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Alive on paper but dead in reality — why fewer people may be reaching advanced age

In some areas of the world, people may not be living quite as long as researchers once thought, according to new research.
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In some areas of the world, people may not be living quite as long as researchers once thought, according to new research.

There are places in the world that are vaunted for having an outsized number of long-lived individuals. A lot of attention has been paid to puzzling out how all these people have reached such an advanced age.

A new pre-print study that has yet to be formally peer reviewed proposed these places may have surfaced, at least in part, as a result of clerical error or fraud.

Here's the crux of the problem: to tell how old someone is, people rely on documents. "There's no way to validate a human age against a physical measure," says Saul Justin Newman, a research fellow at Oxford University.

"If you go into a hospital without paperwork, there's no machine in there that says, 'Oh, bing!' and knows your age," he says. "So if you get consistently wrong errors in your paperwork, they're undetectable."

When Newman examined U.N. data from 236 states and nations, he found errors connected to centenarians — people ages 100 and above — all over the world. Certain countries had more detailed accounting than others.

"The best predictor of where 100-year-olds are within Okinawa [Japan] is places that have had their cities bombed by the Americans, burning the birth records," he says. "So the more bombing you have, the more 100 year-olds you have."

There are other examples. "Forty-two percent of centenarians in Costa Rica turned out to be lying in the census," Newman says. "At least 72 percent of the centenarians in Greece disappeared when they did an audit."

On paper, some of these folks were alive. "But dead in reality," Newman says. "You know, I had a lady reach 103 in a freezer."

Some of these errors may not actually be errors. Newman says to picture yourself jobless and broke.

"And then your father dies or your mother dies at the age of 95," he says "Their pension check turns up the week after they're dead. All you have to do for that pension check to keep turning up in perpetuity is not register the death. Very easy thing to get away with."

Newman says this is the reality that he's surfaced. The places on the planet that seem to have residents reaching super advanced age are rife with pension fraud, which obscures how old they were whenever they did pass away.

Not knowing how long people actually live has all sorts of ramifications. "We're all the time using these old age data to estimate how many old people we're going to have to take care of," Newman says, "and project how many hospitals we need in the future."

"It really is an important study because it pushes the field to scrutinize the data more rigorously," says Raya Kheirbek, who wasn't involved in the research. She's chief of geriatrics at the University of Maryland School of Medicine. "But the conclusions may overstate the extent of errors."

While this work doesn't necessarily contradict thinking on longevity, she's concerned it could add complexity to an already nuanced field and that it may cast doubt on what she says is legitimate research, including a set of U.S. studies showing what people who do reach 100 have in common — that they age more slowly, as do their kids.

"This robust data does not depend on birth certificates from areas of unreliable records," she says, "highlighting the significant role of genetic and environmental factors in longevity." Kherirbek says these factors might include exercise, social engagement, mental resilience, and diet — "moderation in all areas."

Kheirbek says there are other explanations for age inflation, like the inevitable loss of documents. Take Spain, for instance.

"During the civil war," she says, "many birth records were kept in government agencies and churches and they were all destroyed. So that is a complicating factor in age verifications."

Newman agrees. He says these errors, and bad record keeping arise for all sorts of reasons, from war to fraud to bureaucracy.

He uses this analogy: "Imagine you had the Hubble space telescope," he says, "and a percent of the stars turn out to be dust on the lens."

Newman says his hope is simply to wipe down that lens.

Copyright 2024 NPR

Ari Daniel
Ari Daniel is a reporter for NPR's Science desk where he covers global health and development.