Dying of old age: an examination of death certificates of Minnesota centenarians.
OBJECTIVE
To compare how causes of death are recorded on the death certificates of centenarians with those who die in their 70s, 80s, and 90s. We also examined direct and indirect acknowledgment of age as a cause of death.


METHODS
Retrospective review of death certificates.


METHODS
State of Minnesota.


METHODS
The death certificates of 26,415 individuals aged 70 and over who died in Minnesota in 1998 were examined for underlying causes of death. Of these, 449 were for individuals who were aged 100 and older at the time of their death.


METHODS
Causes of death.


RESULTS
Diabetes mellitus, chronic obstructive pulmonary disease, cirrhosis, myocardial infarction, and most cancers decreased in frequency as reported causes of death with advancing age. Conversely, congestive heart failure, atherosclerosis, and neurological/mental and poorly defined conditions increased in frequency with age.


CONCLUSIONS
Centenarians appear to "outlive" the risks for many of the conditions that are common causes of death for those who die in their 70s, 80s, and 90s, such as cancer and myocardial infarction. Conditions associated with aging, such as congestive heart failure and degenerative neurological conditions become more prominent as reported causes of death in the oldest individuals. The guidelines for the completion of death certificates should be modified to facilitate direct acknowledgment of age-related frailty as a contributing cause of death.
Gessert
Charles E
CE
Division of Education and Research, St. Mary's/Duluth Clinic Health System, Duluth, Minnesota 55805, USA. cgessert@smdc.org
Elliott
Barbara A
BA
Haller
Irina V
IV
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002423:Cause of Death; D003644:Death Certificates; D006801:Humans; D008910:Minnesota; D012189:Retrospective Studies