A new study has found that Centenarians are more likely to die of pneumonia and frailty or and less likely to die of the chronic conditions such as cancer or ischemic heart disease. Centenarians were most likely to die in a care home (61%) or hospital (27%) and less likely to die at home (10%) or in hospice care (0.2%). Higher care bed capacity was associated with fewer deaths of centenarians in hospital.
The authors linked Office for National Statistics death registration data for England 2001-2010 with area level data on deprivation (a measure of socioeconomic status of the region), settlement type place of residence, and care home bed capacity. They state that people aged 100 years or over are a rapidly growing demographic group worldwide, projected to reach 3,224,000 by 2050. Furthermore, in the UK, the number of centenarians has doubled every 10 years since 1956 and is estimated to reach over half a million by 2066. Despite these increases their health and social care needs are rarely considered in studies of older adults.
The number of centenarian deaths per year in England increased by 56% in 10 years from 2,823 in 2001 to 4,393 in 2010. The 10-year study included 35,867 people with a median age of 101 years at time of death, of whom 87% were women. The proportion dying in hospital changed little over time despite the increased numbers of centenarians, that most older people would prefer to die in their usual residence (e.g. at home or in a care home) and hospital admission in the last weeks of life is a major driver of healthcare costs at the end of life.
They conclude, "To reduce reliance on hospital care at the end of life requires recognition of centenarians' increased likelihood to ''acute'' decline, notably from pneumonia, and wider provision of anticipatory care to enable people to remain in their usual residence, and increasing care home bed capacity."