Social isolation and likelihood of becoming centenarians: evidence from the Chinese longitudinal healthy longevity survey

Background: Social isolation, defined as an individual’s lack of social connections, is particularly prevalent among older adults. However, its association with health outcomes among the oldest-old population (aged 80 and above) was understudied. Aims: To examine the association between social isolation and the likelihood of becoming a centenarian among the oldest-old people in China, aiming to provide novel insights into promoting healthy aging and longevity. Methods: Using data from The Chinese Longitudinal Healthy Longevity Survey, conducted in 22 provinces in mainland China since 1998, we performed a community-based, prospective nested case-control study. The primary outcome was survival to the age of 100 by 2018 (the end of follow-up). Information on social isolation and other covariates was collected via a questionnaire at baseline. The degree of social isolation was categorized as low, moderate, and high. Included (n = 5,716) were 1,584 identified centenarians and 4,132 controls (deceased before reaching 100 years), matched by age, sex, and year of entry. A conditional logistic regression model was used to evaluate the association between social isolation and the likelihood of becoming a centenarian, adjusting for demographic factors, lifestyle factors, chronic disease, potential disability, optimistic attitude, and perceived loneliness. Results: Individuals with the highest social isolation score had lower odds of becoming centenarians (adjusted OR:0.82; 95% CI: 0.68, 0.98), relative to those with the least social isolation (P-value < 0.05), and this association persisted in sensitivity analyses. The association was more pronounced among ever smokers, compared to never smokers (P-value = 0.001). We did not observe significant interactions between social isolation and other covariates (P-value > 0.05 for all). Conclusions: This study highlights the inverse association between social isolation and the likelihood of becoming a centenarian, emphasizing the need for public health initiatives to combat isolation in the older population.