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More People Are Living to 100 Than Ever Before

A birthday cake with 100 candles on.
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The number of centenarians continues to grow in the UK

Not too long ago, the prospect of reaching 100 years of age would have been a mere pipe dream – a centenarian was a rare thing. Now, they’re becoming more commonplace.

New data from the UK’s Office for National Statistics (ONS) estimates that 15,120 centenarians were living in England and Wales in 2022, a 3.7% increase from 2021. This is the highest number of centenarians ever recorded for the region and marks a 100% increase from 2002 figures.

In most parts of the world, women have a higher life expectancy than men, resulting in a higher prevalence of female centenarians than males. The ONS data show that this statistic still stands, at least in England and Wales, but there has been a 5% increase in male centenarians since 2021.

By 2030, over 21,000 centenarians are projected to be living in the UK. King Charles is certainly going to be writing his fair share of birthday cards over the coming years.

Centenarian statistics across the world

The rise in people living to 100 isn’t limited to the UK. In the US, 2021 records show that in a population of 336,996,624 people, there were 89,739 centenarians (a prevalence of 0.27%). This figure has almost doubled in the last 20 years and centenarians are projected to make up 0.1% of the population by 2054.

Japan currently holds the record for the highest number of centenarians and the highest per 100,000 people. Okinawa in Japan is considered a “blue zone”, a region of the world where people live longer than average, and where there is a high number of centenarians. Five regions are currently recognized as Blue Zones, including Okinawa in Japan, Sardinia in Italy, the Nicoya Peninsula in Costa Rica, Ikaria in Greece and Loma Linda in California.

Is there a secret recipe for a longer life?

Centenarians are fascinating to study. What can their lifestyle and biology reveal about human disease risk and longevity?

Japanese centenarians’ diets

The Okinawa Centenarian Study (OCS), which began in 1975, is the longest-running study of centenarians in the world. Over the last ~50 years it has analyzed the diets, exercise habits, genetics, spiritual practices and behavior patterns of more than 3,000 people. The study has found that, in Okinawa, roughly one third of centenarians are functionally independent and have had high levels of physical activity throughout their lifetime.

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Much of the longevity of Okinawa centenarians is attributed to the Okinawan diet, which is typically low-calorie, comprising vegetables and fruits with reduced consumption of meat, refined grains, saturated fat, sugar, salt and full-fat dairy products. The composition of this diet is similar to diets that have been studied in the West and are associated with a reduced risk of chronic diseases.

Japanese centenarians have a unique gut microbiome

A 2023 study studied Japanese centenarians and found a unique combination of bacteria and viruses in their gut, suggesting the gut microbiome constitution could contribute to longevity. “High microbial diversity is usually associated with a healthy gut microbiome, and we expect people with a healthy microbiome to be better protected against aging-related disease,” said Dr. Joachim Johansen, a postdoctoral researcher at the Novo Nordisk Foundation Center for Protein Research, and the study’s first author.

The immune system and blood biomarkers

Researchers from Boston University Chobanian & Avedisian School of Medicine and Tufts Medical Center published a study in early 2023 that analyzed blood cells from 7 centenarians living in North America. The scientists also included single-cell RNA-sequencing data from a further 7 centenarians, obtained from public databases, in their analyses.

Studying the participants’ peripheral blood mononuclear cells (PBMCs), the researchers identified a unique cell composition in centenarians when compared to a sample of 52 participants that were aged 20-89 years. “Our transcriptional analysis identified cell type signatures specific to exceptional longevity that included genes with age-related changes (e.g., increased expression of STK17A, a gene known to be involved in DNA damage response) as well as genes expressed uniquely in centenarians’ PBMCs (e.g., S100A4, part of the S100 protein family studied in age-related disease and connected to longevity and metabolic regulation),” the authors described.

A more recent study published in GeroScience compared biomarker profiles among long-lived individuals and their shorter-lived peers.

The researchers, including scientists at the Karolinska Institute, measured a variety of molecules in the blood of Swedish people born between 1893 and1920. Participants had undergone clinical testing between 1985 and 1996 and were followed up until 2020 as part of the AMORIS population-based study. “We examined biomarkers of metabolism, inflammation, liver, renal, anemia and nutritional status using descriptive statistics, logistic regression and cluster analysis,” the researchers said.

A total of 1224 participants (84.6% of which were female) lived to their 100th birthday, making this the largest study of its kind to date.

“We found that, on the whole, those who made it to their hundredth birthday tended to have lower levels of glucose, creatinine and uric acid from their sixties onwards. Although the median values didn’t differ significantly between centenarians and non-centenarians for most biomarkers, centenarians seldom displayed extremely high or low values,” Dr. Karin Modig, associate professor in epidemiology at the Karolinska Institute, and the study’s lead author, said. “For many of the biomarkers, both centenarians and non-centenarians had values outside of the range considered normal in clinical guidelines. This is probably because these guidelines are set based on a younger and healthier population.”

While the study did not identify any specific lifestyle factors or genes that contributed to the centenarians’ longevity. Modig did note that it’s “reasonable” to think that factors such as nutrition and alcohol intake might play a role.

Centenarians – opportunities and challenges to be embraced

As more people live to be 100, there are opportunities and challenges related to this that must be both embraced and addressed.

The fact that people are reaching their second century is a testament to improved living conditions and access to healthcare, among many other factors. The study of centenarians can provide new insights into the aging process and how to promote healthy aging, which is a huge priority for the World Health Organization.

However, the prospect that we all might live longer than anticipated has ramifications that affect not only our own lives, but also public health systems. Global policymakers and healthcare professionals will need to actively address the unique needs of centenarians to ensure that the public health systems are sustainable and capable of providing care and support to an aging population.