Why Some People Live to 100 (and Why Most of Us Won’t)

Helen Reichert was a 100-year-old smoker who continued smoking despite everyone’s best efforts, especially her doctors, to convince her to quit. She ended up living almost another decade before passing away. People like Helen are captivating, however, their habits may also be misleading. While some centenarians can defy health advice, research shows most of us cannot. Practicing unhealthy habits and expecting to live long healthy lives is a paradox that is simply not in the cards for most people. While a balance of genetics and lifestyle factors determines how long we live, this balance actually shifts as we age.

Centenarians: Escapers, Delayers, and Survivors

Some researchers have grouped centenarians like Helen into three different categories–the “escapers” (15%), who reach 100 without significant disease; the “delayers” (43%), who avoid age-related illnesses until their 80’s; and the “survivors” (42%), who live long despite early health challenges. Within these groups, women dominate the longevity scene, representing about 85% of centenarians and up to 90% of supercentenarians (110+), though men who reach these ages often maintain better physical health. Achieving extraordinary lifespans is desired by most, but it requires an interplay between lifestyle habits and genetic resilience that may only be found in a very small percentage of the population.

The Role of Lifestyle: How to Reach 80 or 90

Adopting healthy habits can significantly extend life expectancy. A major study found that adopting five key habits–eating healthy, staying active, maintaining a normal weight, not smoking, and moderating alcohol consumption–could add 14 years to women’s lives and 12 years to men’s after age 50. Similarly, another study with U.S. veterans revealed that adherence to these five key habits, plus the addition of three other key habits–stress management, restorative sleep, and positive social connections–could extend life expectancy by over 20 years for 40 year-olds. What is interesting about these lifestyle habits is that most of them are inexpensive. Yet, the U.S. is one of the wealthiest nations and still lags behind most high-income countries in life expectancy. While traditional factors like diet and exercise remain critical, these findings emphasize the importance of sleep, stress, and social support. This is encouraging news because even focusing on one of these, such as social connections, may be one of the easiest health strategies to access and implement. It requires no special equipment or regimen, and we can practice it in many ways daily. By focusing on some or even all of these key habits, reaching our 80’s or 90’s may be easier to achieve than we think. As we get older, though, our genetics begin to prevail.

The Genetic Lottery: Why Some People Beat the Odds

For those who make it to 100, genetics play an outsized role. Research on Ashkenazi Jews with exceptional longevity found their lifestyle habits were not significantly healthier than those of the average U.S. population. Instead, genetic factors seem to play a larger role, potentially “buffering” against the harmful effects of less healthy habits. Longevity-associated genes like FOXO3 (linked to cellular health) and APOE2 (which reduces Alzheimer’s risk) may protect against age-related diseases like cardiovascular conditions and dementia, even in the presence of disease-risk genes.

Another groundbreaking research initiative known as the Long Life Family Study (LLFS) explores the genetic, behavioral, and environmental factors behind exceptional longevity and healthy aging. Compared to general populations, LLFS participants demonstrate better physical and cognitive function, healthier metabolic profiles, and delayed onset of diseases like dementia and heart disease. In their research, findings reveal that healthy aging varies across families, with some excelling in specific areas more than others, such as memory or cardiovascular health, due to rare protective genetic variants. These rare genetic variants help explain why some people live exceptionally long lives despite having unhealthy habits. Overall, this body of research suggests that while lifestyle accounts for 75% of longevity in the general population, that percentage usually flips for centenarians.

The Takeaway: Control What You Can

Living to 100 is like winning the genetic lottery–only about 1% of people have the genes to reach this milestone. For the rest of us, lifestyle matters. While a few individuals can break the rules, most of us require sticking to the proven formula for a longer, healthier life: eat well, stay active, sleep enough, avoid harmful substances, and foster positive relationships. Receiving health advice from centenarians may be intriguing, however, always remember that they are the exception–not the rule!