Social Characteristics and Health Status of Exceptionally Long‐Lived Americans in the Health and Retirement Study

Objectives To characterize the social characteristics and physical, functional, mental, and cognitive health of exceptional survivors in the U nited S tates and how the experience of exceptional longevity differs according to social status. Design Nationally representative longitudinal study of older A mericans. Setting United States. Participants One thousand six hundred forty‐nine men and women born from 1900 to 1911 from the Health and Retirement Study: 1,424 nonsurvivors who died before reaching the age of 97 and 225 exceptional survivors who survived to age 97 and older. Measurements Self‐reported data on sociodemographic characteristics, social environment, physical and mental health, and physical and cognitive function. Results At baseline, exceptional survivors were more likely to live independently and had fewer diseases, better mental health, and better physical and cognitive function than those who did not survive to age 97. Exceptional survivors experienced declines from baseline in all health domains upon reaching 97 years of age, but between one‐fifth and one‐third of exceptional survivors remained disease free, with no functional limitations or depressive symptoms, and one‐fifth retained high cognitive function. Of exceptional survivors, men were healthier than women, and whites were generally healthier than nonwhites. Highly educated exceptional survivors had better cognitive function than their less‐educated counterparts. Conclusion On average, exceptional survivors are relatively healthy and high functioning for most of their lives and experience health declines only upon reaching maximum longevity. Heterogeneity in the population of exceptionally old adults indicates that, although many individuals reach maximum longevity in a state of poor health and functioning, a considerable portion of exceptional survivors remain healthy and high‐functioning even in very old age.