For centuries people have sought the secret of eternal youth. No such secret has yet been discovered, but thanks to advances in medicine and in our knowledge about how to achieve a healthy lifestyle, the chances of living to a ripe old age in good health are increasing with every generation. It's possible that some day soon it will become the norm to live to be 100. What is needed to make this possible?

In recent years Poland has not recorded any significant increase in the number of people 100 years old and over, but this can be expected over the next 15-25 years. Statistics show a clear drop in the number of deaths of people in their early seventies. This results from better medical care and living conditions that help elderly people live longer and that make them more self-sufficient. Today, living alone when you are elderly is not as difficult as in the past. For example, many people now have central heating and natural gas in their kitchens, which means they no longer have to struggle with bringing coal in and lighting a fire in the stove in order to prepare a meal.

The expected increase in an elderly population results from the fact that a great number of children were born shortly after the end of World War I in 1918, when Poland regained independence after over 100 years of foreign occupation. These, if still alive, will soon turn 100.

Central Statistical Office (GUS) data shows that more than 1,500 people in this country are over 100. That figure is expected to exceed 9,000 in 2030. People worldwide are living longer, and turning 100 is no longer something extraordinary. There are more than 210,000 people aged over 100 across the world. By 2050, that number is expected to grow to 3.2 million.

When the United Nations proclaimed 1999 the International Year of Older Persons, the International Institute of Molecular and Cell Biology in Warsaw (IIMCB) and the Nencki Institute of Experimental Biology started a Polish Centenarians Program. The program, launched under the lead of Prof. Jacek Kuźnicki, was based on preliminary results obtained in a multidisciplinary multi-center project entitled Genetic and Environmental Determinants of Longevity. The project coordinator was Małgorzata Mossakowska, Ph.D., from the IIMCB. The study was conducted between March 1, 2001 and Feb. 28, 2004, and the conclusions were published in a collective work called Destined for Longevity: In Search of Determinants of Successful Aging printed by Ośrodek Wydawnictw Naukowych in Poznań.

Methodology of studies

Data on 100-year-olds was provided by the Ministry of Internal Affairs and Administration, showing there were about 2,000 such people in Poland.

Selecting the study group was not easy. Identity cards were not sufficient to prove someone's age. The researchers established the age of the people in question using birth records, marriage certificates, pre-World War II identity cards, passports and school certificates. Sometimes no such document was available and then the researchers had to analyze a person's and their family's history, comparing the information provided by the elderly person and their relatives. A document confirming the date of birth was found for 70 percent. For the remaining 30 percent, all the other factors were analyzed, for example the age of their children, whether they took part in World War I or the Polish-Bolshevik War in 1920. In the case of 55 people, their age could not be confirmed in any way and so they were excluded from the study.

There were 251 women and 53 men in the study, and the oldest participant was 111 years old. The biggest number lived in Warsaw, Cracow, Katowice, Białystok and Radom. The Ethics Commission of the Organization Committee gave the green light to the study and the forming of a group of doctors who started working across Poland in the spring of 2006. They visited all the people who had agreed in writing to be examined, and took blood samples for analysis and for isolating DNA and RNA from lymphocytes, and asked them to fill out a questionnaire.

The questionnaire was developed based on a form used by an Italian research team led by Prof. C. Franceschi. It includes questions about the current condition of health, diet, lifestyle, a memory test, a depression scale test, and questions about the longevity of relatives. Other questions posed were whether it is possible to identify family longevity markers, whether longevity may be linked to people having a small number of children, and what environmental factors could have affected longevity.

The researchers visited 346 people-296 women and 50 men, and the oldest participant was 108 years and two months old. Doctors examined 216, including 183 women and 33 men, and took blood samples from 156 women and 26 men. Additionally, DNA samples from the cheek were collected from 132.

The program attracted doctors with different specializations who carried out various tests, for example, neurological, cardiological and endocrinological. "One of the main tasks was to create a group of doctors and researchers of different specialties who would be interested in the subject and, consequently, to consolidate the community dealing with geriatrics and experimental gerontology in broad terms," said Mossakowska.

Obtaining and gathering a bank of biological material was an integral part of the program. Such banks are created in many countries, and the material is used in various research projects on aging and longevity.

Portrait of a Polish 100-year-old

The research provides a unique picture of the Polish elderly, who, it turns out, are doing quite well. Most of them are women-the typical centenarian is a woman, a widow who lives with her children, is deeply religious, and happy with her long life. The people studied are the best proof that differences between peers are the biggest at an advanced age. However, all these people share a common trait: they are cheerful, they all cope with stress well and are able to enjoy everyday life.

"Many Polish 100-year-olds are an example of what is called in medicine successful aging-they are in fairly good health, have an alert mind, and are able to spend their time actively," said Mossakowska. The findings appear to indicate that optimists live longer.

Most of the centenarians come from families with a history of longevity. More than 90 percent have been slim throughout their lives, which have often been difficult and full of dramatic experiences. Many of them lived through periods of hunger and malnutrition, forced expatriation, prison and labor camps. Some of the female centenarians have outlived all their children.

Most did not follow any special diet; they rarely smoked and none have abused alcohol. All of them tried to be useful to society as long as possible, taking care of their grand and great grandchildren, helping around the household, working in the garden, or performing in folk groups or choirs. They had three children on average. The women gave birth to their first children quite late. Only one of them was under 20, and 41 of them were aged over 40 at the time.

"The centenarians often talk about death, and they start the subject themselves," said Mossakowska. "This is a calm conversation because they usually have the feeling of a long and well-lived life. They speak about dying without fear or nervousness. For example, when asked what they were afraid of, some would reply, 'Nothing.'"

Does long mean healthy?

Assessing the health status of the people studied was an important and complex task. "This should come as no surprise, if you assume that health is a broad concept, including both subjective feelings and objective factors evaluated during a doctor's examination and additional tests," said Mossakowska. "The examinations were time-consuming as elderly people get tired easily. Meanwhile, the examinations had to be detailed and comprehensive."

The health assessment showed that none of the respondents was completely healthy. In this respect, Polish 100-year-olds are not different from their peers in, say, Denmark or Italy. However, their general health status was better than might be expected at this age.

One in five women and one in three men were in good health, and more than half of women and two-thirds of men in quite good health. More than a third of the people studied have never been hospitalized, and only 18 of them stayed in a hospital more than five times. One in five respondents never suffered from any chronic disease. Only three percent had diabetes, and most of them fell ill only after turning 80. They rarely had respiratory problems, while circulatory diseases were quite common among them. More than 47 percent had hypertension, but in three out of four it appeared only after turning 80. The people studied had the biggest problems with eyesight; only 15 percent of them had normal vision. The most frequent cause of problems were cataracts that had not been treated surgically. Most also had some problems with hearing.

Despite these ailments, 46 percent said their health and how they felt in themselves was acceptable, and 25 percent said it was good. Only 19 percent of those who could be comprehensively interviewed said their health was bad, and 4 percent said very bad.

Typical complaints

• Joint pains are among the most frequent problems of the elderly, and are usually ignored by doctors, who say this is a typical symptom of old age. Fifty-seven percent of people studied complained on this type of pain, mainly in hip joints, hands, knees and the spine.
• Teeth-of the 309 people examined, only 44 had several of their own teeth left, and half of them had used dentures at some time in their life. A total of 205 respondents had problems with swallowing due to lack of teeth.
• Eyesight and hearing. Polish centenarians have more problems with eyesight and hearing than their peers from other countries. Mossakowska says this is because Polish physicians do not examine, diagnose and treat very old people comprehensively. Half of those examined in the study had some eyesight problems diagnosed earlier, mostly cataracts. Even though the ailment can be treated surgically at any age, in two-thirds of cases no treatment was given. In all, 183 people studied used glasses, while 126 never used any. Fourteen percent had sight impairments that made them dependent on other people's help; 33 percent had significantly impaired sight; and 2 percent were blind. Only 18 percent of respondents had good hearing, and 28 percent had significantly deteriorated hearing. Slightly deteriorated hearing was reported in 35 percent.
• Sleep problems-researchers have recognized sleeping disorders as some of the most serious health problems that affect increasing numbers of the population of different ages-currently, over 10 percent of the population. At least a third of the people studied had problems with sleeping. Five percent of them used sleeping pills.
• Mobility problems-physical fitness and cognitive skills are the most important factors in leading an independent life. A fear of losing one's independence is among the biggest fears of the elderly. Ten percent of the people studied were unable to get out of bed without someone's help; yet 25 percent lived actively, including going out of their homes. They were also quite self-sufficient in other everyday activities, such as bathing, dressing, preparing meals and taking medicines.

Searching for the longevity gene

The researchers were unable to detect a "longevity gene," but that does not mean such a gene does not exist. There are probably many combinations of genes that protect people against age-related diseases and disabilities, increasing their chance of living to 100, but it is extremely difficult to determine which genes these are.

The study led the researchers to the conclusion that Polish 100-year-olds differ considerably in terms of their state of health. None of them is completely healthy, but many enjoy relatively good health, mobility and self-sufficiency. Men who have turned 100 are usually in better health and have greater mobility than their female peers. Unfortunately, medical care for elderly people in Poland is insufficient, with major gaps in terms of therapy and prevention of physical disability. Those problems, as well as a lack of geriatricians and geriatric wards in hospitals, have encouraged the researchers to start another program.

"We are preparing for another program, aimed at a much larger group of elderly people," said Mossakowska. "We intend to examine more than 6,000 elderly people in order to describe the condition of people aged 60 and over. This project, supported by the Ministry of Science and Higher Education, will be led by Piotr Błędowski and coordinated by the IIMCB. It will be the first such a broad multidisciplinary, multi-center study in Poland devoted to the problems of aging."

The researchers will try to answer the question of what could be done to make the lives of people who are at the threshold of old age healthier and more active. "We want to make every effort to ensure that old age is not a sad period of life," said Mossakowska.

Urszula Imienińska


Małgorzata Mossakowska holds a Ph.D. in biological sciences and works at the International Institute of Molecular and Cell Biology in Warsaw. When the institute was established in 1995, Mossakowska was part of a team that coordinated the center's development. In 1997-2000, she was a member of the institute's managerial staff, working closely with the institute's director. In 2001-2005, she coordinated a nationwide study of Polish centenarians. She is a member of the Polish Society of Gerontology.

Mossakowska obtained her Ph.D. in biochemistry at the Marceli Nencki Institute of Experimental Biology of the Polish Academy of Sciences in Warsaw, where she worked until 1992. In 1993, she received the prestigious Jakub Karol Parnas Award for best experimental project carried out in a Polish laboratory. That same year she obtained a scholarship from the Japanese government and worked at the Kansai Advanced Research Center/Communications Research Laboratory in Kobe, Japan. Later she won a scholarship from the American National Institutes of Health and worked at the National Heart, Lung and Blood Institute in Bethesda, Maryland.

Mossakowska has written and co-authored many scientific publications, including a 2006 guide for parents and children suffering from inflammatory bowel disease. She founded and chairs the Polish Society for Inflammatory Bowel Disease.