The Relationship Between Disease and Longevity

Elderly man on a dock tying a fly onto a fishing pole
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Living to a healthy 100 years sounds like a great goal for anyone, but how do we figure out what it really takes to live to such an old age and to do so with our health intact? Is it just plain luck or do centenarians have something that the rest of us lack?

One way to find out is to study the people who have made it to 100 years old, and that's what some researchers did. They asked people 100 years old or older what chronic illnesses they have and when they got them.

What these researchers wanted to find out was if people who live to 100 simply have good genes and have avoided diseases or were they hardier and survived disease. Here is what they found.

Studying Centenarians

Over the course of this study, researchers interviewed a total of 424 centenarians (people aged 100 or more) and asked them (along with their caregiver) about if/when they were diagnosed with the following 10 health conditions:

  1. Hypertension
  2. Heart disease
  3. Diabetes
  4. Stroke
  5. Non-skin cancer
  6. Skin cancer
  7. Osteoporosis
  8. Thyroid condition
  9. Parkinson’s disease
  10. Chronic obstructive pulmonary disease (COPD)

In addition to gathering data on these chronic diseases, they also asked about lifestyle factors, such as nutrition, exercise, and smoking habits. Though they were originally trying to link a person's age of diagnosis with their life expectancy, what they found was a bit surprising.

Three Categories of Centenarians

Over the course of the study, the centenarian participants generally fell into one of three categories, which say something different about their long lives.

  • Survivors: 24% of the male centenarians and 43% of the female centenarians in the study fit the profile of “survivors.” These were people who had a diagnosis of (at least) one of the age-related illnesses listed above before age 80.
  • Escapers: These were people who reached age 100 without any of the above medical conditions. Thirty-two percent of the men and 15% of the women in the study were considered escapers.
  • Delayers: This term represented those centenarians with a delayed the diagnosis of one of the illnesses above until after age 80. Forty-four percent of men and 42% of women in the study fit this profile.

The Type of Disease Matters

In addition to effectively dividing the centenarians into three distinct groups based on their disease state and age of diagnosis, the researchers dug a little deeper and also looked at the data surrounding specific diseases on the list.

When the researchers looked at only the three most deadly conditions, heart disease, stroke, and cancers (excluding skin cancer), they found that almost all of the centenarians were escapers of those diseases. A total of 87% of men and 83% of women in the study had reached the age of 100 without having any of these three health conditions. While these conclusions require more research before any medical science-changing discoveries are made, we can draw at least one interesting conclusion: people reach old age with differing medical histories.

Multiple Routes to Very Old Age

Of the many theories that can be drawn from this research, one simple conclusion that can be drawn is that there is no one route to living to a very old age.

People who live to 100 years old do not necessarily simply “have good genes” that make them immune to the common age-related illnesses. That is true, certainly, for some percentage of people, but others actually survive illness and continue to live to well past age 100.

How to Live to 100

This study shows us that delaying the diagnosis of an illness to 80 or beyond is statistically (and experientially) a very, very good thing. There are many lifestyle factors that can help you delay (and even prevent) age-related illnesses. These include regular exercise, healthy eating, proper sleep, and relaxation.

You should also work to prevent disease by making good use of the medical care available to you.

Ultimately, one of the many things that the study doesn’t tell us is how taking good care of your health and actively working toward successful aging can impact your life expectancy. The study also did not consider the quality of life of the people who made it to 100. So what can you do in your daily life to be sure you have as many healthy years as possible? Taking an active approach to the lifestyle factors mentioned above is a good place to start.

For more reading, be sure to check out all of our How to Live to 100 resources.


Jessica Evert, Elizabeth Lawler, Hazel Bogan and Thomas Perls. Morbidity Profiles of Centenarians: Survivors, Delayers, and Escapers. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:M232-M237 (2003)