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Although the incidence of dementia increases exponentially with age, some individuals reach more than 100 years with fully retained cognitive abilities. To identify the characteristics associated with the escape or delay of cognitive decline, we initiated the 100-plus Study (www.100plus.nl). The 100-plus Study is an on-going prospective cohort study of Dutch centenarians who self-reported to be cognitively healthy, their first-degree family members and their respective partners. We collect demographics, life history, medical history, genealogy, neuropsychological data and blood samples. Centenarians are followed annually until death. PET–MRI scans and feces donation are optional. Almost 30% of the centenarians agreed to post-mortem brain donation. To date (September 2018), 332 centenarians were included in the study. We analyzed demographic statistics of the first 300 centenarians (25% males) included in the cohort. Centenarians came from higher socio-economic classes and had higher levels of education compared to their birth cohort; alcohol consumption of centenarians was similar, and most males smoked during their lifetime. At baseline, the centenarians had a median MMSE score of 25 points (IQR 22.0–27.5); most centenarians lived independently, retained hearing and vision abilities and were independently mobile. Mortality was associated with cognitive functioning: centenarians with a baseline MMSE score ≥ 26 points had a mortality percentage of 17% per annual year in the second year after baseline, while centenarians with a baseline MMSE score < 26 points had a mortality of 42% per annual year (p = 0.003). The cohort was 2.1-fold enriched with the neuroprotective APOE-ε2 allele relative to 60–80 year-old population controls (p = 4.8 × 10⁻⁷), APOE-ε3 was unchanged and the APOE-ε4 allele was 2.3-fold depleted (p = 6.3 × 10⁻⁷). Comprehensive characterization of the 100-plus cohort of cognitively healthy centenarians might reveal protective factors that explain the physiology of long-term preserved cognitive health.

We use a set of linked reproductive histories taken from Sweden, the Netherlands, and Spain for the period 1871-1960 to address key issues regarding how reproductive change was linked specifically to mortality and survivorship and more generally to individual agency. Using event-history analysis, this study investigates how the propensity to have additional children was influenced by the number of surviving offspring when reproductive decisions were made. The results suggest that couples were continuously regulating their fertility to achieve reproductive goals. Families experiencing child fatalities show significant increases in the hazard of additional births. In addition, the sex composition of the surviving sibset also appears to have influenced reproductive decisions in a significant but changing way. The findings offer strong proof of active decision-making during the demographic transition and provide an important contribution to the literature on the role of mortality for reproductive change.

BackgroundWeight for height has been used in the past as an indicator of obesity to report that prenatal exposure to the Dutch famine of 1944–1945 determined subsequent obesity. Further evaluation is needed as unresolved questions remain about the possible impact of social class differences in fertility decline during the famine and because being overweight is now defined by a Body Mass Index (BMI: kg/m2) from 25 to <30 and obesity by a BMI of 30 or more.MethodsWe studied heights and weights of 371,100 men in the Netherlands born between 1943 and 1947 and examined for military service at age 19. This group includes men with and without prenatal exposure to the Dutch famine.ResultsThere was a 1.3-fold increase in the risk of being overweight or obese in young adults at age 19 after prenatal famine exposure in early gestation. The increase was only seen in sons of manual workers born in the large cities of Western Netherlands and not among those born in smaller cities or rural areas in the West. Social class differentials in fertility decline during the famine did not bias study results.ConclusionsThe long-term adverse impact of prenatal famine on later life type 2 diabetes and mortality through age 63 is already showing at age 19 in this population as a significant increase in overweight risk.Key messagesWe examined the relation between undernutrition in early life and young adult body size in men born at the time of the Dutch famine of 1944–1945.To avoid possible biases arising from the decline in conceptions during the famine we concentrated on births to women who were already pregnant during the famine.We found a 1.3-fold increase in being overweight at age 19 for men exposed in early gestation but not for men exposed later in gestation. This points to an especially sensitive period in fetal development. The increase was limited to sons of manual workers, consistent with more limited access to food in this group.Our findings suggest that a body size increase in young adulthood foreshadows the long-term increase in later type 2 diabetes and mortality after early gestation famine.

Even in present-day high-income countries, there is a lot of evidence of a high degree of vulnerability of the population to both high and low outdoor temperatures. The magnitude of temperature-related mortality is strongly related to a wide variety of social, economic, and behavioural factors. To gain insight into the changing impact of cold and heat on mortality, we analyze Dutch individual death records in relation to daily temperature for the period 1855-2006 for one of the 11 Dutch provinces. Making use of negative binomial regression analysis, we study whether the effect of temperature varied by age, sex, and social class, and analyze the changes in the vulnerability to temperature fluctuations.

Practising arts has been linked to lowering stress, anxiety and blood pressure. These mechanisms are all known to affect the ageing process. Therefore, we examine the relation between long-term involvement in arts and life expectancy at age 50 (LE50), in a cohort of 12,159 male acoustic, literary and visual artists, who were born between 1700 and 1899 in the Low Countries. We compared the life expectancy at age 50 of the various artists with the elite and middle class of that time. In the birth cohorts before 1850, acoustic (LE50:14.5-19.5) and literary artists (LE50:17.8-20.8) had a similar life expectancy at age 50 compared to the elite (LE50:18.0-19.0). Only visual artists (LE50:15.5-17.1) had a lower life expectancy at age 50 compared to the elite at that time. For the most recent birth cohorts from 1850 through 1899, the comparison between artists and the elite reversed and acoustic and literary artist had a lower life expectancy at age 50, while visual artists enjoyed a similar life expectancy at age 50. Although artists belonged to the middle socioeconomic class and lived predominantly in urban areas with poor living conditions, they had a life expectancy similar to the elite population. This is in line with observed favourable effects of practicing arts on health in the short-term. From our historical analysis, we hypothesize several mechanisms through which artistic creativity could influence the ageing process and life expectancy. These hypotheses, however, should be formally tested before any definite conclusions on effects of arts on ageing can be drawn.

National estimates exist for war- and famine-related deaths in the Netherlands during the last stages of World War II, but no such estimates are available at the local level. To fill this information gap, this article aims at mapping and visualizing the timing of war- and famine-related excess mortality by municipality among the civilian population within the Netherlands. We use mortality statistics at the level of municipalities because these are the smallest administrative units for which this information is available. We use a seasonally adjusted mortality model combined with a difference-in-difference approach to estimate the number of excess deaths in the period between January 1944 and July 1945 separately for each Dutch municipality.

This paper shows the effect that the medical expertise of medical practitioners had on the life chances of their children. We focus on infant and early childhood mortality. We reconstructed the life histories of the offspring of a group of around 2800 medical practitioners who were practicing in a high-mortality region in the Netherlands between 1850 and 1922, the period during which infant and child mortality in the Netherlands underwent the largest changes. The survival of their offspring is compared with that of a random sample of children from the Historical Sample of the Netherlands. Multilevel hazard analysis, using Cox proportional hazards models with shared frailty, is applied to study the effect of belonging to the medical profession on survival, in relation to the level of infant mortality in the regions where children were born. Within the group of medical practitioners, attention is paid to differences in children’s survival according to the level of medical knowledge of the fathers. Our statistical analyses show that the offspring of medical practitioners as a whole did have better survival prospects than children born to families without a father with a medical background. When medical practitioners had effective medical knowledge, measured by the period of graduation and the highest level of medical training reached, the positive effects on the survival of their children were even stronger.

The emergence of the housewife in the Netherlands over the period 1812-1922 was strongly influenced by the social norm that women should withdraw from the labour market on the eve of marriage. Adherence to this norm is most clearly reflected in the emergence of the housewife among the lower classes, especially at the close of the nineteenth century among wives of farmers. Women in urban municipalities, however, set the norm far earlier and differences across social classes were significantly greater in towns than in rural areas. Paradoxically, the rise of the housewife did not change work pressures for lower-class women.

We examine in depth the effect of differences in the smoking adoption patterns of men and women on the mortality gender gap in Netherlands, employing a historical perspective. Using an indirect estimation technique based on observed lung cancer mortality from 1931 to 2012, we estimated lifetime smoking prevalence and smoking-attributable mortality. We decomposed the sex difference in life expectancy at birth into smoking-related and nonsmoking-related overall and cause-specific mortality. The smoking epidemic in Netherlands, which started among men born around 1850 and among women from birth cohort 1900 onwards, contributed substantially to the increasing sex difference in life expectancy at birth from 1931 (1.3 years) to 1982 (6.7 years), the subsequent decline to 3.7 years in 2012, and the high excess mortality among Dutch men born between 1895 and 1910. Smoking-related cancer mortality contributed most to the increase in the sex difference, whereas smoking-related cardiovascular disease mortality was mainly responsible for the decline from 1983 onwards. Examining nonsmoking-related (cause-specific) mortality shed new light on the mortality gender gap and revealed the important role of smoking-related cancers, the continuation of excess mortality among women aged 40–50, and a smaller role of biological factors in the sex difference than was previously estimated.

Spatial inequalities in human development are of great concern to international organisations and national governments. Demographic indicators like the infant mortality rate are important measures for determining these inequalities. Using demographic indicators over long time periods at relatively high levels of geographical detail, we can examine the long-term continuities and changes in spatial inequalities. This paper presents the initial outcomes of a larger project that aims to analyse spatial variation in infant survival across Europe over the last 100 years. In this paper, we focus on spatial disparities in infant survival in 1910. At that time, the longevity revolution was still at an early stage. We look at general spatial variation patterns within and across countries, and discuss some of the challenges related to the comparativeness of the data. We link official infant mortality data from more than 5,000 European regions and localities for the period around 1910 to a European historical GIS of administrative boundaries. The data are analysed using descriptive spatial analysis techniques. In 1910, a number of countries in northern and western Europe led the longevity revolution in Europe, with the area of low infant mortality also extending into the northwestern parts of the German Empire. Other areas with low infant mortality levels included the Belgian region of Wallonia, most parts of Switzerland, as well as central and south-western France. In eastern and southern Europe, we find significant variation within and across countries, which might stem in part from data quality problems.