Abstract
A survey to investigate the psychiatric and physical characteristics of centenarians was conducted from 1987 to 1989 in the Tokyo metropolitan area with a team of psychiatrists and psychologists using a semi-structured interview form. In that 3-three period, out of 509 centenarians living in Tokyo, 294 persons and their caregivers (57.8%) including the 65 institutionalized centenarians were examined. Two hundred and fifteen centenarians were not able to be interviewed due to various reasons. Out of 294 centenarians, 76 persons (25.9%) were interviewed by telephone. Also out of these, 176 (59.8%) were living with their son's or daughter's family. Ten male centenarians (12.8%) were living with their wives, while no female was living with a spouse. Five men and four women were living alone. There was a marked difference of education in years between both sexes. Mean years of education were 10.2 in the male and 5.5 in the female. According to the Clinical Dementia Rating, 31.6% out of 218 centenarians interviewed were not demented and those with dementia were even distribution of mild, moderate and severe dementia. There were marked differences according to sex, similar to that found in ADL. Of 63 males, 46.0% were not demented, whereas 25.8% of 155 females were not demented. Only 3.2% of males were severely demented, but in females 27.1% showed severe dementia. HDS scores decreased in relation to the advance in severity of dementia. Approximately 27% of the cases had no previous physical histories; 21.8% for the male and 29.2% for the female. Hypertension, cerebrovascular diseases and cardiac diseases were found in 51.1, 6.8 and 7.1%, respectively, without any marked difference according to sex. The most common previous illness was ophthalmologic diseases, found in 15.3%. In the present physical illness, 42.2% of all subjects were free from physical illnesses; 43.6% of males and 41.7% of females. As in the previous histories, ophthalmologic diseases were found most commonly in 17.0%, and hypertension, cerebrovascular diseases and cardiac diseases were recognized in 8.8, 3.7 and 7.8%, respectively. Cerebrovascular diseases and hypertension were most common in females (4.6% vs 1.3%, 10.2% vs 5.1%). Nine of the females with a cerebrovascular disease were demented. Of 218 centenarians 44% were almost bedridden, while 27.1% were active at home or outside the home. The rate of almost bedridden females was nearly twice that of males (52.9% vs 22.2%), and eight males (10.3%) were able to go out without any difficulty, whereas there was only one female (0.5%) who showed such activity. In conclusion, it was revealed that the prevalence rate of centenarians with dementia was 62.9% and some centenarians living in Tokyo in 1987-89 were able to keep their psychosomatic activity until the extremely old age. Though various hypotheses concerning determinants of longevity have been proposed, none have been confirmed. This is mainly due to the difficulty in conducting londitudinal studies to confirm factors relating to longevity, and also due to the difficulty in collecting a sufficient number of centenarians with reliably confirmed age. In this context, results from the present study could be a standard for future studies.
