The Real Facts Supporting Jeanne Calment as the Oldest Ever Human

Longevity Science and Women's Health and Wellbeing

In most areas of the world women comprise the majority of older persons (especially at the most advanced ages), but the additional longevity (globally it is 4.8 years) women have often comes with poorer health status compared to age-matched men. This article draws attention to four distinct ways an applied gerontological intervention designed to increase the human healthspan via "rate (of ageing) control" could positively impact the health and wellbeing of women in today's ageing world. The four benefits examined are: (1) improving women's health in late life; (2) increasing reproductive longevity and improving maternal health, (3) reducing the financial vulnerability many women experience at advanced ages (especially in the developing world); and (4) reducing the caring burdens which typically fall, at least disproportionately, on daughters to care for their ageing parents. Highlighting these factors is important as is helps focus geroscience advocacy not only on the potential health dividend age retardation could confer on those in late life, but also the distributional effects on health throughout the lifespan (e.g. improving maternal health) and on helping to ameliorate other important inequalities (e.g. reducing the financial vulnerabilities of late life and easing the burdens on the care givers for ageing parents). By making vivid the benefits "rate (of ageing) control" could confer on women, especially in the developing world, the goal of retarding biological ageing can be rightly construed as a pressing public health priority for the 21st century.

On the emergence of the correlation between life expectancy and the variance in the age at death

Recent empirical studies have found various patterns in the correlations between lifespan inequality and life expectancy in modern human populations. However, it is unclear how general these regularities are. Here we establish three theorems that provide theoretical foundations for such regularities. We show that for populations with a finite maximum lifespan ω, and under certain continuity assumptions, the variance in the age at death is bounded by a function of lifespan that has a maximum and tends to zero as life expectancy tends to zero and ω. We show how the change in said variance is determined by a particular interplay between the coefficient of variation and the mean age in the population. These results lead to three hypotheses-a three-phased pattern of change for the correlation between the variance and life expectancy, a particular shape of the associated variance function, and that survival curve Type is one driver of the pattern. We illustrate those hypotheses empirically via a study of the 10 countries in the Human Mortality Database with the oldest available data. Our results elucidate the emergence of the aforementioned correlation patterns and provide demographically meaningful conditions under which those correlations reverse.

Comparison of Japanese Centenarians' and Noncentenarians' Medical Expenditures in the Last Year of Life

IMPORTANCE

Although research has shown that centenarians tend to experience shorter periods of serious illness compared with other age groups, few studies have focused on the medical expenditures of centenarians as a potential indicator of the scale of medical resources used in their last year of life.

OBJECTIVE

To compare Japanese centenarians' and noncentenarians' monthly medical expenditures during the year before death according to age and sex.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective cohort study used linked national health and long-term care insurance data collected from April 2013 to March 2018 in Nara Prefecture, Japan, for residents aged 75 years or older who were insured under the Medical Care System for older adults and died between April 2014 and March 2018. Data were analyzed from April 2013 to March 2018.

EXPOSURES

Age of 100 years or older (centenarians) vs 75 to 99 years (noncentenarians).

MAIN OUTCOMES AND MEASURES

The numbers of unique inpatients and outpatients and medical expenditures related to decedents' hospitalization and outpatient care were extracted and analyzed based on sex and age group. The Jonckheere-Terpstra test was used to identify trends in unadjusted medical expenditures by age group, and generalized estimating equations were used to estimate monthly median expenditures by age group with adjustment for comorbidity burden and functional status.

RESULTS

Of 34 317 patients aged 75 to 109 years (16 202 men [47.2%] and 18 115 women [52.8%]) who died between April 2014 and March 2018, 872 (2.5%) were aged 100 to 104 years (131 men [15.0%] and 741 women [85.0%]) and 78 (0.2%) were aged 105 to 109 years (fewer than 10 were men). The analysis of unadjusted medical expenditures in the last year of life showed a significant trend of lower expenditures for the older age groups; the median adjusted total expenditures during the 30 days before death by age group were $6784 (IQR, $4884-$9703) for ages 75 to 79 years, $5894 (IQR, $4292-$8536) for 80 to 84 years, $5069 (IQR, $3676-$7150) for 85 to 89 years, $4205 (IQR, $3085-$5914) for 90 to 94 years, $3522 (IQR, $2626-$4861) for 95 to 99 years, $2898 (IQR, $2241-$3835) for 100 to 104 years, and $2626 (IQR, $1938-$3527) for 105 to 109 years. The proportion of inpatients among all patients in the year before death also decreased with increasing age: 4311 of all 4551 patients aged 75 to 79 years (94.7%); 43 of all 78 patients aged 105 to 109 years (55.1%); 2831 of 2956 men aged 75 to 79 years (95.8%); 50.0% of men aged 105 to 109 years (the number is not reported owing to the small sample size); 1480 of 1595 women aged 75 to 79 years (92.8%); and 55.7% of women aged 105 to 109 years (the number of women is not reported to prevent back-calculation of the number of men). Specifically, 274 of 872 patients aged 100 to 104 years (31.4%) and 35 of 78 patients aged 105 to 109 years (44.9%) had not been admitted to a hospital in the year before death.

CONCLUSIONS AND RELEVANCE

This cohort study found that medical expenditures in the last year of life tended to be lower for centenarians than for noncentenarians aged 75 years or older in Japan. The proportion of inpatients also decreased with increasing age. These findings may inform future health care services coverage and policies for centenarians.

Technology Enhanced Health and Social Care for Vulnerable People During the COVID-19 Outbreak

The COVID-19 pandemic has spread rapidly worldwide with critical consequences in health, as well as in social, economic, and particularly in psychological conditions of vulnerable people, especially older adults. Therefore, it is necessary the direct attention to their health care needs and related interventions. Information and Communication Technology (ICT) have direct impact on older adults' health and quality of life leading to decreased depression and loneliness, along with empowerment of independent life. Many studies involve cognitive training programs/software based on new technological systems that provide to vulnerable people access to gamified, attractive, cognitive exercises for overall functionality everywhere and at any time. Twenty-four participants (mean age 69.3 years) were assigned to this study. The cognitive training component of LLM Care was used as an interactive software to enhance participants' cognitive functions. The intervention lasted 12 weeks with the frequency of 2-4 times per week in sessions of at least 30 min. Participants used their personal devices (tablets/laptops) in their own residence, while technical and consulting guidance was provided by LLM Care certified trainers. They were informed about the purpose of the study, while consent forms along with psychological assessments were distributed every 2 weeks to periodically evaluate their psychosocial and mental health conditions. The assessments included the World Health Organization-Five Well-Being Index (WHO-5), the Short Anxiety Screening Test (SAST), the System Usability Scale (SUS) and the Impact Factor Event Scale (IES-R). According to the results, the participants with improved well-being tended to report decreased subjective distress caused by COVID-19, and their engagement with new technologies can potentially minimize the negative outcomes occurred by the current stressful situation, mitigating the effect of hyperarousal symptoms, while increasing their overall well-being. Well-being seems to remain relatively stable among older adults and decreases only when adversities occur, while the usability of the software was perceived as marginally acceptable by participants. The exploitation of the LLM Care contributes to the improvement of older adults' well-being and alleviates the negative experience caused by stressful situations like COVID-19.

Nonhuman primates at the intersection of aging biology, chronic disease, and health: An introduction to the American journal of primatology special issue on aging, cognitive decline, and neuropathology in nonhuman primates

Aging across the Primate Order is poorly understood because ages of individuals are often unknown, there is a dearth of aged animals available for study, and because aging is best characterized by longitudinal studies which are difficult to carry out in long-lived species. The human population is aging rapidly, and advanced age is a primary risk factor for several chronic diseases and conditions that impact healthspan. As lifespan has increased, diseases and disorders of the central nervous system (CNS) have become more prevalent, and Alzheimer's disease and related dementias have become epidemic. Nonhuman primate (NHP) models are key to understanding the aging primate CNS. This Special Issue presents a review of current knowledge about NHP CNS aging across the Primate Order. Similarities and differences to human aging, and their implications for the validity of NHP models of aging are considered. Topics include aging-related brain structure and function, neuropathologies, cognitive performance, social behavior and social network characteristics, and physical, sensory, and motor function. Challenges to primate CNS aging research are discussed. Together, this collection of articles demonstrates the value of studying aging in a breadth of NHP models to advance our understanding of human and nonhuman primate aging and healthspan.

Regularities in human mortality after age 105

Empirical research on human mortality and extreme longevity suggests that the risk of death among the oldest-old ceases to increase and levels off at age 110. The universality of this finding remains in dispute because of two main reasons: i) high uncertainty around statistical estimates generated from scarce data, and ii) the lack of country-specific comparisons. In this article, we estimate age patterns of mortality above age 105 using data from the International Database on Longevity, an exceptionally large and recently updated database comprising more than 13,000 validated records of long-lived individuals from eight populations. We show that, in all of them, similar mortality trajectories arise, suggesting that the risk of dying levels off after age 105. As more high-quality data become available, there is more evidence in support of a levelling-off of the risk of dying as a regularity of longevous populations.

Diagnoses of Chronic Health Conditions and Change in Subjective Age: The Moderating Role of Chronological Age

BACKGROUND AND OBJECTIVES

Health is a predictor of subjective age, and although inconclusive, the strength of this association is not uniform across different age groups. This study investigates if new diagnoses of chronic health conditions are associated with a change in subjective age and if chronological age moderates this relationship.

RESEARCH DESIGN AND METHODS

Using data from the Health and Retirement Study, residualized change regression analysis was performed for a sample of 5,158 respondents older than 50 years to examine their subjective age in 2014 relative to that reported in 2010. The main predictor was the number of chronic health conditions newly diagnosed between 2010 and 2014. Chronological age in 2010 was the moderator.

RESULTS

Results showed that each new diagnosis of a chronic health condition was significantly associated with a 0.68-year increase in subjective age reported in 2014, compared to subjective age reported in 2010. However, this increase in subjective age was attenuated by 0.05 years for each additional year in 2010 chronological age.

DISCUSSION AND IMPLICATIONS

According to Social and Temporal Comparison theories, people compare themselves to their age peers and earlier selves. Given expectations for better health at younger chronological ages, being diagnosed with chronic health conditions may have a stronger association with subjective age among middle-aged persons as compared to older persons. The findings suggest that subjective age may be used as a screening tool to predict how chronic disease diagnosis may influence peoples' sense of self, which in turn shapes future health.

Aging Successfully: Possible in Principle? Possible for all? Desirable for all?

The human lifespan is constantly increasing across the world. Therefore, the question whether aging can take a "successful" route likely never has been as up-to-date as today. Still, gerontology continues to struggle with the concept of successful aging. In part I of this work, I outline six models of successful aging currently most discussed in aging science. Next, I compare the models according to four indicator domains: Psychologically oriented, socially oriented, bio-physical functioning oriented, and other. In part II, I address three key questions related to successful aging: Is successful aging possible in principle? Is it possible for all? Is it desirable for all? Regarding the first question, the conclusion based on empirical data is that across all models except the biological model aging successfully is possible in principle. Hence, I answer this question with a "YES, BUT." Successful aging at the bio-level so far seems very limited. In terms of question 2, expecting largely increasing portions of older adults fulfilling various of the so far established criteria of aging successfully in the future seem overly optimistic. Hence, I answer this question with "NO." For question 3, I critique the at first glance obvious persuasiveness of successful aging as a generally to be achieved end state. For example, it may be that norms of successful aging undermine old age's cultural richness in the future. Hence, I answer this question with "NOT SURE."

Why are supercentenarians so frequently found in French Overseas Departments? The cases of Guadeloupe and Martinique

Many more cases of supercentenarians are observed in the French Départements d’Outre-Mer (DOM) than in metropolitan France. A first possible explanation is that the standard French protocol for validating age does not sufficiently cover DOMs. However, if additional checks can confirm the verity of this phenomenon, forming explanatory hypotheses can be relevant and quite interesting. Thanks to an INED research funding, a special protocol of deep age checking has been established to be applied to the two DOMs where the phenomenon is the most pronounced: Guadeloupe and Martinique. First results not only show that combining several additional checks does not leave much room for further doubting the ages of supercentenarians but they also support some arguments in favor of a possible fundamental explanation: genetic selection due to the extreme severity of mortality inflicted on their slave ancestors.

Jeanne Calment's Unique 122-Year Life Span: Facts and Factors; Longevity History in Her Genealogical Tree

Jeanne Calment's (JC) still unmatched validated human life span of 122 years and 164 days, over 3 years longer than any other, surprises many. While her case is broadly accepted as a golden standard of validation, her record age still raises skepticism among some. The probability of such a record to be achieved by someone born in the second half of the 19th century, in the world population documentarily eligible to age validation, and also in the G7 countries, can be calculated by applying some logistic and Gompertz mortality models to these populations, taken, respectively, from the age of 117 and of 100. This probability appears substantial, respectively, 7.1% and 4.7%, when using a four-parameter logistic model, which I validated on the observed survivals of centenarians until the age of 118. A 3-year interval with the second oldest is then expected. The known facts and documents constitute consistent evidence that JC died at 122: regular official records during her life, her verified memories from her 19th century life, her usage of specialized terms and of an abbreviation system specific to this period of time, photographs, her signature and handwriting, testimonies from numerous witnesses of her life, plus the expertise of gerontologists. Meanwhile, nothing contradicts her record: the daughter/mother identity swap hypothesis appears unrealistic and not supported by any evidence; especially no plausible motive can be found, on the contrary. The latest article, which defends this hypothesis, "Bayesian assessment of the longevity of JC," contains major errors, making its result subjective and invalid. The study of JC's genealogical tree on six generations, using longevity performance and total immediate ancestor longevity indicators, shows how, in two centuries, her ancestors have been living 10% longer on average at each generation, increasingly overperforming their French 25-year-old contemporaries, from around 7% in the early 18th century to 43% for her parents, and up to 56% for her older brother and 80% for herself, which suggests a progressive concentration of longevity factors. In addition to the hereditary factors, JC's personal overperformance suggests also some environmental factors, and indeed many are known. Further knowledge could be obtained by studying JC's existing blood and DNA samples: those could not only provide an additional proof of her authenticity, but more importantly could be of immense contribution for understanding deeper the factors and patterns of her longevity, and more generally the longevity and aging processes in humans in general as well.

If Jeanne Calment Were 122, That Is All the More Reason for Biosampling

This article discusses the need for biosampling as a way to test "super-duper" centenarians (persons aged >120 years) to identify biological pathways for Homo sapiens to live to their fullest biological lifespan potential (estimated by extreme value theory to be currently between 123 years and 128 years) and, by extension, the possibility of biosampling leading to the identification through scientific research testing and data analysis areas of potential life extension. Studies of twins have shown that the proportion of longevity attributed to heredity (genetic potential) versus environment increases substantially the higher the age group being tested, especially after age 75 years. Even among the oldest-old, the proportion attributed to biological factors continues increasing the higher the age category, which is a selective process as the genetically weaker of the remaining survivors continue to die off first, leaving a more and more highly selected remaining population. This self-selection process means that the very oldest individuals are already the "genetic lottery winners" who have the biological potential to come close to the maximum human lifespan. Testing of these persons may result in faster breakthroughs in the attempt to extend the human lifespan through biological testing and analysis. Indeed, it is possible that, just as some human lifespans are shortened due to random genetic mutations unique to the individual (such as persons with progeria), it is possible that there could be some humans whose maximum genetic potential was due in part to a genetic mutation unique to that particular individual. This remains an area of potential research that has not yet been thoroughly biotested-but one that could change soon, and biotesting a 122-year-old woman's biosamples would be a prime opportunity for such a test: Jeanne Calment. Because only one 122-year-old woman has been validated in recorded scientific history, the uniqueness of the case makes it a unique opportunity that should not be passed by. Herewith, I take a closer look at the Jeanne Calment case and the conclusion is the same as the start: Jeanne Calment was 122 years, her age is relatively unique but not impossible to repeat in the future; however, her samples may be available right now, and thus remains the only current opportunity to study a >120-year-old person from a biological perspective.