aerobic exercise can reduce the risk of CVD mortality by up to 60% and all cause mortality up to 50%. Some studies have indicated that regular exercise also reduces AD risk by up to 40%. 

So, how is the lifestyle of elderly - how much exercise do they get and is it enough? 

There have been a couple of studies done in exercise diversity amongst 60-64 yo. in UK, 60+ in US and 65+ in AUS, according to which walking was clearly the most popular choice amongst older adults (70% in UK and 50% in AUS), and more vigorous training like jogging/running or gym training was done only by 5% or less of the participants. About 30% in AUS, 25% in UK and 50% in US reported no or very little physical exercise. Seems that there would be a lot of room for improvement?

It's not clear at all that vigorous exercise is better for longevity than moderate exercise: https://www.fightagi...rily-better.php

It's not clear at all that vigorous exercise is better for longevity than moderate exercise: https://www.fightagi...rily-better.php

'High-moderate' would perhaps be closer to the correct term - something between moderate and vigorous.  

The Copenhagen study has been discussed in 'light jogging' thread in Exercise section, the problems with the study (at the moment) are that there's only a few deaths (<10 per group) so far, and the group borders for light/moderate/strenuous are a bit weird, meaning that 'strenuous' is the 5% extreme of the group.  

There's been a number of studies that show that interval training is better for endothelial markers ( http://www.ncbi.nlm....pubmed/22720199), medium-fast pace is better than slow ( http://www.sciencedi...735109714027466 ) and that the optimal exercise level seems to be around 1 hour of high-moderate speed running a few times a week ( http://www.ncbi.nlm....pubmed/25128072 ). 

I would take this as 'jogging with some faster running included' type of routine a few times per week - I would see it beneficial that there's an element of pushing yourself hard a bit, although not quite to the extreme. This seems to contrast with the typical elderly activities, such as walking or other light exercise.

hi Proileri,

what does CVD stand for ?

CVD = CardioVascular Disease.  I find it interesting the way cancer as a cause of death drops so radically in the very elderly.  It shows a steady decline from 80 onward.  I guess that most everyone who was going to get cancer already died of it, leaving the very old enriched in people with some degree of natural resistance.  Pneumonia (a much better thing to die from-- it's been called "the old man's friend") increases steadily, though not to as great a degree.  All this is confounded by the BS diagnosis of "Old Age", .  That's about as useful as saying that the cause of death was "because they died".

The standart cretenism in medical statistics. 

What does it mean "old age" as a reason for death 

What are the "others" section 

Cancers not spread in localizations 

Diseases shown on groups only, not as diseases list "cerebrobascular" for example. What is cerebrovascolar dicky? ischemic brain and haemorrhagic brain has to be separated at least. 

etc.