Centenarians represent a phenomenon of successful aging, yet little is known about their lifestyle and health practices, including diet/nutrition, medication use, and health conditions. A protocol for this systematic review was registered previously(1). We systematically searched Medline, CINAHL, Scopus, and grey literature from 2000 to 2022, limited to quantitative studies published in English among adults aged 95 years or above. Two reviewers independently screened 3,392 records and identified and extracted data from 34 eligible studies. Additionally, they independently assessed the study quality using the Modified Newcastle-Ottawa Scale (mNOS)(2). Any disagreement was discussed and resolved with a third reviewer. In analysis, pooled prevalence was provided for categorical variables on demographics, lifestyles, medications, and diseases using % (95%CI); mean or median was provided for continuous variables. Due to study heterogeneity, we conducted a narrative synthesis for the associations between the exposures and outcomes. Over 70% of the included studies met 6/8 criteria based on the mNOS; nearly half did not mention or control for confounders in statistical analyses. The age ranged from 95-118y (32 studies: 100y+; 2 studies: mean age 97-98 y); the majority were females (75%; 95%CI: 71%,78%). Most centenarians did not smoke or drink [current smokers: 7% (5%, 9%); former smokers:16% (12%, 19%); daily drinkers: 27% (20%, 34%); former drinkers:21% (13%, 30%)]. Most centenarians were physically inactive (23%; 20%, 26%). Over 50% had normal weight (52%; 42%, 61%), 33% (14%, 52%) underweight, and 14% (8%, 20%) overweight. Regarding nutrition, the narrative synthesis suggests that centenarians had normal levels of albumin (3.8g/dL), total triglycerides (111mg/dL), total (188mg/dL), and HDL cholesterol (54mg/dL) but high levels of LDL cholesterol (109mg/dL). Regarding medications, nearly 50% took antihypertensive medications (49%; 14%, 84%) or other cardiovascular drugs (48%; 24%, 71%); they took a median of 5 (range: 2-7) drugs. Common conditions included impairment of basic activities of daily living (ADL) (54%; 33%, 74%), hypertension (43%; 21%, 65%), and diabetes (22%; 9%, 52%). In regression analyses among centenarians, high dietary diversity, lower salt preference, and weight status were significant factors for more independence in basic ADL, lower mortality, and greater longevity. For example, a high dietary diversity score was associated with a low mortality risk [0.93 (0.92, 0.94) per unit increase]; those who preferred salty food versus those who did not had a 3.6-fold risk of impaired ADL [adj.OR: 3.59 (1.14, 11.25)]. Being overweight vs. normal weight reduced the risk of ADL impairment [adj.OR: 0.84 (0.78, 0.91] while underweight increased this risk [adj.OR:1.34 (1.28, 1.41)]. Also, overweight [adj.OR: 0.92 (0.90, 0.94)] or abdominal obesity [adj.OR: 0.72 (0.52, 0.996)] reduced the likelihood of longevity per kg increase. This systematic review suggests a healthy lifestyle, good nutrition, and normal body weight may contribute to extreme longevity. Interpreting these summary findings should be cautious due to potential recall bias and heterogeneity of the included studies.

Demographic transitions are defining events for human societies, marking shifts from natural mortality and fertility rates to the low rates seen in industrialised populations. These transitions can affect trait evolution through altering the direction and strength of selection when variance in fertility and mortality decline. One key feature of human evolution is the evolution of extended post-reproductive life through indirect fitness benefits from grandmothering. Although studies in pre- and post-transition societies have documented beneficial grandmother presence, it remains unknown whether these associations changed before, during, or after the transition. Here, we use genealogical data from eighteenth- to twientieth-century Finland to show grandmother-associated changes of two measures of evolutionary fitness (grandchild survival and birth rate) over the transition. We find that grandmothers had greater opportunity to help as the transition progressed, but their effect on grandchild survival declined alongside general mortality rates, implying that selection on lifespan from grandmothering declined too. Whilst grandmother presence was still associated with reduced birth intervals and hence more grandchildren born post-transition, the nature of this relationship changed greatly. This suggests that although potential for intergenerational interactions increased over the demographic transition, the (hypothesised) evolutionary importance of these interactions declined, which reduced selection for extended post-reproductive lifespan.

Fertility, particularly at its current low level in many developed countries and high level in some less developed countries, is a key factor driving demographic, economic, and societal changes at local, national, and global levels. Population ageing due to low fertility and increasing longevity represents one of the most significant global megatrends and risks. Many countries are already experiencing population decline and rapid growth of their elderly populations, with implications for workforce size, economic development, health and pension schemes, and social security arrangements. Actuaries are well known for their work on mortality and morbidity, but they have rarely considered fertility and its proximate determinants, despite their demographic and economic effects. This paper explores key explanations and outcomes of past and projected future fertility trends, and the implications for actuaries and for political and economic decision-makers.

It is well-known that marital status is an important predictor for life expectancy. However, non-married individuals are often misclassified as singles which ignores the heterogeneity within the group. This paper shows the importance of distinguishing between types of singles, and in particular whether they are cohabiting, when predicting life expectancies. We use unique and detailed longitudinal register data to track marital status throughout the individual's lifetime. We find that all types of singles consistently benefit from living with a spouse, i.e., after divorce, becoming widower or being never married. This result holds for both men and women. For certain types of cohabiting singles we reject significant differences in life expectancy compared to married individuals. Finally, we use a case study to show that, like married individuals, all types of singles that cohabit also serve as informal caregivers and have the potential to limit the end-of-life long-term care expenditure levels.

In this study, we quantify the relationship between socio-economic status and life expectancy and identify combinations of socio-economic variables that are particularly useful for explaining mortality differences between neighbourhoods in England. We achieve this by examining socio-economic variation in mortality experiences across small areas in England known as lower layer super output areas (LSOAs). We then consider 12 socio-economic variables that are known to have a strong association with mortality. We estimate the relationship between those variables and mortality rates using a random forest algorithm. Based on the resulting estimate, we then create a new socio-economic mortality index – the Longevity Index for England (LIFE). The index is constructed in a way that eliminates the impact of care homes that might artificially increase mortality rates in LSOAs with care homes compared to LSOAs that do not contain a care home. Using mortality data for different age groups, we make the index age-dependent and investigate the impact of specific socio-economic characteristics on the age-specific mortality risk. We compare the explanatory power of the LIFE index to the English Index of Multiple Deprivation (IMD) as predictors of mortality. While we find that the IMD can explain regional mortality differences to some extent, the LIFE index has significantly greater explanatory power for mortality differences between regions. Our empirical results also indicate that income deprivation amongst the elderly and employment deprivation are the most significant socio-economic factors for explaining mortality variation across LSOAs in England.

The term ‘autophagy’ literally translates to ‘self-eating’ and alterations to autophagy have been identified as one of the several molecular changes that occur with aging in a variety of species. Autophagy and aging, have a complicated and multifaceted relationship that has recently come to light thanks to breakthroughs in our understanding of the various substrates of autophagy on tissue homoeostasis. Several studies have been conducted to reveal the relationship between autophagy and age-related diseases. The present review looks at a few new aspects of autophagy and speculates on how they might be connected to both aging and the onset and progression of disease. Additionally, we go over the most recent preclinical data supporting the use of autophagy modulators as age-related illnesses including cancer, cardiovascular and neurodegenerative diseases, and metabolic dysfunction. It is crucial to discover important targets in the autophagy pathway in order to create innovative therapies that effectively target autophagy. Natural products have pharmacological properties that can be therapeutically advantageous for the treatment of several diseases and they also serve as valuable sources of inspiration for the development of possible new small-molecule drugs. Indeed, recent scientific studies have shown that several natural products including alkaloids, terpenoids, steroids, and phenolics, have the ability to alter a number of important autophagic signalling pathways and exert therapeutic effects, thus, a wide range of potential targets in various stages of autophagy have been discovered. In this review, we summarised the naturally occurring active compounds that may control the autophagic signalling pathways.

This article proposes a continuous time mortality model based on calendar years. Mortality rates belong to a mean-reverting random field indexed by time and age. In order to explain the improvement of life expectancies, the reversion level of mortality rates is the product of a deterministic function of age and of a decreasing jump-diffusion process driving the evolution of longevity. We provide a general closed-form expression for survival probabilities and develop it when the mean reversion level of mortality rates is proportional to a Gompertz–Makeham law. We develop an econometric estimation method and validate the model on the Belgian population.

Mortality rates are often used in population-level animal welfare assessments because they are assumed to reflect rates of disease or injury and other problems likely to cause poor welfare. High mortality is thus assumed to correlate with factors likely to cause negative affective states. Here, we argue that negative affective states are also related to mortality rates more directly, via causal rather than merely correlational routes. In humans, negative affective states predict elevated morbidity and mortality rates as well as decreased longevity, while self-reported happiness does the opposite. This review investigates whether mortality rates and longevity can thus be used to make inferences regarding past affective states in animals. The proposed mechanism is that chronic stressors cause negative affective states and thence harmful physiological consequences through continual activation of the hypothalamic-pituitary-adrenal and sympathetic-adreno-medullary axes, which in turn can lead to increased mortality. The convergent validity of mortality as an indicator of past negative affect is demonstrated via examples of how stressors such as bereavement in humans and social isolation in social non-human species cause negative affective states, and then increase the morbidity of potentially lethal conditions such as cardiovascular disease, cancer and HIV/AIDS, ultimately leading to increased mortality and reduced longevity in both humans and animals. The potential drawbacks of using mortality rates to infer animal welfare are also discussed, including its low sensitivity and the multiplicity of factors unrelated to affective states that can influence mortality rates. However, providing these issues are accounted for, it is suggested that this indicator has value in welfare assessment, and is especially well suited for cases where animals are allowed to live out their natural lifespans, such as tends to be the case with zoo and companion animals.

Involuntary culling (IC) is where a cow is disposed of due to injury, poor health or infertility. The main reasons for IC are infertility, mastitis and lameness. These reasons have differing age profiles in when they affect cows, cost variable amounts to treat and have an effect on the value of the cow at market. They also reduce cow welfare in different ways. These factors influence the economically optimum cow replacement decision, which must balance the risks of future loss from the current cow against its future prospects and the net costs of a replacement. So the farmer's economic decision as to when to cull a cow may not occur at the same time as when the cow could, and sometimes should, be culled to maximise her welfare. To explore this dilemma, we developed a Dynamic Programme (DP) model to assess the optimum replacement policies for each of 180 possible cow states (12 parities and 15 milk-yield levels) under a simplified set of alternative husbandry systems and remedial practices. The DP was used to explore the relationships between financial outcomes, investment in improving welfare, lifespan and IC in dairy systems. There is a trade-off between dairy cattle lifespan and risk of suffering over which farmers have some control by the replacement and investment decisions they make. Our results show that improving cow welfare by reducing mastitis, lameness or infertility over the long term increases the mean longevity of the herd and also reduces the potential of long-term suffering resulting from chronic conditions. Additionally, it has the effect of increasing replacement opportunities and the annuities for each cow (£ per cow per year) mainly by increasing milk yield and reducing costly on-farm culls, creating a win-win situation for both farmer and cow.

Ageing is known to be the primary risk factor for most neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease and Huntington's disease. They are currently incurable and worsen over time, which has broad implications in the context of lifespan and healthspan extension. Adding years to life and even to physical health is suboptimal or even insufficient, if cognitive ageing is not adequately improved. In this review, we will examine how interventions that have the potential to extend lifespan in animals affect the brain, and if they would be able to thwart or delay the development of cognitive dysfunction and/or neurodegeneration. These interventions range from lifestyle (caloric restriction, physical exercise and environmental enrichment) through pharmacological (nicotinamide adenine dinucleotide precursors, resveratrol, rapamycin, metformin, spermidine and senolytics) to epigenetic reprogramming. We argue that while many of these interventions have clear potential to improve cognitive health and resilience, large-scale and long-term randomised controlled trials are needed, along with studies utilising washout periods to determine the effects of supplementation cessation, particularly in aged individuals.

Trypanosoma rangeli is a protozoan that infects triatomines and mammals in Central and South America. Although it does not cause disease to humans, this parasite produces different levels of pathogenicity to its invertebrate host, mainly in species of the genus Rhodnius. In this study, we followed T. rangeli-infected and uninfected pairs throughout their adult lives and measured the amount of blood ingested, number of eggs laid, number of eggs hatched and proportion of infertile eggs, as well as female life expectancy. We found that all reproductive parameters were drastically decreased during infection, mainly due to the reduced amount of blood the infected insects ingested throughout their lives. Reproductive parameters were also affected by the reduction of the life expectancy of infected females, as survival was positively correlated with the number of eggs laid. The strategies used by the parasite to be transmitted are discussed in view of the pathological effects it causes in the insect.