Trends in places and causes of death among centenarians in Japan from 2006 to 2016

Abstract

Aim Amid the global aging, an establishment of healthcare policies for the aged population is a common issue to be addressed. However, few studies on centenarians have reported place and cause of death (PoD and CoD, respectively) as indicators of end‐of‐life care quality. This study aimed to analyze trends in PoD and CoD among centenarians in Japan. Methods Data from death certificates from Japanese vital statistics were analyzed; 205 513 deaths occurred among centenarians (aged ≥100 years) in Japan during the period from 2006 to 2016. PoD prevalence was calculated for each CoD. Trends in PoD prevalence were analyzed using the Joinpoint regression model. Changing points, annual percentage changes, and average annual percentage changes (AAPCs) were calculated to examine trends. Results The number of deaths more than doubled from 10 340 in 2006 to 26 427 in 2016. PoDs were composed of hospitals (52.7%), nursing homes (31.4%), own homes (13.6%) and others (2.2%). Dementia and old age increased rapidly as CoD. Proportions of hospital and home deaths decreased, with AAPCs of −2.3% (95% confidence interval [CI], −2.6 to −1.9) and −2.3% (95% CI, −3.2 to −1.4), respectively. Conversely, the proportion of deaths in nursing homes rapidly increased, with an AAPC of 6.8% (95% CI, 6.0–7.7). Conclusions The results revealed changes in PoD among centenarians in Japan. Understanding these transitions is indispensable for health policy in aging societies. Geriatr Gerontol Int 2022; 22: 675–680.

Epidemiological characteristics of centenarian deaths in China during 2013–2020: A trend and subnational analysis

“…[21] Another study also showed that centenarians had higher proportion of home death (92.8%) than that of elderly people aged 90–99 years (91.6%) and those aged 80–89 years (86.3%). [22] Moreover, a similar proportion of centenarians' deaths in their own homes (63.8%) in Taiwan province of China, [6] which has a common cultural background, also supports this hypothesis. Therefore, although the prevalence of nursing homes as PoDs increased consistently from 2014 to 2020 and relatively high proportions of centenarians dying in the hospital were observed in Shanghai (39.38%) and Beijing (39.28%), it may still take many years for China as a whole to achieve a shift in the pattern of PoD toward that in Japan characterized by higher numbers of hospital deaths or England characterized by higher numbers of deaths in nursing homes.…”

“…Regarding the PoD, more than 80% of Chinese centenarians died in their homes between 2013 and 2020, which was higher than the corresponding proportion for the whole population in the same period, approximately 73% [Supplementary [5] In Japan, 58.47% of centenarians died in the hospital, 25.59% of them died in nursing homes, and only approximately 15% of them died in their own homes. [6] This difference in PoD may be related to the degree of population aging, socioeconomic status, and the accessibility of medical and health resources across these countries. However, it may also be related to traditional Chinese culture, in which elderly people generally prefer to die in a home environment rather than a clinical environment.…”

“…This difference precisely reflects the selective survival hypothesis for longevity and centenarians, [23] since most people with cancer usually die before the age of 100 years. For the death of centenarians, the mainland of China had similar proportions attributed to heart disease (35.8% vs. 34.6%) and pneumonia (4.0% vs. 3.2%) as the United States, [24] while the proportion of ischemic heart disease (27.3%) was much higher than that in England (8.6%), [5] Japan (3.2%), [6] and the proportion of pneumonia was much lower than that in the two countries [Supplementary Table 7, http://links.lww.com/CM9/B689]. This may also explain the higher proportion of home deaths and lower proportion of hospital deaths in China.…”

“…[4] Recently, several population-based observational studies began to examine the trends in PoDs and CoDs through national samples, although their findings were slightly different. [5,6] According to the latest (seventh) national census, there were 118,466 centenarians living in the Chinese mainland. [7] As one of the countries with the highest number of centenarians, little attention has been given to the analysis of centenarian deaths in the mainland of China, although a previous study examined the trends in the leading CoD among centenarians in Hong Kong, China and another study explored the effect of hospice care on the PoD among centenarians in Taiwan, China.…”

“…[ 4 ] Recently, several population-based observational studies began to examine the trends in PoDs and CoDs through national samples, although their findings were slightly different. [ 5 , 6 ]…”