Causes of Death at Very Old Ages, Including for Supercentenarians

Abstract

The causes of death reported on the death certificates of the oldest old are generally seen as unreliable, and as thus providing little useful information on the process leading to death. However, in advanced countries, a majority of the people who die each year are relatively old, and the level of detail provided on medical certificates about the causes of death among this older population is improving. At the same time, scholars are becoming increasingly interested in studying not just the initial cause of death, but multiple causes of death, thereby taking all of the information reported on the certificate into account. This study demonstrates that in a country like France, the cause-of-death pattern evolves regularly until around age 105. The share of people dying of circulatory diseases tends to be quite stable over the age range, while the share of individuals dying of cancer is declining, and the share of people dying of respiratory/infectious diseases is rising. Furthermore, among people who die at very old ages, a typology of multiple causes of death highlights the growing importance of ill-defined causes, while opening the door to an interesting discussion about the concept of cause of death in the supercentenarian population. Instead of representing an ill-defined cause, senility could be considered an actual cause of death. This suggests that daily care is more crucial to the survival of the oldest old than any conventional medical care or treatment. Supercentenarians tend to be so frail that any minor health event or brief lapse of attention on the part of their caregivers can be lethal.

Investigating years of life lost in Belgium, 2004– 2019: A comprehensive analysis using a probabilistic redistribution approach

“…According to Meslé and Vallin, ICD coding is less straightforward for deaths at old age compared to younger ages. [25] Deaths at old ages are often the result of a general deterioration of health or a complex multifactorial chain of events in which no speci c cause is decisive. Furthermore, medical investigations are limited in the elderly and therefor precise diagnoses are often lacking.…”

“…We completed the life table by assuming a SEYLL of 0 for death at the age of 122, the highest observed lifespan worldwide to date. [25] The resulting number of deaths and SEYLL are presented as absolute numbers, crude rates (per 100,000 inhabitants), and agestandardized rates based on ve-year age groups using both the 2013 European standard population [26] and the Belgian standard population, de ned as the o cial population residing in Belgium on 1 January 2019. [27] In this article, the focus will be on presenting the age-standardized rates by sex and region based on the European standard population.…”

Les causes de décès aux grands âges en France, évolution récente

“…On peut même se demander s'il ne conviendrait pas de considérer un peu plus la sénilité comme une vraie cause de décès aux âges très avancés, résumant utilement le fait qu'à ces très grands âges, l'usure générale de l'organisme crée une fragilité indépendante de telle ou telle cause particulière et qu'elle serait, fondamentalement, la vraie cause initiale du décès. C'est en tout cas ce que nous concluions à l'issue d'une étude cas par cas des causes de décès chez les super-centenaires, ces personnes qui ont vécu au moins 110 ans (Meslé, Vallin, 2021).…”