Online Program

How and where do centenarians die? implications for public health

Tuesday, November 5, 2013

Lusine Nahapetyan, PhD, Health Promotion and Behavior, University of Georgia, Athens, GA
Anne P. Glass, PhD, Institute of Gerontology, College of Public Health, University of Georgia, Athens, GA
Leonard Poon, PhD, Institute of Gerontology, University of Georgia, Athens, GA
Background: The centenarian population is growing, yet little is known about where and how centenarians die. This study examines: 1) place and leading causes of death among centenarians, and 2) implications for healthcare systems. Methods: The sample included 119 community-dwelling centenarians who participated in the Georgia Centenarian Study (mean age of death 103.1 ± 2.4; 73.9% females; 76.5% White, 23.5% Black). Death certificate data was retrieved and coded as underlying cause of death based on the International Classification of Diseases (ICD-9). We used descriptive statistics, chi-square and Fisher's exact test to examine the association of cause of death, place of death, and demographics. Results: Leading causes of death were: Heart disease (33.6%); Respiratory diseases (14.3%); Stroke (10.1%); Ill-defined conditions (old age/senility/senescence/natural, 9.2%); Other circulatory diseases (6.7%); Malignancy (5%); Sepsis (2.5%); Genitourinary (2.5%), Nervous system (2.5%), and Injury (2.5%). Two-thirds died in hospitals, with about equal numbers dying in nursing homes (16.8%) or at home (17.6%). Significantly more Black centenarians died in hospitals; none died in nursing homes. There were no significant gender, education, religion, or marital status associations with place of death. Conclusion: This study highlights important characteristics in the cause of death in centenarians. While malignancy and diabetes are the second and sixth leading causes of death in adults 65 and older, a striking difference was the low cause-specific mortality from these diseases among centenarians. The majority of deaths occurred in institutions, which may adversely affect quality of death and has important implications for healthcare costs.

Learning Areas:

Administration, management, leadership
Advocacy for health and health education
Public health administration or related administration
Public health or related nursing
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the leading causes of death among community-dwelling centenarians. Describe the common sites of death for community-dwelling centenarians. Discuss how the leading causes of death among centenarians differ from the leading causes of death for the general older adult population. Discuss implications for public health policy.

Keyword(s): Aging, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have strong research interests in aging and provision of high-quality end-of-life care. I have been working as a research assistant on multiple aging related research projects for four years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.