Dying of Old Age: An Examination of Death Certificates of Minnesota Centenarians


  • This work was presented as a poster presentation at the Academy for Health Services Research and Health Policy conference in Atlanta, Georgia, June 10–12, 2001; as part of a panel presentation at the American Public Health Association conference in Atlanta, Georgia, October 22–24, 2001; and as a poster presentation at the Gerontological Society of America conference in Chicago, Illinois, November 15–18, 2001.

Address correspondence to Charles E. Gessert, MD, MPH, Senior Research Scientist, Division of Education and Research, St. Mary's/Duluth Clinic Health System, 400 East 3rd Street, Duluth, MN 55805. E-mail: cgessert@smdc.org


OBJECTIVES: To compare how causes of death are recorded on the death certificates of centenarians with those who die in their 70s, 80s, and 90s. We also examined direct and indirect acknowledgment of age as a cause of death.

DESIGN: Retrospective review of death certificates.

SETTING: State of Minnesota.

PARTICIPANTS: The death certificates of 26,415 individuals aged 70 and over who died in Minnesota in 1998 were examined for underlying causes of death. Of these, 449 were for individuals who were aged 100 and older at the time of their death.

MEASUREMENTS: Causes of death.

RESULTS: Diabetes mellitus, chronic obstructive pulmonary disease, cirrhosis, myocardial infarction, and most cancers decreased in frequency as reported causes of death with advancing age. Conversely, congestive heart failure, atherosclerosis, and neurological/mental and poorly defined conditions increased in frequency with age.

CONCLUSIONS: Centenarians appear to “outlive” the risks for many of the conditions that are common causes of death for those who die in their 70s, 80s, and 90s, such as cancer and myocardial infarction. Conditions associated with aging, such as congestive heart failure and degenerative neurological conditions become more prominent as reported causes of death in the oldest individuals. The guidelines for the completion of death certificates should be modified to facilitate direct acknowledgment of age-related frailty as a contributing cause of death.