Zhang Yuge, Murata Shunsuke, Schmidt-Mende Katharina, Ebeling Marcus, Modig Karin
Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden.
EClinicalMedicine. 2025 Aug 2;87:103396. doi: 10.1016/j.eclinm.2025.103396. eCollection 2025 Sep.
Previous research suggests that centenarians reach exceptional ages primarily by avoiding major diseases rather than surviving them. However, how they manage multiple conditions over the life course remains less understood. Examining the accumulation and distribution of diseases across lifespan can provide insights into mechanisms underlying their resilience.
We conducted a nationwide historical prospective study including all individuals born in Sweden between 1920 and 1922 (n = 274,108), tracking their health from age 70 for up to 30 years. Disease trajectories of centenarians were compared to those of shorter-lived peers using national health registers. We analysed disease burden, the rate of disease accumulation, and patterns of multimorbidity across age groups.
Centenarians had fewer diagnosed conditions and accumulated diseases at a slower rate than non-centenarians. Cardiovascular diseases were the most common diagnoses in all age groups, but contributed less to the overall disease burden among centenarians. In contrast, malignancies accounted for a relatively larger share of their disease profile. Neuropsychiatric conditions were consistently less common among centenarians, showing the largest relative difference across all ages. Centenarians also had fewer co-occurring diseases and were more likely to have conditions confined to a single disease group.
Our findings of a lower overall disease burden, a delayed onset of multiple conditions, and fewer co-occurring diseases over time among centenarians (compared to non-centenarians) suggest a preserved homeostatic capacity and sustained functional integrity in the face of cumulative physiological stressors. Future research should aim to identify genetic, epigenetic, and environmental factors underlying these patterns to inform early-life preventive strategies that promote longevity and resilience.
Karolinska Institutet.
先前的研究表明，百岁老人主要通过避免重大疾病而非战胜疾病来达到超长寿命。然而，他们在一生中如何应对多种疾病仍鲜为人知。研究疾病在整个生命周期中的积累和分布情况，可以深入了解其恢复力的潜在机制。
我们开展了一项全国性的历史前瞻性研究，纳入了1920年至1922年在瑞典出生的所有个体（n = 274,108），从70岁开始跟踪他们的健康状况长达30年。使用国家健康登记册，将百岁老人的疾病轨迹与寿命较短的同龄人进行比较。我们分析了疾病负担、疾病积累率以及各年龄组的共病模式。
与非百岁老人相比，百岁老人的确诊疾病更少，疾病积累速度更慢。心血管疾病在所有年龄组中都是最常见的诊断，但在百岁老人的总体疾病负担中所占比例较小。相比之下，恶性肿瘤在他们的疾病谱中占相对较大的比例。神经精神疾病在百岁老人中一直较少见，在所有年龄段中显示出最大的相对差异。百岁老人的共病也较少，且更有可能患有局限于单一疾病组的疾病。
我们的研究结果表明，与非百岁老人相比，百岁老人总体疾病负担较低、多种疾病发病延迟且共病较少，这表明他们在面对累积的生理应激源时，保持了体内稳态能力和持续的功能完整性。未来的研究应旨在确定这些模式背后的遗传、表观遗传和环境因素，为促进长寿和恢复力的早期预防策略提供依据。
卡罗林斯卡学院。
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