Leading Cause of Death and Life Expectancy Among US Superagers
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Importance
The United States has the largest gap between lifespan and healthspan, highlighting a need to understand how some older adults maintain good health into advanced age.
Objective
To describe life expectancy and leading causes of death among US “superagers,” defined as adults aged 80 years and older who report good or excellent health.
Design, Setting, and Participants
Cross-sectional study of adults aged 80–98 years using 1986–1995 National Health Interview Survey data linked to the National Death Index through 2019. These cohorts were chosen to ensure near-complete mortality follow-up.
Exposure
Self-reported health status, categorized as superager (excellent/very good/good) or non-superager (fair/poor).
Main Outcomes and Measures
Weighted mean age at death, cause-specific mortality, and sociodemographic characteristics.
Results
Among 25,241 participants, 16,491 (65%) were superagers, representing 3.7 million older adults nationally. Superagers lived an average of 2 years longer than their peers (mean age at death 91.6 vs 89.6 years, P <.001). Diseases of the heart were the leading cause of death in both groups (40.7% vs 41.2%). Superagers were more likely to be non-Hispanic White, have at least a high school education, and live alone, but less likely to be Black, Hispanic, or have low education.
Conclusions and Relevance
US superagers live slightly longer and die from similar causes as peers in poorer health, suggesting their advantage lies in delaying disease onset rather than avoiding it. Persistent racial and educational disparities emphasize the need to expand opportunities for healthy aging across all populations.
