Do men and women follow different trajectories to reach extreme longevity?

Gender accounts for important differences in the incidence and prevalence o f a variety of age-related diseases. Considering people of far advanced age , demographic data document a clear-cut prevalence of females compared to m ales, suggesting that sex-specific mortality rates follow different traject ories during aging. In the present investigation, we report data from a nat ionwide study on Italian centenarians (a total of 1162 subjects), and from two studies on centenarians living in two distinct zones of Italy, i.e., th e island of Sardinia (a total of 222 subjects) and the Mantova province (No rthern Italy) (a total of 43 subjects). The female/male ratio was about 2:1 in Sardinia, 4:1 in the whole of Italy, and about 7:1 in the Mantova provi nce. Thus, a complex interaction of environmental, historical and genetic f actors, differently characterizing the various parts of Italy, likely plays an important role in determining the gender-specific probability of achiev ing longevity. Gender differences in the health status of centenarians are also reported, and an innovative score method to classify long-lived people in different health categories, according to clinical and functional param eters, is proposed. Our data indicate that not only is this selected group of people, as a whole, highly heterogeneous, but also that a marked gender difference exists, since male centenarians are less heterogeneous and more healthy than female centenarians. Immunological factors regarding the age-r elated increase in proinflammatory status, and the frequency of HLA ancestr al haplotypes also show gender differences that likely contribute to the di fferent strategies that men and women seem to follow to achieve longevity. Concerning the different im pact of genetic factors on the probability of r eaching the extreme limits of the human lifespan, emerging evidence (regard ing mtDNA haplogroups, Thyrosine Hydroxilase, and IL-6 genes) suggests that female longevity is less dependent on genetics than male longevity, and th at female centenarians likely exploited a healthier life-style and more fav orable environmental conditions, owing to gender-specific cultural and anth ropological characteristics of the Italian society in the last 100 years. ( C) 2000, Editrice Kultis.