Centenarians in Europe: profile and drivers of longevity

The ageing of Europe’s population is accompanied by a steady increase in the number of centenarians. Over the past twenty years, life expectancy has increased by almost four years across the continent. In France, the national statistics office (INSEE) projects that the number of centenarians could quadruple by 2070.

In eight out of ten cases, the typical European centenarian is a woman, reflecting a life expectancy that is on average five to six years longer than that of men.

Although the vast majority are widowed (81%), centenarians are also, perhaps surprisingly, better educated than others from their generation: 9% completed higher education, compared with only 3% of their contemporaries. This difference is far from incidental, as education is one of the best-established determinants of longevity.

Another distinguishing feature is where they live. Forty-two percent of centenarians live in rural areas, in communities of fewer than 10,000 inhabitants, compared with 28% of the general population. This profile is consistent with research linking exceptional longevity to daily physical activity, locally sourced food and strong community ties.

Finally, 73% of all centenarians in the European Union live in just four countries: France, Italy, Germany and Spain.

Centenarians are not evenly distributed across Europe. A clear geographical gradient emerges: Southern European countries have 77% more centenarians than Western European countries, while Eastern European countries have 55% fewer.
France and Italy rank first, each with 33 centenarians per 100,000 inhabitants, whereas Bulgaria ranks last with only 5 per 100,000.

Regional differences are even more striking. In France, the ratio ranges from 13 centenarians per 100,000 inhabitants in French Guiana to 92 in Martinique, a sevenfold difference. In Spain, it ranges from 12 in Melilla to 56 in Castile and León.
These findings confirm that the regional level provides the most relevant scale for understanding exceptional longevity.

The econometric analysis conducted by Asterès identifies five factors significantly associated with a higher concentration of centenarians.

• Geography is the strongest determinant, capturing a combination of factors that are difficult to isolate individually, including the Mediterranean diet, the density of family and social ties, population genetics and health history. 
• Education also plays a measurable role: each additional percentage point of higher education graduates among the population aged 25–64 increases the ratio of centenarians by 1.2%. 
• Maintaining a marital relationship into advanced age is another marker of high-longevity regions. Areas where more centenarians remain married tend to have a higher proportion of centenarians, suggesting that lasting social bonds have a direct positive effect on health. 
• Extreme heat has a negative effect. This helps explain why the hottest regions of Southern Europe, such as Sicily, Crete and Andalusia, do not record the highest proportions of centenarians within their respective countries. 
• Smoking is the main negative lifestyle factor. Each additional percentage point of daily smokers reduces the ratio of centenarians by 6.4%. Eastern European countries, which combine the highest smoking rates with the lowest proportions of centenarians, provide a particularly clear illustration of this relationship. 

One of the study’s most counter-intuitive findings is that neither regional wealth nor the density of hospital care provision has a measurable statistical effect on the proportion of centenarians.
GDP per capita, the number of hospital beds and the number of physicians do not predict the concentration of centenarians across European regions.

For example, Epirus (Greece), with a GDP per capita of €14,000, records 55.6 centenarians per 100,000 inhabitants, compared with only 14.1 in Luxembourg, despite its GDP per capita of €87,100

This study forms part of Clariane’s research programme on the major challenges of healthy ageing. It is available free of charge in the document below.