scholarly journals Stratification in health and survival after age 100: evidence from Danish centenarians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesús-Adrián Alvarez ◽  
Anthony Medford ◽  
Cosmo Strozza ◽  
Mikael Thinggaard ◽  
Kaare Christensen

Abstract Background The existence of a super-select group of centenarians that demonstrates increased survivorship has been hypothesized. However, it is unknown if this super-select group possesses similar characteristics apart from extreme longevity. Methods In this study, we analyse high-quality health and survival data of Danish centenarians born in 1895, 1905 and 1910. We use Latent Class Analysis to identify unobserved health classes and to test whether these super-select lives share similar health characteristics. Results We find that, even after age 100, a clear and distinct gradient in health exists and that this gradient is remarkably similar across different birth cohorts of centenarians. Based on the level of health, we identify three clusters of centenarians - robust, frail and intermediate - and show that these groups have different survival prospects. The most distinctive characteristic of the robust centenarians is the outperformance in different health dimensions (physical, functional and cognitive). Finally, we show that our health class categorizations are good predictors of the survival prospects of centenarians. Conclusions There is a clear stratification in health and functioning among those over 100 years of age and these differences are associated with survival beyond age 100.

2021 ◽  
Author(s):  
Jesús-Adrián Alvarez ◽  
Anthony Medford ◽  
Cosmo Strozza ◽  
Mikael Thinggaard ◽  
Kaare Christensen

Abstract BackgroundThe existence of a super-select group of centenarians that demonstrates increased survivorship has been hypothesized. However, it is unknown if this super-select group possesses similar characteristics apart from extreme longevity. MethodsIn this study, we analyse high-quality health and survival data of Danish centenarians born in 1895, 1905 and 1910. We use Latent Class Analysis to identify unobserved health classes and to test whether these super-select lives share similar health characteristics. ResultsWe find that, even after age 100, a clear and distinct gradient in health exists and that this gradient is remarkably similar across different birth cohorts of centenarians. Based on the level of health, we identify three clusters of centenarians - robust, frail and intermediate - and show that these groups have different survival prospects. The most distinctive characteristic of the robust centenarians is the outperformance in different health dimensions (physical, functional and cognitive). Finally, we show that our health class categorizations are good predictors of the survival prospects of centenarians. ConclusionsThere is a clear stratification in health and functioning among those over 100 years of age and these differences are associated with survival beyond age 100.


2017 ◽  
Vol 139 (6) ◽  
pp. 1935-1945.e12 ◽  
Author(s):  
Alexander J. Hose ◽  
Martin Depner ◽  
Sabina Illi ◽  
Susanne Lau ◽  
Thomas Keil ◽  
...  

2019 ◽  
Vol 4 (2) ◽  
pp. e000930 ◽  
Author(s):  
Rachel R Yorlets ◽  
Katherine R Iverson ◽  
Hannah H Leslie ◽  
Anna Davies Gage ◽  
Sanam Roder-DeWan ◽  
...  

IntroductionIn the era of Sustainable Development Goals, reducing maternal and neonatal mortality is a priority. With one of the highest maternal mortality ratios in the world, Malawi has a significant opportunity for improvement. One effort to improve maternal outcomes involves increasing access to high-quality health facilities for delivery. This study aimed to determine the role that quality plays in women’s choice of delivery facility.MethodsA revealed-preference latent class analysis was performed with data from 6625 facility births among women in Malawi from 2013 to 2014. Responses were weighted for national representativeness, and model structure and class number were selected using the Bayesian information criterion.ResultsTwo classes of preferences exist for pregnant women in Malawi. Most of the population 65.85% (95% CI 65.847% to 65.853%) prefer closer facilities that do not charge fees. The remaining third (34.15%, 95% CI 34.147% to 34.153%) prefers central hospitals, facilities with higher basic obstetric readiness scores and locations further from home. Women in this class are more likely to be older, literate, educated and wealthier than the majority of women.ConclusionFor only one-third of pregnant Malawian women, structural quality of care, as measured by basic obstetric readiness score, factored into their choice of facility for delivery. Most women instead prioritise closer care and care without fees. Interventions designed to increase access to high-quality care in Malawi will need to take education, distance, fees and facility type into account, as structural quality alone is not predictive of facility type selection in this population.


2009 ◽  
Author(s):  
Tomoko Udo ◽  
Jennifer F. Buckman ◽  
Marsha E. Bates ◽  
Evgeny Vaschillo ◽  
Bronya Vaschillo ◽  
...  

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