Background: The population of the elderly is
rapidly increasing around the world. In
particular, the population of the oldest old is
growing at an amazing pace. There is a
pessimistic concern that the increase of dependent
elderly will cause a burden to the society.
However, maintaining autonomy in the later life
will alleviate the burden. How to maintain
autonomy is an important issue for both
individuals and the society. Centenarians are
considered to be a model of successful aging.
From them, we can learn how to age successfully
and how to attain autonomy in later life.
Aim: 1) to understand phenotypes of aging, 2)
to know the factors modifying phenotypes of
aging, 3) to clarify the factors related with
QOL, and finally 4) to construct a model
predicting QOL and life expectancy in
centenarians.

Subjects and Methods: Centenarians living in
Tokyo who gave their or their proxy consent to
participate in this study were enrolled. A
multidisciplinary approach was used to study
centenarians; medical examinations, family tree,
dietary analysis, assessment of cognitive function
and ADL, personality, analysis of care system,
DNA polymorphism and others. This study
was approved by the ethical committee of Keio
University, School of Medicine.
Results: In 2001, over 15,000 centenarians are
living in Japan. Ten % of total centenarians in
Japan are living in Tokyo. Half of centenarians
in Tokyo were born in Tokyo and the rest were
mainly born on Honshu island. And while they
were young, they moved to Tokyo. One of the
characteristics of centenarians was heterogeneity;
from total autonomy to total dependence.
Although the ratio of women to men was about
4, the cognitive function and ADL in men was
high, compared with women.    The score of

 MMSE was distributed from 0 to 29 (mean
score was 15). The distribution of Barthel index
was U shaped. About 30% of centenarians
enjoyed their life without severe diseases. The
prevalence of diabetes mellitus was extremely
low. The characteristics of blood chemistry in
centenarians were, 1)low level of nutritional
parameters indicating that centenarians were
usually undernourished, 2)high level of CRP
and inflammatory cytokines, 3)high level of
plasma von Willibrand factor and thrombinantithrombin complex, suggesting the presence of prothrombotic status, 4) low prevalence of atherosclerosis. Neo FFI was used for the assessment of the personality in centenarians.
The score of conscientiousness was high. The
care system of centenarians was analyzed. To
our surprise, the burden of the caregiver in
centenarian family was less, compared with
that in octogenarian families. We defined this
as successful care.

Conclusion: Here we describe the characteristics
of centenarians in Tokyo. The relations between
these characteristics are now investigated.
There are many interesting and productive
questions, such as, how personality is related
with longevity? And why is the care system of
centenarians efficient? To find the answers to
these questions will help promote QOL in later
life.

Acknowledgements: We express sincere
gratitude to centenarians, their families and
their caregivers who participated willingly in
this study. This study was partly supported by
a grant from the Ministry of Health, Welfare
and Labor (Japan).