Want to enjoy a long, healthy, and happy life? Just live like a centenarian.
That’s the advice of Stacy Andersen, a behavioral neuroscientist at Boston University and co-director of the New England Centenarian Study, the largest study of centenarians and their families in the world.
The study, which has enrolled more than 3,000 centenarians over its 30-year history, has been exploring the genetic factors, lifestyle choices, and environmental influences that appear to play a role in the longevity of people who live to 100 and beyond. The hope is that by studying centenarians, researchers can find treatments, as well as identify habits and environmental factors, that could help everyone live healthier for longer.
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“Our goal is not to get everyone to live to age 100. What we’re trying to understand is: How do you live to whatever age—your 70s, 80s, or 90s—in very good health?” Andersen says.
It turns out that centenarians, on average, don’t smoke, eat a varied diet, are social, and generally don’t sweat the small stuff. They typically spend more years of their life in good health, known as “healthspan.” They also tend to have a feeling of purpose and can find joy in the everyday, even in their twilight years, Andersen says.
As part of TIME’s series interviewing leaders in the longevity field, we spoke to Andersen about her work with centenarians and what all of us can learn from them about aging well.
This interview has been condensed and edited for clarity.
You run the New England Centenarian Study. What is it?
The study was started in 1995 by Dr. Thomas Perls [a Boston University geriatrician]. When Dr. Perls was a fellow doing his training in geriatrics, he was assigned to two patients over the age of 100 who were living in a retirement community. He had always been taught that the older you get, the sicker you get, so he expected the patients to be confined to their rooms and to be his sickest patients—but that wasn’t the case. Much to his surprise, they were two of his healthiest and most active patients. They were giving piano concerts to the community. They were out there doing things. He wondered if the two patients were just two remarkable outliers or if there was something different about people who reach these extreme ages—100 and over. So, he started the New England Centenarian Study. It has that name because it originally started in the eight towns around Boston, but over the years we’ve enrolled people all over the U.S., Canada, and other countries as well.
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To date, we’ve enrolled over 3,000 centenarians, as well as many of their siblings and offspring. Our oldest participant died at the age of 119. Her daughter lived to 101.
What we’ve seen with our centenarians is that the older you get, the healthier you’ve been, because, on average, centenarians have significantly delayed or avoided many chronic age-related illnesses. So in addition to having many extra years of life, they also have very long healthspans. And I think that’s what most of us want.
What kinds of data do you collect from the study participants?
The first thing we do is get a blood sample. We’re looking at many different factors in the blood that could tell us about how people age in a healthy way. We look at genetics, but then we go beyond the genes and look at other -omics data [which refers to the study of biological molecules like DNA, RNA, proteins, and metabolites]. We also collect a stool sample so that we can understand how bacteria in the gut might contribute to healthy aging, and we send participants preconfigured touchscreen tablets through which we can administer an array of cognitive function tests. We also check their blood pressure and measure their grip strength.
Then we follow up with them every year. We want to see what medical conditions they develop after we meet them. Are they still able to walk a certain distance? Are they still able to manage their medications on their own over time? We are really trying to understand their aging trajectory.
For one of our studies, we focus on what we call “cognitive superagers” [those who maintain cognitive function similar to people who are 30 years younger]. For that study, we ask people to sign up for our brain donation program so we can look at their brain tissue after they pass away and identify whether there is the protein buildup that’s associated with Alzheimer’s disease or frontotemporal dementia. For some of our centenarians, we’ve seen a real disconnect. They functioned very well in their daily lives, but then we look at their brain tissue and they have significant buildup of amyloid and tau [proteins associated with Alzheimer’s disease]. From those cases, we can learn a lot about resilience. We’re still trying to understand how that disconnect happens. How do they maintain such good cognitive function when they have evidence of Alzheimer’s disease in their brains?
How big of a role does genetics play in centenarians’ longevity?
For the vast majority of us, genetics accounts for only about 25% [of longevity], and the rest is related to the health behaviors that we follow. Do you maintain a healthy weight? Are you eating a nutritious diet? Are you getting moderate activity every day? Those are things that can help everyone live 10 years longer.
For centenarians, there’s a much bigger genetic component. Genetics accounts for about 75% of what gets you to really extreme ages like 105 and older. We’ve learned over the years that it really isn’t one or two genes that are getting people to these extreme ages, but more like 200 genetic variants.
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We also always assumed that our centenarians wouldn’t have disease variants of genes and that they must be enriched for protective factors, but it turns out that, with a couple of exceptions, they do have most of the same disease genes. This suggests even more strongly that they are enriched with protective factors, and that’s what we’re trying to learn more about, because that could help everyone. If we can understand these biological mechanisms, we could in theory come up with therapeutics that would help the general population.
Like a longevity pill?
Well, we’ve seen that centenarians have a healthier immune profile. We’ve seen that they have better DNA repair, and their cells seem to react differently to stress. We’re trying to dig into those mechanisms and those could be translated into a pill that could replicate those same effects.
Are there environmental factors and lifestyle habits that seem to contribute to centenarians’ longevity?
Yes, genetics isn’t everything. Environmental factors are a big piece that we’re trying to dive into more now. We are looking at things like sleep and leisure activities, social networks, how long people worked for and why they retired, how long people drive for and why they stopped driving. We want to understand if continuing to do rich activities over your lifetime plays a role in reaching age 100.
There are many centenarian studies all over the world, and each one takes a different lens on longevity, but I would say that across studies it really seems like centenarians have very good psychological well-being. They tend to score low in neuroticism. They don’t worry too much about bad things that happen. They’re able to deal with them and move on. They also score high in extraversion. They’re willing to try new things. They tend to be very outgoing, which I think helps them make new social connections as their peers pass away. They’re out doing things and meeting new people, and that helps their social networks. It also helps keep their brains strong.
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Another big piece is that there seems to be a feeling of having purpose in life—so waking up in the morning with things that you want to do. I think that’s a little bit surprising to hear about people at age 100; you might think they are just sitting around doing nothing, but that’s really not the case. They still have things that they want to accomplish. Maybe they’re not planning 10 years out, but they’re still finding joy in life.
Generally, our centenarians say that they never followed any specific diet and they didn’t go to the gym but they stayed busy and they were careful not to overeat and they ate a wide range of foods.
How about smoking and alcohol?
Smoking is very rare among our centenarians. Once in a while you’ll see in the media a 105-year-old woman who’s smoking a pack a day, but that’s a needle in a haystack.
In terms of alcohol, it varies. They mostly aren’t drinking excessively, but some of our centenarians do have a glass of wine a day or a shot of whatever they like every day. There’s a lot of variability in the different health behaviors of our centenarians. They aren’t all doing one thing.
Does gender play a role?
About 85% of our centenarians are women. But the interesting thing is, the men who live to 100 tend to be healthier. The women are better at surviving a long time with chronic diseases. The men, although there are far fewer of them who reach age 100, generally have very good physical and cognitive function. The men tend to be what we call “escapers,” where they are avoiding disease until after the age of 100.
I don’t think we know yet why there’s this difference, but it’s an area that we keep looking at, and it’s a reason that looking at sex differences even among centenarians is really important.
Has working with centenarians changed the way you think about aging?
It has given me a very positive view of aging. Most people I know say they don’t want to age or they’re scared of aging, and what we hear from our centenarians is that they also were scared of aging, but then they reached age 100 and they found that they actually enjoyed it.
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I think seeing people at age 100 who are enjoying life and doing the things they want to do and who still love learning is really eye-opening. Centenarians also just have so much wisdom, and to actually speak with one is really a gift.
What’s next for the centenarian study?
Our study has shown that centenarians reach their extreme ages because they are, on average, very healthy agers. And now we’re trying to delve into the biological mechanisms underlying that, as well as health behaviors and environmental factors that might help them age so well.
I think the most interesting piece of our work right now is focused on people who are really bucking the trend of aging and are just superstars of aging—centenarians who are still biking three miles a day or are still working or who are cognitive superagers. We’re trying to learn everything we can about how they are managing to do that.
Also, we are always looking for new participants. If you know an amazing centenarian living anywhere in the U.S. who may be willing to help with the study—or are a centenarian yourself—call 888-333-6327, email agewell@bu.edu, or visit our study website.
This article is part of TIME Longevity, an editorial platform dedicated to exploring how and why people are living longer and what this means for individuals, institutions, and the future of society. For other articles on this topic, click here.