Not many people make their 100th birthday. It’s a big deal, and rightly so: the family celebration and obligatory photos, the card from HRH (not so far off the Big Day herself), perhaps a write-up in the local paper. “Tell us!” the journalist asks, “what is the secret of your longevity?” We collectively lean forward to catch their snippets of wisdom. What is their secret? A Philosopher’s Stone? The Elixir of Life? After all, living for a Very Long Time is as close to immortality as we can achieve in the here-and-now.
Stats NZ estimates there are approximately 400-500 centenarians alive in New Zealand at the present time. Fewer than ten percent are older than 105 years. Centenarians are models of successful aging, and we thought their lives may reveal some of the clues to their longevity. Our study team, led by Yoram Barak, and including Pip Greco, Paul Glue, Andrew Gray and myself, decided to conduct a review of a large set of routinely collected data to see if we could learn some of the secrets of these “Super Agers”.
Everyone in New Zealand who requests, or is referred for, home care support or residential care is required to have an interRAI (international Resident Assessment Instrument) assessment. This internationally validated tool consists of 236 items, which comprehensively assess all elements of a person’s life.
We reviewed the data from all New Zealanders living in the community who had their first interRAI assessment during the past five years. We compared data from more than 73,095 elderly people aged 65-99, with 191 centenarians aged 100 or over. The two groups were very different. The centenarians were significantly more likely to be female, widowed, and free from depression compared to the elderly group. Centenarians were also much less likely to be lonely, with a 22-32% lower risk of loneliness compared to people under the age of 100. We were able to identify three psychosocial variables which were protective against loneliness. These included living with others, having family support, and being free from depression.
During the course of our research I was surprised to learn how detrimental loneliness is to our well-being, so much so that it has been called a public health hazard. People who are lonely are at increased risk of poor mental and physical health, including depression, insomnia, high blood pressure, heart disease, stroke, Alzheimer disease, as well as premature death. Loneliness typically worsens with aging, but we observed the opposite in our data, possibly attributable to the fact our sample population were all based in the community (rather than living in residential care) and had good family support.
The New Zealand population is aging due to increased life expectancy and low fertility rates. The number of Kiwis aged over 65 years has doubled over the past decade to 700,000 in 2016, accounting for 15% of the population. Future estimates predict this group will double again by 2046, to comprise approximately 21-27% of the population. Ensuring that this large group of Kiwis is socially connected and meaningfully engaged will play an important part in improving their health and well-being.
Different ideas for improving social inclusion of the elderly can be found internationally, and may well be worth replicating in New Zealand. Shared and communal housing projects are on the increase in many places, providing mutual support and reduced living costs. Some countries provide incentives allowing students to live cheaply in shared housing arrangements with older folk, in exchange for companionship and assistance with household chores. Intergenerational care started in Japan in 1976 with the integration of a pre-school and residential care home. This unusual but successful model is now found in several other countries including the United States, the United Kingdom and Australia.
Closer to home, New Zealand school children are frequent and popular visitors to local rest homes. They practice their reading, learn to knit, share technology, and provide entertainment in cultural groups. Increasing opportunities for these type of interactions can provide mutual benefit.
Human connections are vital for our well-being. Loneliness is a social problem with serious adverse medical outcomes. We need to consider how we ensure our elderly relatives and neighbours feel included and supported in society, to help reduce the burden of loneliness and avoid the negative health implications that can arise from it.
We have all known the long loneliness, and we have found that the answer is community.” Dorothy Day
- Leitch S, Glue P, Gray A, Greco P, Barak Y. Comparison of Psychosocial Variables associated with Loneliness In Centenarians vs Elderly Populations in New Zealand. JAMA Network Open 2018;1(6):e183880. doi:10.1001/jamanetworkopen.2018.3880
- Ong AD, Uchino BN, Wethington E. Loneliness and Health in Older Adults: A Mini-Review and Synthesis. Gerontology. 2016;62(4):443-449.
- Stats NZ. Population projections overview. March 8, 2017. archive.stats.govt.nz/browse_for_stats/population/estimates_and_projections/projections-overview/nat-pop-proj.aspx
- Harris J. Why some Dutch university students are living in nursing homes. Dec 4, 2016. Independent. www.independent.co.uk/life-style/health-and-families/why-some-dutch-university-students-are-living-in-nursing-homes-demential-a7451486.html
- Handicare UK. How care homes and nurseries are coming together for good. April 26, 2018. Age UK. www.ageukmobility.co.uk/mobility-news/article/intergenerational-care
- Wise C. What happens when a nursing home and a day care center share a roof? PBS NewsHour. May 10, 2016. www.pbs.org/newshour/show/what-happens-when-a-nursing-home-and-a-day-care-center-share-a-roof