Objective:To investigate the distribution characteristics of sex hormones and their relationship with all-cause mortality in Hainan female centenarians.Methods:All the subjects were from China Hainan Centenarian Cohort Study. A total of 717 female centenarians were included in the final analysis. Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard regression was used to analyze the relationship between sex hormones and survival time.Results:The M( Q1, Q3) of estradiol and progesterone among female centenarians was 32.60 (18.40, 58.70) pmol/L and 0.62 (0.32, 1.01) nmol/L. The estradiol (pmol/L) and progesterone (nmol/L) in the survival and death groups were 26.65 vs.37.80, 0.54 vs.0.69, respectively, with statistical differences ( P<0.05). Cox multivariate analysis showed that estradiol and progesterone were significantly associated with death ( P<0.05), the hazard ratio ( HR) of estradiol Q4 was 1.58 (95% CI: 1.17-2.15), and the HR of progesterone Q3 was 1.53 (95% CI: 1.10-2.12), HR for Q4 was 1.63 (95% CI: 1.15-2.32). Subgroup and cross-analysis showed that estradiol was statistically significant with hypertension, diabetes, and low high-density lipoprotein cholesterol ( P<0.05), and progesterone interacted with diabetes ( P=0.016), while testosterone interacted with low high-density lipoprotein cholesterol ( P=0.034). Conclusion:It is suggested that the estrogen levels of female centenarians in Hainan were associated with a higher mortality risk and an increased risk of cardiovascular metabolic disease (such as diabetes, hypertension, and abnormal lipid metabolism).

Objective:To explore the association between hair trace element and all-cause death in the elderly in Hainan Province.Methods:The subjects of the study were elderly people from China Hainan Centenarian Cohort Study, a total of 163 elderly were included. The association between hair trace element level and all-cause death was analyzed by using Cox proportional risk regression model.Results:After fully adjusting the covariates, the multiple Cox proportional hazards regression analyses showed that selenium (Se), manganese (Mn), strontium (Sr) concentrations in hair were significantly associated with all-cause mortality, the hazard ratio ( HR) were 0.72 (95% CI: 0.54-0.98, P=0.035), 1.50 (95% CI: 1.07-2.11, P=0.020) and 0.54 (95% CI: 0.37-0.79, P=0.001), respectively. Subgroup and cross analysis showed that hair copper (Cu) were significant association with death in the people with anemia, the HR were 1.81 (95% CI: 1.13-2.88, P=0.013). And, hair Mn interacted with anemia, the HR was 0.46 (95% CI: 0.22-0.94, P=0.033). Conclusions:Se, Mn and Sr concentrations in hair were associated with the elevated risk for all-cause death in the elderly in Hainan. Se, Mn and Sr concentrations in hair can be used as a reference index for the prediction of the death risk of long-lived elderly in community, suggesting that the daily diet of elderly people are rich and diverse, in order to maintain normal and balanced trace element content in the body.

Objective:To investigate the prevalence of depression and to analyze its determinants among centenarians in Hainan.Methods:A cross-sectional study on centenarians was conducted in Hainan from June 2014 to December 2016.A total of 910 centenarians, including 166 males and 744 females, were interviewed in their domiciles by trained investigators.A 15-item Geriatric Depression Scale(GDS-15)was used to assess depression for centenarians, and general sociodemographic details, sleep quality, cognitive function, activities of daily living, and lifestyles were recorded.Multivariate logistic regression analysis was used to determine major related factors for depression in centenarians.Results:Of the 910 centenarians, 292 were regarded as depressed and the prevalence was 32.1%.Univariate analysis showed that there were significant differences in gender, education, marital status, self-reported health, incontinence, dietary habits, sleep quality, activities of daily living, cognitive function, outdoor activities, watching TV, and social engagement between subjects with and without depression( P<0.05). Multivariate logistic regression analysis showed that living conditions, self-reported health, activities of daily living, and sleep quality were independent related factors for depression in centenarians( P<0.05). Among the above related factors, living with families( OR=0.50, P=0.026)and good sleep quality( OR=0.67, P=0.010)were protective factors for depression, whereas poor self-reported health( OR=3.34, P<0.001)and disability( OR=2.37, P=0.002)were risk factors for depression in centenarians. Conclusions:Living conditions, self-reported health, activities of daily living, and sleep quality were independently correlated with depression in Hainan centenarians.This study provides empirical evidence for depression interventions and mental health improvement in centenarians.

Objective:To describe and analyze the relationship between traditional and new obesity related anthropometric indicators and all-cause death in centenarians in Hainan, the traditional and new obesity related anthropometric indicators included BMI, waist circumference (WC), waist hip ratio (WHR), waist height ratio, calf circumference (CC), waist-calf ratio (WCR), lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), a body shape index (ABSI), a body shape index of Chinese (CABSI) and body roundness index.Methods:A total of 1 002 centenarians in Hainan were selected by cluster sampling. The M( Q1,Q3) follow-up time was 4.16 (1.31, 5.04) years and the outcome was all-cause death. Multiple Cox regression model was used to analyze the relationship between the obesity related anthropometric indicators and all-cause death, and the area under receiver operating characteristic curve was used for comparison. Results:In all the centenarians, CC had the strongest power to predict death, with area under curve (AUC) of 0.61 (95% CI:0.57-0.64), the gender specific results were consistent with that in overall population ( P<0.05), followed by WCR with AUC of 0.58, and then BMI, LAP and WC with AUC of 0.55, 0.55 and 0.54 respectively, while CABSI, WHR and VAI had the weaker power to predict death with AUC of 0.51, 0.50 and 0.50 respectively. Conclusions:This was the first study to prospectively compare and analyze the association between 12 obesity related anthropometric indicators and all-cause death in a large sample cohort of centenarians in China. It was found that CC had the best prediction power for death, and the risk for death decreased with the increase of CC value in a dose-response manner. It is suggested that CC can be used as a reference index for death risk monitoring in the elderly.

Objective To investigate the health status,functional ability,mental psychology,health care and other longevity-related characteristics of individuals aged ≥ 100 years as well as risk factors in Hainan province,China.Methods China Hainan Centenarian Cohort Study (CHCCS) is a community-based,prospective cohort study to establish multi-dimensional database consisting of questionnaire findings,anthropometric parameters and biological specimens as well as imaging features.With the household registration information provided by the Department of Civil Affairs of Hainan province,a baseline survey was conducted in centenarians in 18 counties in Hainan with the oldest old in 5 counties as controls between 2014 and 2017.The survey included face to face interview,physical examination and biological specimen collection.After the baseline survey,the participants of CHCCS were followed up at an interval of 2 years to collect the information about their living status,disease status or major death causes.Results According to the information provided by the Department of Civil Affairs of Hainan province in 2014,the survey found that 1 473 centenarians were still living.By December 2016,1 002 of them had agreed to be surveyed.The average age of 722 centenarians with complete information in the baseline survey was (102.7± 2.7) years,the majority of them were females (83.0％),widows (88.8％),in Han ethnic group (84.5％),lived with family members (87.8％),illiterates (89.7％) and farmers (81.0％).Conclusion CHCCS has provided longevity-related information of the large longevity population and collected the valuable and rare biological specimens with great urgency to establish an interdisciplinary platform and base for longevity,senility and healthy aging research.

Objective:To investigate reference intervals for anemia-related routine blood test indicators in Hainan oldest-old and Hainan centenarians.Methods:A cross-sectional data set of China Hainan Centenarians Cohort Study (CHCCS) was used. Household interview, physical examinations, and blood sample analysis were conducted in accordance with standardized procedures. The hemoglobin level, red blood cell count, and hematocrit were analyzed with automatic biochemical analyzer and the reference intervals were determined following CLSI C28-A3 guidelines using a non-parametric method.Results:A total of 715 centenarians, including 137 males (19.2%), and 767 long-lived individuals aged ≥80 years, including 312 males (40.7%), were surveyed. The reference interval of hemoglobin level was 89.1-173.5 g/L in males and 94.4-146.0 g/L in females, respectively, in long-lived individual group. The reference interval of hemoglobin level was 68.4-145.6 g/L in males and 81.0-140.0 g/L in females, respectively, in centenarian group.Conclusion:The reference intervals of hemoglobin level, red blood cell count, and hematocrit were set for the first time for the oldest-old and centenarians in Hainan, which was lower than that currently used in adults.

Objective:To investigate the association between serum albumin levels and health-related quality of life in centenarians in Hainan province, China.Methods:We conducted a full sample centenarian cohort study in a community population in Hainan from 2014 to 2016, which included 1 002 centenarians for questionnaire surveys, physical examinations and biological tests. The EQ-5D-VAS scale was used to evaluate health-related quality of life, and multiple linear regression and multiple logistic regression analyses were used to analyze the association between serum albumin levels and health-related quality of life.Results:There was a positive linear relationship between serum albumin levels and EQ-5D/VAS score. The normalized β values in the fully adjusted model was 0.156 ( P<0.001). In the multivariate logistic regression analysis, after fully adjusting the covariates, the risk of health related life quality impairment in the lower albumin group was 2.369 times(95% CI: 1.424-3.939) than that in the higher albumin group. Gender stratified analyses showed that the OR was 4.406 (95% CI: 1.537-12.631) in male centenarians and 2.035 (95% CI: 1.125-3.680) in female centenarians. Conclusion:Lower serum albumin level was associated with impaired health-related quality of life in centenarians in Hainan.

Objective:To explore the association between nutritional status and all-cause death in the centenarians in Hainan Province.Methods:Based on the survey data of China Hainan Centenarian Cohort Study from 2014 to 2021, a total of 1 002 Hainan centenarians with complete baseline data were included in this study, and their survival status and death outcome were surveyed. According to the Mini Nutritional Assessment Short-Form (MNA-SF), the centenarians were divided into three groups: well-nourished (12-14), at risk of malnutrition (8-11), and malnutrition (0-7). The survival status of the centenarians was evaluated by Kaplan-Meier curve. Cox proportional hazards regression model was used to assess the association between nutritional status and all-cause death.Results:After the follow-up on May 31, 2021, we had found that 522 centenarians died, with an all-cause mortality rate of 52.10% (522/1 002). Compared with the well-nourished group, the average life lost caused by malnutrition was 0.62 years. Kaplan-Meier survival analysis showed that all-cause mortality rate was higher in the malnourished centenarians than in other groups ( χ2=16.45, P<0.001). Multivariate Cox proportional hazards regression model showed that the risk of all-cause mortality rate in malnourished centenarians was higher than that in well-nourished centenarians ( HR=1.65, 95% CI: 1.18-2.31). Subgroup analysis found that the association in female centenarians was more significant. Conclusions:Malnutrition was associated with a high risk of all-cause death in Hainan centenarians. It is suggested that we should timely evaluate and pay attention to the impact of nutritional status of centenarians on their health and longevity, and death, especially in the female elderly.

Objective:To investigate basic characteristics of diabetes prevalence and associated factors in centenarians in Hainan province of China.Methods:All the subjects were from China Hainan Centenarian Cohort Study. A total of 1 002 centenarians were included in the final analysis, who were divided into three groups: diabetes group, impaired fasting glucose (IFG) group, and normal glucose group according to the guideline.Results:The average age of centenarians was (102.77±2.55) years, and the proportion of females was 82.0%. There were 95 centenarians who suffered from diabetes, and the prevalence rate was 9.5%. There were 81 centenarians who had IFG, and the prevalence rate was 8.1%. The mean fasting plasma glucose (FPG) level of centenarians was (5.12±1.44) mmol/L, while 43.5% of centenarians had FPG levels ranging from 4.00 to 5.00 mmol/L and 22.1% of centenarians had the FPG levels ranging from 5.00 to 6.00 mmol/L. Increased triglyceride level and abdominal obesity might be associated with the risk for diabetes.Conclusion:The glycometabolism in centenarians in Hainan was better than that in other age groups, and no gender specific difference was observed.

Objective:To explore the blood pressure levels and the influencing factors of hypertension among Hainan centenarians, and provide basic data for the further blood pressure related studies of the centenarian population.Methods:The baseline data were from China Hainan Centenarian Cohort Study (CHCCS). This cross-sectional data, based on the community population, was a complete sample study of centenarians, including questionnaire survey, physical examination and physiological index detection. A total of 1 002 centenarians were recruited to describe the blood pressure level. According to the guidelines for the prevention and treatment of hypertension in Chinese adults in 2018, the prevalence of hypertension was analyzed.Results:The median levels of systolic blood pressure, diastolic pressure and pulse pressure were 152.0, 76.0 and 76.5 mmHg, respectively. Blood pressure level was higher in females than in males. The prevalence of hypertension was 71.9%, mainly in isolated systolic hypertension with the prevalence of 60.1%. The results of multivariate analysis showed that the risk of hypertension in women was higher than that in men ( OR=1.624, 95% CI: 1.155-2.283), and the risk of hypertension in the northern ( OR=0.625, 95% CI: 0.434-0.901) and central areas ( OR=0.586, 95% CI: 0.346-0.993) was lower than that of the Eastern. Conclusion:The prevalence of hypertension, mainly in isolated systolic hypertension, showing gender and regional distribution differences.