Mixed
Chronic systemic inflammation is a primary, malleable driver of mortality and functional decline (capability and cognition) in extreme old age (85+ years), whereas telomere length is not a predictor of successful aging in this demographic.
In extreme old age (85+), managing chronic inflammation is more critical for maintaining independence and longevity than focusing on telomere length. Since inflammation is a 'malleable driver,' strategies that reduce systemic inflammation (such as managing infections like CMV, maintaining metabolic health, and potentially using safe anti-inflammatory agents like melatonin) may help preserve cognitive function and physical capability. This is distinct from younger ages where other factors might dominate.
In Cox proportional hazard models, inflammation predicted all-cause mortality with hazard ratios (95% CI) 1.89 (1.21 to 2.95) and 1.36 (1.05 to 1.78) in the very old and (semi-)supercentenarians, respectively... telomere length was not a predictor of successful ageing in centenarians and semi-supercentenarians. We conclude that inflammation is an important malleable driver of ageing up to extreme old age in humans.
Why this rating
Large longitudinal cohort (n=1554) with multi-decade follow-up, but observational nature prevents causal inference for interventions.
Source
Inflammation, But Not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians
Yasumichi Arai et al. · EBioMedicine · 2015
DOI 10.1016/j.ebiom.2015.07.029
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