Effects of physical disability and widowhood on the survival of centenarians: a 7-year follow-up of CHCCS centenarians

BACKGROUND: Centenarians, being at the end of their life span, are particularly vulnerable to various health risks. Multiple factors can influence their survival and targeted intervention on these factors may promote healthy aging. PURPOSE: This study aims to explore the effect of physical disability and widowhood on the survival of centenarians. METHODS: Based on the China Hainan Centenarian Cohort Study (CHCCS), this study followed 787 centenarians for 7 years. Data were collected using formal designed questionnaire, physical examination and experimental tests. Questionnaire contains information including geographical data, cognitive and physical function. All the participants were followed-up annually. The endpoint of the follow-up was death or the end of the study. Cox regression analysis was conducted to identify survival-related factors, followed by stratified analysis according to their marital status. RESULTS: Out of the 787 centenarians, only 382 survived after 7 years, resulting in a mortality rate of 51.46%. Multivariate Cox regression analysis showed that activities of daily living (ADL) (for ADL<60 vs. ADL≥90: HR = 1.933, 95% CI: 1.411-2.648, p < 0.001; for 60≤ADL<90 vs. ADL≥90: HR = 1.438, 95% CI: 1.084-1.907, p = 0.012) was significant factors affecting survival. Stratified analysis based on marital status showed that physical disability was an influence factor of survival in widowed (for ADL<60 vs. ADL≥90, HR = 2.020, 95% CI: 1.450-2.814, p < 0.001; for 60≤ADL<90 vs. ADL≥90, HR = 1.493, 95% CI: 1.108-2.011, p = 0.008) centenarians. CONCLUSION: Physical disability and widowhood were important predictors of survival among centenarians. Adequate external assistance should be provided to the disabled and widowed centenarians to enhance their quality of life and survival prospects.