By Brenda L. Mooney
WASHINGTON—Older does not necessarily mean sicker, especially with the fast-growing centenarian population, a new veterans study reveals.
The research from the DCVAMC and George Washington University finds that VA patients 100 or older actually have a lower incidence of chronic illness than their cohorts in their 80s and 90s.
The Social Security Administration predicts that more than a million centenarians will live in the United States by the end of this century.
To explore why some veterans have achieved such great longevity, Raya Elfadel Kheirbek, MD, MPH, a geriatrician and palliative care physician at the VA and associate professor of medicine at the GW School of Medicine and Health Sciences, and colleagues embarked on a study to take a close look at the oldest old. The focus was on octogenarians, nonagenarians and centenarians within the VA.
The results, which largely involved white males who had fought in World War II, were published recently in the Journal of the American Geriatric Society.1
“Additionally, this generation lived through the Great Depression,” Kheirbek said. “It is a wonder, considering the hardships they had faced, that they have achieved such longevity. This never-before studied group of centenarians at the VA imparts a very important message of resilience to anyone struggling as they did.”
Information for the retrospective longitudinal cohort study was obtained from the VA’s Corporate Data Warehouse (CDW). Data was pulled on community-dwelling veterans born between 1910 and 1915 who survived to at least age 80. The group included 86,892 veterans—31,121 octogenarians, 52,420 nonagenarians and 3,351 centenarians.
Of the centenarians, 97% were male, 88.0% were white, 31.8% were widowed, 87.5% served in World War II, and 63.9% did not have a service-related disability.
Even though they were years younger, the study found that incidence rates of common chronic illnesses were higher in octogenarians than centenarians:
- atrial fibrillation, 15.0% vs 0.6%,
- heart failure, 19.3% vs 0.4%,
- chronic obstructive pulmonary disease, 17.9% vs 0.6%,
- hypertension, 29.6% vs 3.0%,
- end-stage renal disease, 7.2% vs 0.1%,
- malignancy, 14.1% vs 0.6%,
- diabetes mellitus, 11.1% vs 0.4%, and
- stroke, 4.6% vs 0.4.
Centenarians had similarly lower rates than nonagenarians.
“In a large cohort of predominantly male community-dwelling elderly veterans, centenarians had a lower incidence of chronic illness than those in their 80s and 90s, demonstrating similar compression of morbidity and extension of health span observed in other studies,” the study authors concluded.
Kheirbek pointed out that, because of their military services, many of the older veterans had a strong sense of discipline and, subsequently, were more likely to make healthy decisions. In fact, she noted, many did not smoke or drink.
Compression morbidity was also suggested as a potential explanation for the extended health span in an individual’s life span. That hypothesis states that the lifetime burden of illness could be reduced if the onset of chronic illness is postponed until very late in life.
Kheirbek put it this way, “The older you get, the healthier you have been.”
Kheirbek RE, Focar A, Shara N, Bell-Wilson LK, Moore HJ, Olsen E, Blackman MR, Llorente, M. Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians. Journal of the American Geriatrics Society, 2017; DOI: 10.1111/jgs.14900