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Comparative Study
. 2008 Aug;45(3):673-91.
doi: 10.1353/dem.0.0011.

The exceptionally high life expectancy of Costa Rican nonagenarians

Luis Rosero-Bixby  1
Affiliations
Comparative Study

The exceptionally high life expectancy of Costa Rican nonagenarians

Luis Rosero-Bixby. Demography. 2008 Aug.

Abstract

Robust data from a voter registry show that Costa Rican nonagenarians have an exceptionally high live expectancy. Mortality at age 90 in Costa Rica is at least 14% lower than an average of 13 high-income countries. This advantage increases with age by 1% per year Males have an additional 12% advantage. Age-90 life expectancy for males is 4.4 years, one-half year more than any other country in the world. These estimates do not use problematic data on reported ages, but ages are computed from birth dates in the Costa Rican birth-registration ledgers. Census data confirm the exceptionally high survival of elderly Costa Ricans, especially males. Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor Costa Rican nonagenarians are survivors of cohorts that underwent extremely harsh health conditions when young, and their advantage might be just a heterogeneity in frailty effect that might disappear in more recent cohorts. The availability of reliable estimates for the oldest-old in low-income populations is extremely rare. These results may enlighten the debate over how harsh early-life health conditions affect older-age mortality.

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Figures

Figure 1.
Figure 1.
Observed and Adjusted Age-Specific Death Rates: Costa Rica (1983–2004) and Kannisto-Thatcher Average (1990–1999)
Figure 2.
Figure 2.
Life Expectancy, by Age and Sex: Costa Rica (1983–2004), the United States (whites only, 1990–1995), and Japan (1990–1995) Note: “Costa Rica, corrected” refers to Costa Rican estimates based on death rates smoothed with the regression model and restricted to timely registered births and residence in Central region.
Figure 3.
Figure 3.
Age-90 Life Expectancy, by Sex, for Selected Countries Ordered by Female Life Expectancy: Costa Rica (1983–2004) and Other Countries (1990–1995)
Figure 4.
Figure 4.
Mortality Rate Ratio by Cause of Death in Costa Rica Relative to the United States and Sweden for Those Aged 85 and Older in the 1990s: Indirect Standardization by Age and Sex
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