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Morbidity of Tokyo-Area Centenarians and Its Relationship to Functional Status

¹ Division of Geriatric Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
² Tokyo Metropolitan Institute of Gerontology, Japan.
³ Health Care Center, Shoko Chukin Bank, Tokyo, Japan.
⁴ Tohoku Bunka Gakuen University, Miyagi, Japan.

Address correspondence to Michiyo Takayama, MD, Division of Geriatric Medicine, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 Japan. E-mail: michiyo{at}sc.itc.keio.ac.jp

Background. Research in Western countries has shown most centenarians to be survivors with multiple comorbidities. However, Japanese centenarians' morbidity and its relationship to functional status has yet to be elucidated. The aim of this study is to clarify the association of morbidity with the physical and cognitive function of centenarians. We examined Tokyo-area centenarians to determine their kinds of morbidity profiles and how such morbidity related to their functional status.

Methods. We studied 302 centenarians living in Tokyo (101.2 ± 1.8 years; 65 men, 237 women), and assessed their physical status, morbidity, and use of medication. Activities of daily living and cognitive function were also assessed using the Barthel Index and the Clinical Dementia Rating.

Results. More than 95% of the centenarians had chronic diseases. Both the physical and cognitive functions were significantly higher in men. The present and previous illnesses most frequently included hypertension, heart disease, stroke, fractures, and cataracts. Fractures were observed significantly more frequently in women. Diabetes mellitus was uncommon. The physical and cognitive function of centenarians with a history of stroke or fracture were particularly poor, whereas those centenarians with hypertension tended to show a high level of physical and cognitive function.

Conclusions. Almost all centenarians had chronic diseases. Stroke and fracture were correlated with poorer function; therefore, we hypothesize that prevention of stroke and fracture might improve functional status in the oldest-old.

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