The number of people who lived past the age of 100, also known as centenarians, surpassed 300,000 globally in 2011. As the number of centenarians increases, so does the need for better end-of-life care in the form of at-home health care and planned health services. A study conducted at King’s College London has revealed that the number of centenarians worldwide is expected to reach three million by 2050 and that improvements to health care services can help reduce the number of hospital admissions among people at such an advanced age.

"Centenarians have outlived death from chronic illness, but they are a group living with increasing frailty and vulnerability to pneumonia and other poor health outcomes,” Dr. Catherine Evans, clinical lecturer in palliative care at the Cicely Saunders Institute at King's College London, said in a statement. “We need to plan for health care services that meet the 'hidden needs' of this group, who may decline rapidly if they succumb to an infection or pneumonia. We need to boost high quality care home capacity and responsive primary and community health services to enable people to remain in a comfortable, familiar environment in their last months of life.”

Evans and her colleagues compared the cause and place of death among 35,867 centenarians living in England between 2001 and 2010 against people who died in their eighties and nineties. The age range among centenarians was from 100 to 115, with the average age being 101. Throughout the research team’s investigation, the number of centenarian deaths each year increased from 2,800 in 2001 to 4,400 in 2010. Eighty-seven percent of the centenarians were women and 85 percent were widowed people.

Around 60 percent of centenarians died while in a residential or nursing care home, 25 percent died in a hospital, a tenth died at home, and 0.2 percent died in hospice care over the course of the 10-year period. According to centenarian death certificates, “old age” was considered the most common cause of death at 28 percent, followed by pneumonia and other respiratory diseases at 24 percent, stroke at 10 percent, heart disease at nine percent, dementia and Alzheimer’s disease at six percent, and cancer at four percent. However, centenarians in a hospital setting were more likely to die as the result of pneumonia, while centenarians at home were more likely to pass away due to “old age.”

"Hospital admission in the last weeks of life accounts for a third of the total cost of end-of-life care per patient,” Evans added. “Increasing the number of care home beds could reduce the reliance on hospital care, but we need to ensure caliber services are provided by GPs, community nurses and other healthcare working with social care providers to enable people to remain in their usual residence at the end of life if they choose."

The 2010 Census Special Reports by the United States Census Bureau found that the number of centenarians living in the U.S. increased from 50,454 in 2000 to 53,364 in 2010.

Source: Evans C et al. Place and Cause of Death in Centenarians: A Population-Based Observational Study in England, 2001 to 2010. PLOS Medicine. 2014.

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