Centenarians: who are they? A description of the total Swedish centenarian population in terms of living arrangements, health, and care utilization

Abstract

Background: The global centenarian population has doubled each decade and is expected to continue growing. However, information regarding how they live, their health status, and care needs is limited.

Aims: This study aims to describe the total Swedish centenarian population in terms of health status, living arrangements, and socio-demographic characteristics.

Methods: This nationwide register-based study included all Swedish people reaching age 100 between 2013 and 2018. We analyzed their socio-demographic characteristics, living arrangements, number of prescribed drugs, and health status. Moreover, their care transitions from age 100 and two years forward were described.

Results: Of 5,882 centenarians (80.7% women), only 15.0% lived at home without formal care and 24.5% cohabited on their 100th birthday. Men (22.7%) were more likely than women (13.2%) to live at home without care. Approximately half of the centenarians lived in care homes, with fewer men (41.0%) than women (54.0%). Around 66.6% had a child living within the 50 km range. Most (76.5%) had an income below the median for Swedish older adults. Almost none were free from drugs, and polypharmacy was common (65.3%). Over half had at least one morbidity. Two years later, only 4.3% lived at home without care, and 63.9% died.

Conclusion: Sweden's centenarian population is highly dependent on home care and care homes. Among the ones still living at home, the vast majority live alone and have low incomes. Strategies to manage health and social care demands of this growing population group in the coming decade are important.

Keywords: Exceptional longevity; Home care services; Long-term care; Registries.

Fig. 1

CCI, specific morbidity, drug information, hospitalizations, and death stratified by sex. Upper panel shows distribution of Charlson comorbidity index (a) and the number of drugs (b). Lower two panels show proportion of diseases (c) and drugs, hospitalizations, and death (d). CCI Charlson comorbidity index, COPD Chronic obstructive pulmonary disease, RAS Renin-angiotensin system

Fig. 2

Proportion of polypharmacy, multimorbidity, and specific morbidity with stratification by living arrangement, income below median or not, and existence of children within 50 km. Y-axis shows the proportion with polypharmacy, CCI 2 or more, and prevalent disease. Point color reflects subgroup. Disposable income was dichotomized based on the sex-and-year-specific median of people living alone aged 80 years old or more. CCI Charlson comorbidity index

Fig. 3

Two-year care transition in centenarians. Left column shows care and death transitions, and right column shows proportion of care status in survivors. Panel (a) and (b) are results of total centenarians. Panel (c) and (d) are results of men. Panel (e) and (f) are results of women