谁能活到 100 岁？答案可能会让你大吃一惊

【中美创新时报2024 年 12 月 7 日编译讯】（记者温友平编译）一项新研究表明，在老年时期，不同种族的预期寿命发生了巨大变化。对此，《波士顿环球报》记者 Kay Lazar 作了下述详细报道。

想象一下两个邻居，都在 80 多岁。一个是黑人，另一个是白人。哪一个活到 100 岁的机会更大？

传统观点认为，白人 80 多岁老人在爬到 100 岁的过程中会占上风，因为大量研究表明白人美国人更容易获得医疗保健和其他机会。此外，美国黑人在年轻时死亡率通常较高。

但波士顿和加拿大研究人员的一项新研究为这一死亡方程式的不寻常逆转提供了重要的深度——美国黑人八十多岁老人活到 100 岁的几率明显高于白人。而且随着年龄的增长，这种几率会越来越高。

这项发表在《内科医学杂志》上的研究发现，80 岁的白人女性活到 100 岁的几率为 4%，而黑人女性的几率为 6%。到 90 岁时，白人女性的几率上升到 9%，黑人女性的几率上升到 13%。

男性的存活几率较低，但模式相同；80 岁的黑人男性活到 100 岁的几率约为 3%，而白人男性的几率仅为 2%。到 90 岁时，白人男性的几率为 5%，黑人男性的几率为 9%。

研究人员还研究了西班牙裔和亚裔美国人的生存模式，结果显示，这两种人的长寿几率都更高。他们发现，西班牙裔女性从 80 岁活到 100 岁的几率约为 8%，亚裔女性为 10%。到了 90 岁，这两个群体的几率都上升到 15% 左右。研究人员没有足够的数据来分析美洲印第安人或阿拉斯加原住民的生存模式。

“从这些不同的群体中，我们可以学到很多东西，看看他们有什么共同点和不同点，”研究合著者、波士顿大学医学院医学和老年医学教授、新英格兰百岁老人研究主任汤姆·珀尔斯博士说。

“通过研究这一点，我们将解开这个谜团，即长寿和健康老龄化的环境和遗传基础是什么，”珀尔斯说。

该研究还承认了黑人和白人出生时存在显著差异，2019 年黑人的预期寿命为 78 岁，而白人为 81 岁。西班牙裔和亚裔美国人的预期寿命甚至更长，西班牙裔预计可活到 84 岁，亚裔可活到 87 岁。

但它也戏剧性地凸显了一个长期存在争议的现象，即黑人和白人死亡率交叉：直到大约 80 岁左右，黑人的死亡率都高于白人，但随后与白人相比下降，预期寿命变得更长。

这一现象在一个多世纪前首次被研究人员注意到，此后一直存在争议和调查。怀疑论者长期以来一直表示，“交叉”并不真实，黑人晚年比白人长寿的现象只是出生和死亡记录不准确的反映，尤其是几十年前黑人的记录。

这种担忧仍然存在，但随着记录保存的改善，这种担忧有所缓解。 Perls 和他的合著者、蒙特利尔大学人口学副教授 Nadine Ouellette 用于计算存活率的数据来自美国国家卫生统计中心，被认为是可靠的。

如今，大多数研究人员表示，交叉现象可能反映了他们所谓的“选择性生存”，这意味着许多黑人由于社会、经济和其他不利因素而在较年轻时死亡，而最顽强的人则得以生存。或者，正如欧莱特所说：“那些活到这么高龄的人可能是最顽强的，这就是我们在生存方面看到的。”

在他们的研究中，黑人与白人的交叉发生在 86 岁至 88 岁之间（取决于性别），并持续到 100 岁甚至更久。

未参与这项研究的研究人员表示，这是首次证明黑人与白人的交叉持续时间比之前的研究显示的时间长 10 年。

但他们表示，不仅仅是持续的黑人与白人的交叉才令人感兴趣。该研究还表明，在 100 岁时，黑人人口的估计额外预期寿命与西班牙裔和亚裔人口相似，而且这三者的预期寿命都显著高于白人人口。

“有趣的是，所有少数族裔的存活概率都差不多。他们彼此非常相似，但加起来又与白人群体截然不同，这是新闻，”德克萨斯大学奥斯汀分校研究老年人人口健康和死亡率的社会学教授马克·海沃德 (Mark Hayward) 说。

研究表明，即使在 100 岁时，这些更高的存活几率也意味着 2019 年黑人的预期寿命比白人长约六个月。而对于西班牙裔和亚裔人群来说，与白人相比，这一预期寿命增加了约四到五个月。

黑人长寿最引人注目的例子之一可能是韦尔斯利的赫尔达·森豪斯 (Herlda Senhouse)，她上个月去世，享年 113 岁。她身材娇小，性格活泼，是美国第二年长的已核实年龄的人。年龄最大的是宾夕法尼亚州 114 岁的娜奥米·怀特黑德 (Naomi Whitehead)，她也是黑人。

Perls 和 Ouellette 的研究并没有试图回答为什么黑人、西班牙裔和亚裔美国人在步入老年后预期寿命更长的问题。

但研究人员指出，Perls 在新英格兰百岁老人研究中正在进行的其他工作表明，某些基因的组合似乎在长寿方面发挥着越来越重要的作用。

即便如此，正如研究人员指出的那样，行为和环境因素是导致 90 岁左右死亡率的主要因素。例如，对加利福尼亚州基督复临安息日会信徒（其成员通常不吸烟）的研究表明，他们的预期寿命比整个加利福尼亚州人口长约四到七年。素食、不吸烟、从事大量体育活动且体重不超标的基督复临安息日会信徒比他们的加利福尼亚州白人同龄人长约 10 年。

卡内基梅隆大学经济学教授洛厄尔·泰勒 (Lowell Taylor) 研究过黑人与白人交叉现象，他说，珀尔斯和欧莱特的研究将有助于研究人员和公众关注类似的长寿方法。

“了解影响高龄死亡率的力量将让我们真正了解理论上我们可以做些什么来延长寿命，”泰勒说。

德克萨斯大学医学分校的先驱社会学教授 Kyriakos Markides 表示，这项新研究证实并补充了他的研究成果。Markides 因创造“西班牙裔悖论”而受到赞誉，该悖论是指美国的西班牙裔人比白人寿命更长，尽管他们的社会经济水平和医疗保健机会普遍较低。

早在 1984 年，Markides 就与他人合作撰写了一项关于黑人与白人交叉的研究，发现当时美国的这种现象发生在 75 岁左右——当时的总体预期寿命较低。研究表明，与白人相比，黑人在高龄时体格健壮的比例更高，这或许可以解释为什么老年黑人的自杀率较低，而且当时住在养老院的人数也更少。

但马基德斯指出，在讨论黑人和白人的交叉时，经常被忽视的是黑人群体在早年生活中经常面临的巨大劣势，这些障碍往往导致黑人在年轻时死亡的比例高于白人。

“当你到了很老的时候，”他说，“你享受到某些优势，这是件好事。”

题图：波士顿大学研究员 Tom Perls 博士负责开展全球最大的百岁老人及其家庭研究，去年他与当时 112 岁的 Herlda Senhouse 坐在一起。Senhouse 上个月去世，享年 113 岁，是美国第二年长的人。Jessica Rinaldi/Globe 工作人员

附原英文报道：

Who gets to live to 100? The answer may surprise you.

In old age, life expectancy among the races shifts in dramatic ways, a new study shows.

By Kay Lazar Globe Staff,Updated December 4, 2024 

Dr. Tom Perls, a Boston University researcher who runs the largest study of centenarians and their families in the world, sat last year with Herlda Senhouse, who was 112 at the time. Senhouse, who died last month at 113, was the second oldest person in the United States.Jessica Rinaldi/Globe Staff

Imagine two neighbors, both in their mid-to-late 80s. One is Black and the other is white. Which one might have a better chance of reaching 100 years old?

Conventional wisdom would suggest the white octogenarian would have a leg up on that climb to 100, because of the mountains of research showing better access to health care and other opportunities for white Americans. Additionally, Black people in the United States generally have higher death rates at younger ages.

But a new study from Boston and Canadian researchers adds important depth to an unusual reversal of that death equation — that Black octogenarians in the United States have significantly better odds of living to 100 than their white counterparts. And those odds get better with age.

The study, published in the Journal of Internal Medicine, found that white women at 80 years old have a 4 percent chance of living to 100, while the odds are 6 percent for Black women. By the time they hit 90, that stretches to 9 percent for white women — and 13 percent for Black women.

The survival odds are lower for males, but the pattern is the same; a roughly 3 percent chance for Black men at age 80 to make it to 100, but just 2 percent for white men. By age 90, it was 5 percent for white men and 9 percent for Black men.

The researchers also studied survival patterns among Hispanics and Asian Americans and both showed even better longevity odds. They found a roughly 8 percent chance for Hispanic women, and 10 percent for Asian women to make it to 100 from age 80. That expanded to roughly 15 percent for both groups at 90. The researchers did not have sufficient data to analyze survival patterns for American Indian or Alaska Native populations.

“There is a tremendous amount to be learned from these different groups in what they have in common and don’t have in common,” said study coauthor Dr. Tom Perls, professor of medicine and geriatrics at Boston University’s school of medicine and director of the New England Centenarian Study.

“By studying this, we will solve this puzzle, which is, what are the environmental and genetic underpinnings of exceptional longevity and healthy aging,” Perls said.

The study also acknowledged the significant disparities between Black and white populations at birth, showing a life expectancy of 78 years in 2019 for Black people, but 81 for whites. Hispanic and Asian American life expectancies were even greater, with Hispanics projected to live to 84 and Asians to 87.

But it also dramatically highlights a long-debated phenomenon known as the Black-white mortality crossover: Up until roughly their mid-80s, Black people have higher mortality rates than whites, but then decline in comparison to whites, and their life expectancy becomes greater.

The phenomenon was first noted by researchers more than a century ago, and it has been debated and investigated ever since. Skeptics have long said that the “crossover” was not real, and that the phenomenon of Black people outliving whites in their later years was merely a reflection of inaccurate birth and death records, especially from decades ago for Black people.

That concern remains but has eased as record-keeping has improved. The data Perls and his coauthor, Nadine Ouellette, an associate demography professor at the University of Montreal, used to calculate survival rates came from the US National Center for Health Statistics and are considered reliable.

Today, most researchers say the crossover phenomenon likely reflects what they call “select survival,” meaning that many Black people die at younger ages because of social, economic, and other disadvantages, leaving the hardiest to live on. Or, as Ouellette puts it: “Those who survived to these great old ages are probably the most robust and this is what we are seeing in terms of survival.”

In their study, the Black-white crossover occurred between the ages of 86 and 88, depending on gender, and persisted to age 100 and beyond.

Researchers not involved in the study said it is the first to demonstrate the Black-white crossover continued a decade longer than previous studies have shown.

But it wasn’t just the persistent Black-white crossover that was intriguing, they said. The study also demonstrated that at age 100, estimated additional life expectancy for the Black population was similar to that of the Hispanic and Asian populations, and all three were significantly greater than for the white population.

“It’s interesting how all the minority groups were together in terms of their probability of survival. They are very similar to each other, and all of them together are very different than the white population, and that’s news,” said Mark Hayward, a sociology professor at the University of Texas at Austin who studies population health and mortality rates of older adults.

Those greater odds of survival, even at age 100, translated to a life expectancy that was roughly six months longer for Black people compared to white people in 2019, the study showed. And for the Hispanic and Asian populations, it added up to about four to five additional months, compared to the white population.

Perhaps one of the most dramatic illustrations of Black longevity came in the life of Herlda Senhouse of Wellesley, who died last month at age 113. A petite woman with a firecracker personality, she was the second oldest person in the United States whose age was verified. The oldest is Naomi Whitehead, a 114-year-old in Pennsylvania, who is also Black.

The research by Perls and Ouellette did not try to answer the question of why Black, Hispanic, and Asian-American populations have longer life expectancies once they hit old age.

But the researchers noted other ongoing work by Perls at the New England Centenarian Study has demonstrated that combinations of certain genes appear to play an increasingly stronger role in survival to very old ages.

Even so, as the researchers point out, behavariol and environmental factors are the main drivers of mortality rates up to about age 90. For example, studies of Seventh Day Adventists in California, whose members typically don’t smoke, showed their life expectancies were roughly four to seven years longer than the California population as a whole. And Adventists who were vegetarian, did not smoke, engaged in high physical activity, and were not overweight lived roughly 10 years longer than their white California peers.

Lowell Taylor, an economics professor at Carnegie Mellon University who has studied the Black-white crossover phenomenon, said the Perls and Ouellette study will help researchers and the general public focus on similar ways to live better longer.

“Learning about the forces that shape mortality at a very old age would give us really good ideas about what we theoretically can do ourselves to make us have longevity,” Taylor said.

Kyriakos Markides, a pioneering sociology professor at the University of Texas Medical Branch, said the new study confirms and adds to the research he has done. Markides is credited with coining the term the ‘Hispanic paradox,’ where Hispanic people in the United States live longer than white people, despite generally lower socioeconomic levels and health-care access.

Back in 1984, Markides coauthored a study about the Black-white crossover and found the phenomenon in the United States then happened at around age 75 — when overall life expectancies were lower. The study suggested that having a greater proportion of Black people who are more robust at very old ages, compared to white people, might have explained the lower rates of suicide among older Black people and fewer living in nursing homes at that time.

But Markides notes that often overlooked in discussions of the Black-white crossover are the great disadvantages Black populations often face earlier in life, hurdles that often lead to proportionately more deaths at younger ages, compared to white people.

“When you get to be very old,” he said, “and you enjoy certain advantages, it’s nice to see.”