New Swedish research finds people who reach 100 do not simply live longer with more illnesses; they accumulate fewer diagnoses and develop serious diseases much later than their peers, suggesting a distinct pattern of ageing that could reshape how Thailand plans for an ageing society. The two linked cohort studies led by researchers at Karolinska Institutet compared birth cohorts followed for decades and showed centenarians had lower lifetime risks of stroke, heart attack and major cardiovascular and neuropsychiatric disorders, and that disease accumulation in centenarians slowed from their late 80s rather than accelerating into a sharp final decline as seen in shorter-lived groups (The Conversation summary by the lead author; Karolinska news release).
Understanding why a small fraction of people — just a few per cent of a cohort — reach 100 in relatively good health matters in Thailand because the country is ageing rapidly. Thailand’s life expectancy has risen into the mid-70s, and the proportion of older adults is growing, straining healthcare, pensions and family caregiving systems (WHO country data for Thailand; situation report on Thai older persons 2022). If the Swedish findings point to modifiable factors that slow disease onset, Thailand could adopt targeted prevention and health-system reforms that help more people live not just longer, but healthier lives.
The Swedish findings in brief were striking because they challenge the assumption that more years automatically mean more disease. Two population-register studies examined people born in narrow windows to reduce cohort effects: one used 170,787 residents of Stockholm County born between 1912 and 1922 and followed from age 60 up to age 100, calculating risks of stroke, heart attack, hip fracture and various cancers; the other analysed 274,108 people born 1920–1922 followed from age 70 for around three decades, identifying 4,330 centenarians (about 1.5% of that cohort) and tracking 40 different medical conditions ranging from mild (hypertension) to severe (heart failure, dementia) (The Conversation; Karolinska). Both analyses found centenarians accrued fewer diagnoses over their lives, developed major diseases later, and were more likely to have illnesses confined to a single organ system — a pattern that makes long-term management easier and is consistent with preserved physiological resilience.
Key numerical findings highlighted by the researchers illustrate the gap between centenarians and their shorter-lived peers. At age 85, only about 4% of future centenarians had experienced a stroke compared with roughly 10% among those who reached 90–99 years. By age 100, around 12.5% of centenarians had a history of heart attack, versus just over 24% among people who died aged 80–89 in the comparison groups. Centenarians also showed lower rates of cardiovascular diagnoses at ages when most older adults are already affected — for example, about 8% of centenarians had cardiovascular disease by age 80 compared with more than 15% in people who died at 85 (The Conversation; Karolinska). These differences mean that even with more years lived, centenarians’ cumulative lifetime burden of many diseases remained lower than that of shorter-lived peers.
Lead author and epidemiologist Karin Modig summarised the findings as evidence that “exceptional longevity is not just about delaying ill health. It reflects a unique pattern of ageing” and suggested centenarians may have preserved homeostasis and resistance to disease through a favourable combination of genes, lifestyle and environment (The Conversation; Karolinska). The researchers also emphasised that centenarians tended to accumulate multiple conditions much later than non-centenarians — typically around age 89 — and did not experience the same steep increase in multimorbidity seen in many who die earlier.
For Thailand, the Swedish results raise several practical questions and policy implications. First, cardiovascular disease prevention appears central: the Swedish analyses point to cardiovascular conditions as a major differentiator between centenarians and others, a finding that aligns with global evidence on the outsized role of heart disease in late-life mortality. Thailand already faces a high burden of non-communicable diseases (NCDs) such as hypertension, diabetes and ischaemic heart disease; strengthening proven primary-care interventions — routine blood pressure and diabetes control, cholesterol management, smoking cessation programmes, and community-based risk reduction — could delay disease onset at population level and compress morbidity into a shorter period near the end of life (WHO Thailand country profile). Evidence-based NCD control is cost-effective and consistent with Thailand’s long-standing Universal Coverage Scheme, which could be leveraged to prioritise preventive services.
Second, dementia and neuropsychiatric resilience among centenarians in Sweden suggests brain-health promotion must be part of any healthy-ageing strategy. Sweden’s centenarians showed lower prevalence of neuropsychiatric disorders, including dementia and depression, over their lives. Thailand’s Ministry of Public Health and social services should expand dementia risk reduction — targeting cardiovascular risk factors, promoting cognitive activity, social engagement and mental health services — while preparing age-friendly care pathways for the rising number of older adults (situation report on Thai older persons 2022).
Third, the Swedish studies highlight the value of long-term, linked health registers for ageing research. Thailand’s research community and public health authorities could accelerate knowledge by investing in longitudinal cohort studies and harmonised electronic health records that allow researchers to follow birth cohorts and identify predictors of healthy ageing — including social determinants, diet, physical activity, pollution exposure, occupational histories and genetic markers. Such investments would also enable Thailand to test whether the “centenarian pattern” observed in Sweden occurs in Asian populations with different genetic and cultural backgrounds.
There are, of course, important limitations before importing Swedish findings wholesale into Thai policy. The Swedish cohorts benefited from near-universal registry coverage and a healthcare system with long-standing, high-quality administrative data — conditions that vary worldwide. Genetic background, early-life conditions, lifetime infections, diet and social structures differ substantially between Sweden and Thailand, so the specific drivers of centenarian resilience may not generalise. Moreover, register-based studies emphasise diagnosed conditions and may not capture subtler measures of function, frailty or undiagnosed illness; cause-of-death coding and healthcare-seeking behaviour also differ between countries, affecting comparability (Karolinska press summary; The Conversation).
Policy recommendations for Thailand arising from this research should therefore be pragmatic and evidence-led. Focused actions include: doubling down on scalable primary-care prevention for cardiovascular disease and diabetes through community health workers and village health volunteers; expanding hypertension detection and treatment (salt-reduction public campaigns linked to traditional Thai diets can be effective); integrating cognitive-health screening into routine elder care; supporting family carers with respite and training; and piloting regional longitudinal cohorts to identify Thai-specific predictors of healthy ageing. These steps align with Buddhist cultural values of respect for elders and family responsibility, while acknowledging the modern pressures on multi-generational households as urbanisation and smaller family sizes change caregiving norms.
Clinically, Thai hospitals and community clinics can implement “ageing-friendly” care models that prioritise maintenance of function and management of single-organ problems rather than fragmenting care across many specialists. The Swedish finding that centenarians often have problems limited to a single organ system suggests earlier detection and simpler, coordinated interventions can preserve quality of life. Integrating geriatric assessment into district hospitals and improving referral pathways for physiotherapy, nutrition support and cognitive rehabilitation could help compress late-life morbidity.
For researchers and funders, the next steps are clear: replicate and extend the Swedish approach in Thai cohorts to disentangle the relative contributions of genetics, lifelong environment and health behaviours. Thailand can partner with international consortia studying centenarians and “Blue Zone”-style research to compare patterns across regions. Genomic and biomarker studies of long-lived Thais — combined with lifetime exposure data — could identify protective mechanisms that are actionable through public-health interventions.
In the near term, Thai individuals and families can adopt practical measures shown to delay cardiovascular and metabolic disease: maintain healthy weight, reduce tobacco and harmful alcohol use, lower dietary salt and processed-food intake while preserving beloved Thai dishes through cleaner cooking and more vegetables, stay physically active through walking and community-based exercise, and keep socially engaged — activities congruent with Thai cultural life in temples, markets and family gatherings. These actions do not guarantee centenarian status, but they reflect the same prevention-first orientation suggested by the Swedish findings and are supported by global evidence on healthy ageing (WHO NCD priorities).
The Swedish studies offer hope that a longer life need not mean years of poor health. For Thailand, the challenge is to translate the lesson — that delaying disease onset and slowing multimorbidity can extend healthy years — into policies and community practices that fit Thai social structures and healthcare realities. Strengthening primary care, investing in longitudinal research, and promoting culturally appropriate prevention could help more Thais live longer, healthier lives while preserving family and societal resilience in an ageing country.
Sources: the original accessible summary of the research by the lead author and host site (The Conversation) and the Karolinska Institutet news release summarising the cohort analyses (The Conversation summary; Karolinska press release), the ScienceAlert re-reporting of the Conversation piece (ScienceAlert), and Thailand-specific population and health context from WHO country data and a 2022 report on Thai older persons (WHO Thailand data; Situation of the Thai Older Persons 2022).