Swedish centenarian health - a nationwide, observational study on care utilization, drug use, morbidity, and mortality among Swedish centenarians in 1990 to 2022.

Abstract

Centenarians have long been considered a select group who enjoy good health and manage to compress their years of morbidity towards the end of life. However, studies have shown that the health status of centenarians has changed as their numbers have increased. The aim of this study was to examine how the health of Swedish centenarians has changed in recent decades, focusing on healthcare utilization, medication use, morbidity, and mortality. Nationwide, register-based cohort study utilizing historical health records. All individuals born between 1890 and 1922 who turned 100 years old between 1990 and 2022 in Sweden were identified. We tracked and described their diseases prevalence, healthcare utilization, number of prescribed drugs prior to their 100 birthday, and one-year mortality risk at age 100. The results reveal that over time, an increasing proportion of centenarians were diagnosed with chronic diseases. The prevalence of polypharmacy rose from approximately 50% in centenarians in 2006 to 80% in 2022. Concurrently, the proportion of centenarians residing in care homes declined, while the shares receiving formal home care or living without any formal care increased. One-year mortality remained rather stable over the period, with a slight decline for female centenarians. Overall, the data suggest that the health status of Swedish centenarians has worsened over time. Although some of these changes may reflect improved diagnostics and increased drug prescriptions, it is likely that morbidity has also risen as a result of greater survival from disease at older ages.