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The below appears to be a detailed and informative body of
work from the
Perls laboratory on supercentarian profiles.

Schoenhofen EA, Wyszynski DF, Andersen S, Pennington J,
Young R, Terry DF,
Perls TT.

Characteristics of 32 supercentenarians.

J Am Geriatr Soc. 2006 Aug;54(8):1237-40.

PMID: 16913991

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16913991

Abstract:

Aim:To report phenotypic characteristics of 32 age-validated
supercentenarians. Case series. U.S.-based recruitment
effort. Thirty-two supercentenarians. Multiple forms of
proof were used to validate age claims. Sociodemographic,
activities of daily living, and medical history data were
collected. Age range was 110 to 119. Fifty-nine percent had
Barthel Index scores in the partially to totally dependent
range, whereas 41% required minimal assistance or were
independent. Few subjects had a history of clinically
evident vascular-related diseases, including myocardial
infarction (n=2, 6%) and stroke (n=4, 13%). Twenty-two
percent (n=7) were taking medications for hypertension.
Twenty-five percent (n=8) had a history of cancer (all
cured). Diabetes mellitus (n=1, 3%) and Parkinson's disease
(n=1, 3%) were rare. Osteoporosis (n=14, 44%) and cataract
history (n=28, 88%) were common. Data collected thus far
suggest that supercentenarians markedly delay and even
escape clinical expression of vascular disease toward the
end of their exceptionally long lives. A surprisingly
substantial proportion of these individuals were still
functionally independent or required minimal assistance.

Excerpts:

... Case series. U.S ... Multiple forms of proof were
used to validate
age claims. Sociodemographic, activities of daily living,
and medical
history ... Fifty-nine percent had Barthel Index scores in
the partially to
totally dependent range, whereas 41% required minimal
assistance or were
independent. Few subjects had a history of clinically evident
vascular-related diseases, including myocardial infarction
(n=2, 6%) and
stroke (n=4, 13%). Twenty-two percent (n=7) were taking
medications for
hypertension. Twenty-five percent (n=8) had a history of
cancer (all cured).
Diabetes mellitus (n=1, 3%) and Parkinson's disease (n=1,
3%) were rare.
Osteoporosis (n=14, 44%) and cataract history (n=28, 88%)
were common. Data
collected thus far suggest that supercentenarians markedly
delay and even
escape clinical expression of vascular disease toward the
end of their
exceptionally long lives. A surprisingly substantial
proportion of these
individuals were still functionally independent or required
minimal
assistance.

... Great effort and diligence is required to locate
living
supercentenarians and validate their age claims. Claims of
ages beyond that
of the oldest well-accepted age of 122 years (Madame Jeanne
Calment)
regularly surface in the media, but these are invariably
unsubstantiated.13
The U.S. census listed 1,400 supercentenarians in 2000
(about 1 per
200,000),4 but an e-mail based effort facilitated by the
Gerontology
Research Group (GRG, http://www.grg.org) that monitors and
validates claims
of age 110 and older estimates the number of living
supercentenarians in the
United States to be approximately 60 to 70 (or approximately 1
supercentenarian per 6 million people) and 250 to 300
worldwide. One study
reported Medicare data indicating that, in 2000, there were
32,920
centenarians and that, of these, 105 (0.3%) were age 110 and
older [the free
full-text http://tinyurl.com/s7tlu pdf]. One study
estimated that seven in
1,000 people born at the turn of the last century lived to
become
centenarians and that one in 100,000 lived to be 110 or
older [the free
full-text http://tinyurl.com/m9sae report].

Because of the efforts of the GRG and the
International Database on
Longevity (http://www.supercentenarians.org), it has become
possible to go
beyond single anecdotal case descriptions to formal case
series. Reports of
supercentenarians have only examined the demography,
identification, and
age-verification of these individuals.710 Here, the first
phenotypic
characterization of a case series of 32 supercentenarians is
reported.

Centenarians have been found to exhibit marked delays
in functional
decline and in most cases age-related lethal diseases such
as heart disease,
cancer, and stroke.11 Compression of functional decline
toward the relative
end of their long lives might be a prerequisite or at least
a marker of the
ability to live to 100. In a sample of 105 centenarians, 88%
were
functionally independent at a mean age of 92.12 Such
compression of
disability is even more pronounced in male centenarians.13
Early experience
with supercentenarians has led to the hypothesis that such a
delay must be
extended at least through age 100 for a person to survive to
age 110 or
older.

... age verification of centenarians began with
obtaining subjects'
birth certificates.14 In the case of rarer and potentially
sensationalized
ages, such as claims of 110 and older, additional forms of
proof that
indicated ages at different times in the person's life were
obtained. Such
forms of proof included census records, school report card
with age,
military record, marriage license, employment record, old
passport, and
parental age on child's birth certificate. Dates of death
for subjects who
had died were confirmed using death certificates, the Social
Security Death
Index, or when these were unavailable, cemetery or funeral
home records. The
familial reconstitution method was also employed to
determine whether the
ages of parents, grandparents, siblings, and children were
reasonable in
relation to that of the supercentenarian.15 Such stringent
requirements for
age verification were deemed necessary, because according to
the GRG's
experience, the majority of claims of age 115 and older are
false. ...

... Thirty-nine subjects with claims of age 110 and
older were enrolled
during 1997 through 2005. Two individuals did not meet the
age validation
criteria, and five died after consent was received but
before data could be
collected. Thus, demographic and phenotypic data are
reported for 32
subjects. Regarding the two claims that could not be
validated, one subject
believed to be 111 years old lived in Germany for most of
his life, and
birth records or age-verifying documents were unavailable. A
second subject
did not have any documents to substantiate (or contradict)
her claimed age
of 110. ... For 32 supercentenarians, the age range was 110
to 119. The
119-year-old female participant was the oldest living person
in the world at
the time of her enrollment. The sources of age validation
for these 32
subjects are summarized in Table 1.


Table 1. Age-Validating Documents for 35 Supercentenarians
==============================
Document n (%)
==============================
Birth certificate 14 (40)
Census record 25 (71)
Baptismal record 5 (14)
Marriage certificate/license 11 (31)
Passport 1 (3)

As revealed in Table 2, medical history was remarkable
for few subjects
having a history of vascular-related diseases, including
myocardial
infarction (n=2, 6%) and stroke (n=4, 13%), despite their
long lives. Seven
(22%) were taking medication to treat hypertension. Eight
(25%) had a
history of cancer, all cases of which had been successfully
treated, and
none of which were active. Diabetes mellitus (n=1, 3%) and
Parkinson's
disease (n=1, 3%) were rare. Osteoporosis (n=14, 44%) and
cataract history
(n=28, 88%) were common.

Table 2. Sociodemographic, Medical, and Functional
Characteristics of 32
Supercentenarians
======================================
Characteristic Value
======================================
Age, mean ± SD (range) 111 ± 2 (110-119)
Sex, n (%)
Female 27 (84)
Male 5 (16)
Education, years, n (%)
?8 17 (53)
9-12 8 (25)
13-17 7 (19)
?18 0 (0)
Education, years, mean ± SD 10 ± 4 (0)
Race, n (%)
Caucasian 28 (88)
Other 4 (12)
Place of birth, n (%)
Australia 2 (7)
Canada (Prince Edward Island) 1 (3)
Germany 1 (3)
Ireland 1 (3)
Morocco 1 (3)
United States 26 (81)
Grandparents' ethnicity, n (%)
Danish 1 (3)
English 10 (31)
English/Dutch 1 (3)
English/German 1 (3)
English/Irish/Scottish 1 (3)
English/French 1 (3)
French 1 (3)
German 4 (12)
German/Spanish 1 (3)
Irish 1 (3)
Irish/German 1 (3)
Irish/Canadian/French 1 (3)
Norwegian/German 1 (3)
Scottish 1 (3)
Scottish/English 1 (3)
Spanish 1 (3)
Unknown 4 (12)
Living situation, n (%)
With family 5 (17)
Assisted living 5 (17)
Nursing home 19 (65)
Missing data 3 (1)
Medical history, n (%)
Myocardial infarction 2 (6)
Cardiac arrhythmia 1 (3)
Pacemaker inserted 0 (0)
Angina pectoris 0 (0)
Stroke 4 (13)
Treated hypertension 7 (22)
Adult-onset diabetes mellitus 1 (3)
Chronic obstructive pulmonary disease 0 (0)
Hypothyroidism 5 (16)
Other thyroid condition 2 (6)
Osteoporosis 14 (44)
Cataract 28 (88)
Parkinson's disease 1 (3)
Cancer 8 (25)
Bladder 1 (3)
Breast 2 (6)
Colon 2 (6)
Skin 2 (6)
Unknown 1 (3)
Functional status (Barthel Index score), n (%)
Totally dependent (<20) 3 (9)
Very dependent (20-39) 10 (31)
Partially dependent (40-59) 6 (19)
Requires minimal assistance (60-79) 8 (25)
Independent (80-100) 5 (16)

DISCUSSION ... This report of basic sociodemographic and
medical
characteristics of supercentenarians is the first of its
kind. Although the
sample size of 32 is small, it represents half the number of
supercentenarians living in the United States at any one
time. There were
expected and surprising findings. As expected, the vast
majority of
participants were female. The proportion of men (16%) was
statistically
similar to that published in a previous study (1 male per
10.8 women, or 9%;
P=.27), the latter probably more accurately reflecting the
proportion of men
in industrialized nations.7 That study, citing data
collected from the Max
Planck Institute for Demographic Research-based
international research
effort known as the International Database on Longevity

(http://www.supercentenarians.org), indicated that the
numbers of
supercentenarians can be so small in individual countries
that the
prevalence of these individuals in different parts of the
world and the sex
ratio can vary wildly at different times.8 One must still be
wary of sex
bias in studies such as these. It has been previously shown
that male
centenarians, although fewer in number, tend to be more
functionally fit and
therefore may be more likely to participate in studies.
Additionally, it is
possible that male prevalence increases relative to female
at these extreme
ages because of demographic selection, the phenomenon of the
frail dying
off, leaving behind a cohort of healthier individuals with a
greater
propensity for survival.

Regarding age validation, only two of the purported
supercentenarians
in the sample were found not to have adequate substantiating
evidence of
their ages. This is an unusually high validation success
rate, although it
is understandable, because most of the subjects enrolled had
already gone
through an age validity check via the GRG's efforts. High
rates of
inaccurate age reports emerge from national databases in
which people
assumed to be alive are actually dead. Errors also emerge
from inadequate
data entry, such as including only the last two digits of a
birth year. Some
age misreporting may be intentional. At a younger age, some
people might
have exaggerated their age (e.g., to get married or to join
or to be
excluded from the military), and this exaggeration is
maintained for the
rest of their lives. Others or their family members might
claim to be aged
110 and older for secondary gain such as media attention and
monetary
incentives. One study noted a significant disparity in age
validation rates
for claims of age of 110 and older between Caucasians and
African Americans,
particularly in the southern United States. 17

Two groups have reported a 50% annual mortality rate in
supercentenarians.18 One study found that the 50% mortality
rate observed at
age 110 to 114 may not continue to increase at even older
ages and might
even plateau.8 When one is dealing with such small samples
that just a few
individuals can so dramatically affect mortality rates for
the group in
question, the validity of these observations may not be
generalizable for
different birth cohorts; only time, and perhaps larger
samples, will tell.19

Not surprisingly, more than 50% of the cohort had 8 or
fewer years of
education. In 1900, the average highest grade attained was
eighth grade. Not
until 1915 did states begin advocating for at least 12 years
of education.
Given that longevity has been associated with years of
education, the change
in years of required education, in combination with improved
public health
and medical interventions, will likely contribute to the
increasingly higher
prevalence of centenarians and supercentenarians in the future.

Reported cardiovascular disease and stroke were rare
among the
supercentenarians, more than likely because these diseases
would otherwise
prevent survival to extreme age. It was previously reported
that more than
80% of centenarians delay diseases that are normally
associated with
significant mortality, cardiovascular disease and stroke,
beyond the age of
80 or escape them entirely.11 It would be expected that
supercentenarians
would experience the same survival advantage but at a
correspondingly older
age. Also similar to experience with centenarians generally,
Parkinson's
disease was nearly nonexistent, and approximately 25% had a
history of
treated cancer.20

Fifty-nine percent of the subjects had Barthel Index
scores in the
partially to totally dependent range, although remarkably,
the remaining
41%, despite their extreme age, required minimal assistance
or were
independent. The sample of men was too small to make
sex-specific
observations. It has previously been reported that
centenarians compress the
time they experience disability toward the end of their long
lives, in part,
because disability in the extreme old is likely a potent
predictor of
mortality.12 The same would likely be true for
supercentenarians, although
this has yet to be demonstrated with longitudinal data.

Although this is a small sample for a case series, it
is large given
the rarity of supercentenarians. Given that "all comers"
were enrolled in
the study, ascertainment bias is likely minimal, although
the absence of
minorities from the sample is obvious, and the findings may
not be
generalizable to other racial groups or other geographic
regions. As
interest in this exceptional group of people continues to
grow, additional
studies are sure to emerge that will be able to put these
findings into
perspective and to expand upon them.

Older people are well known for their heterogeneity
across a broad
spectrum of genetic and environmental variables known to
effect longevity.
However, it is likely that supercentenarians might be more
homogeneous with
regard to phenotypic presentation and genetic and environmental
characteristics that play significant roles in the ability
to achieve such
exceptional old age. Reported or clinically significant
cardiovascular
disease and stroke were rare in the supercentenarians,
perhaps because these
diseases prevent survival to extreme age. By virtue of their
likely ability
to markedly delay or escape age-related illnesses and
frailty and their
probable sharing of traits that enable such exceptional
survival,
supercentenarians are likely to be an important resource for
discovering
environmental, behavioral, and genetic factors that
predispose to longevity
and decreased susceptibility to vascular and other lethal
diseases
associated with aging.