Copyright 7996 by The Cerontological Society of America The Cerontologist Vol. 36, No. 6, 783-788 This article summarizes recent findings in a case study of exceptional longevity. C M , a resident of San Rafael, California, was 114 years old in August 1996. He is the first properly verified case of a 114-year-old man in human history (although a few women have been known to live longer). Our investigation of C M continues as we attempt to gather additional information about his life, family history, and current condition. Here, we consider only two aspects of this case: its authenticity and its significance in the history of human longevity. We believe that we have proven that CM's stated age is accurate. Based on the available information, it also seems a reasonable conjecture that he may be the oldest man alive today and perhaps the oldest man who has ever lived. This study documents an extreme example of human longevity and records characteristics of the man's life that may provide clues about the causes of his exceptional survivorship. Key Words: Exceptional longevity, Centenarian, Super-centenarian The Oldest Man Ever? A Case Study of Exceptional Longevity1 John Wilmoth, PhD,2 Axel Skytthe, MSc,3 Diana Friou, MA,2 and Bernard Jeune, MD 3 CM was born on August 16,1882, in the village of Skaarup (near Skanderborg), Denmark. He worked on a farm as a child and then moved to Skanderborg to become a tailor's apprentice at age 16. In 1903, he immigrated to the United States, arriving through Ellis Island in New York harbor but moving immediately to Chicago to live with relatives. In 1905, he joined the Danish Brotherhood in America, a fraternal organization of immigrants and their descendants. From around 1908 to 1918, he traveled extensively around the western United States (from Chicago to California), making his living as a tailor. Around 1918, he returned to Chicago and settled there on a more permanent basis. Back in Chicago, CM was married briefly during the late 1910s and 1920s. The marriage ended in divorce, and he never remarried. During these years, he worked as a milkman for the Borden Dairy Company and operated a small restaurant. In 1923, he joined a Masonic lodge in Chicago. In 1929, he took a job as a factory worker for the Continental Can Company, where he was employed for 21 years. He retired in 1950 and lived for many years thereafter in south 1 The authors wish to thank Maxine Weinstein for help in obtaining a copy of CM's immigration record from the National Archives in Washington, DC. Helpful comments on earlier versions of this paper were provided by James Vaupel and Roger Thatcher. Special thanks to CM himself and to the nurses and staff of his retirement community, whose help and cooperation made this study possible. department of Demography, University of California, Berkeley, with support from the National Institute on Aging (R01 AG-11552). Address correspondence to John Wilmoth, PhD, Department of Demography, Program in Population Research, University of California, 2232 Piedmont Avenue, Berkeley, CA 94720-2120. 3 Center for Health and Social Policy, Odense University Medical School, Odense, Denmark, with support from the Danish Research Councils (5.20.34.08). Vol. 36, No. 6,1996 783 Texas, where he enjoyed sailing on Galveston Bay. In 1978, when he was 96 years old, he moved to San Rafael, California, to live in a retirement community. He resided in the "independent living" section of that community for many years, then entered the skilled nursing facility in 1993, when he was 110 years old. At present, CM is completely blind and has difficulty hearing. He spends most of his time in bed, either sleeping or listening to the radio. He can walk only with the assistance of another person. In other aspects, however, his physical condition remains good, with no apparent signs of major degenerative disease or dementia. His memory and reasoning abilities also appear to be largely intact, and he frequently displays a sense of humor. He has willingly participated in a series of interviews conducted mainly by the first author beginning in March 1995. The information presented here has been drawn from those interviews and from various documents. Verification of Age Before describing the details of our age verification procedure, it is worth mentioning the history of how we discovered this case and our original skepticism about it. One of the Danish authors of this article read a story about CM in a Danish newspaper and doubted its accuracy. From earlier studies, it was known that most reports of men above age 110 were likely to be false (Jeune, 1995; Skytthe & Jeune, 1995). An initial check in the Danish archives seemed to confirm the story, however, so a contact was made with the first author, who called the nursing home where CM was living and arranged an initial meeting. From the beginning, all authors were skeptical of the validity of CM's stated age and became con- vinced only slowly of its authenticity. Through a series of interviews, the American authors sought to extract information about CM's life history that could be checked against documentary evidence. Documents were gathered on both sides of the Atlantic in an effort to confirm or disprove CM's reported age. In most cases, the interviews uncovered information that was confirmed only later by documentary evidence. In those instances where the interviewers knew the answer in advance, they asked questions in a manner to avoid revealing their prior knowledge to CM. In verifying the authenticity of a report of exceptional longevity, the first step is to confirm that all available documents contain or imply the same date of birth. In this case, all of the written records that we have found are consistent with the claim that CM is now 114 years old. Table 1 shows the relevant documents that were found, which all give either an exact date of birth (always August 16,1882) or an age that is consistent with this date of birth. It is worth noting that such documents may not each be independent sources of information about CM's current age or date of birth. For example, the date of birth recorded at the time of his confirmation may have been taken directly from the birth registration. Similarly, the date contained on the transfer of Freemasonry membership in 1970 was probably taken, directly or indirectly, from his 1923 application to join the Masons (although we were unable to obtain a copy of the earlier document). This comment is only a precautionary note, however, since several of these documents do indeed represent separate confirmations of his date of birth and span a significant portion of his lifetime (for example, his birth registration in 1882, the Danish census records in 1890 and 1901, the immigration record in 1903, his application to join the Danish Brotherhood in 1905, the U.S. census record in 1920, his pension application in 1950, and the Freemasonry document from 1970). CM's date of birth (August 16, 1982) is thus confirmed by a series of documents beginning with his birth registration. In this and similar cases, however, we must also consider the possibility that the person who claims a particular identity — and a corresponding date of birth — might be an impostor (Thorns, Table 1. Documents Confirming CM's Age and/or Date of Birth Document Year Birth registration Danish census Confirmation of baptism Danish census U.S. immigration record Application to join the Danish Brotherhood in America U.S.census Retirement pension application Transfer of Freemasonary membership to Texas Application for admission to retirement community 1882 1890 1896 1901 1903 1905 1920 1950 1970 1978 Note: All documents on this list give the same date of birth (August 16,1882) or an age that is consistent with this date. 784 1873). Could it be, for example, that some younger person might have assumed the identity of the original CM at some point in the near or distant past? The motivations for such a switch of identity could be numerous: to marry before the legally sanctioned age, to avoid military service, to facilitate migration, to gain early retirement benefits, to claim an inheritance under false pretense, or to enjoy the celebrity status that often accompanies exceptional longevity (Wilmoth & Lundstrom, 1996). In this situation, the scenario that seems most worthy of attention is that a younger person might have assumed CM's identity in order to immigrate to the United States. For example, one might speculate that the original CM went home to Denmark during the 1920s or 1930s, but that a younger brother, cousin, nephew, or some other person returned to the U.S. using his passport. Such a hypothesis is plausible, especially in light of the fact that more restrictive U.S. immigration laws were instituted during the 1920s. Under this scenario, the original CM might have died in Denmark or later returned to the U.S. and died there. In either case, it would now be difficult to find any record of his death (perhaps having occurred several decades ago). In spite of these concerns, our belief that there has been no change of identity is well supported by a variety of evidence. Based on conversations with him, it is virtually certain that CM spent the early years of his life in Denmark (see Appendix, Note 1). Furthermore, a similar physical description has been documented over time. CM is a rather short man, even considering that he was born more than 100 years ago, when average heights were much lower than today. His height was listed as 5'4" (162.6 cm) on a 1905 physical examination taken at the time he joined the Danish Brotherhood in America. Recent measurements (performed by a nurse without knowledge of the earlier data) show a current height of 5'3V2". When asked, CM said that his height was "5'5" with shoes" (see Appendix, Note 2). CM also told us that the Danish army rejected him on the basis of his short stature (see Appendix, Note 3). On their own, however, Danish nativity and consistency of adult height are an inadequate basis for dismissing the possibility that there may have been some switch of identity. Thus, we also asked CM a series of questions regarding his life and family history, and then compared his answers with documentary evidence. The results of this investigation are summarized in Table 2. Admittedly, if the hypothesized impostor were a family member, he could be expected to know the answers to many of these questions. If the impostor were a younger brother, for example, he might know as much about the details of the immediate family as the original CM. Parish records indicate, however, that CM was the youngest of 6 children (see Appendix, Note 4). A younger cousin or nephew might have known some of this information, but it is unlikely that they or even a younger brother could have so accurately recounted the details of CM's life history, as seen in Table 2. The Gerontologist Table 2. Information Confirming CM's Identity Subject Information given by CM Verified Comments Full (given) name: Thomas Peter Thorvald Kristian Ferdinand Mortensen Yes Place of birth: Skaarup (near Skanderborg) Yes Date of birth: Father's full name: Mother's full name: Sibling's names: August 16,1882 Yes Jens Carl Martinus Mortensen Maren Therkildsen Thyboe Yes Yes CM did not know his parents' dates of birth, death, or marriage. Johannes Mortensen Carl Emil Mortensen Julius Mortensen Yes CM did not know his sibling's dates of birth, but he knew the relative ages of the 4 surviving brothers (4 years apart, approximately). CM never mentioned two siblings who died before his birth. Sibling's deaths: Johannes: Carl Emil: Julius: Mostly Records indicate that Julius died at age 72, not 79. All other information agrees well with the official records. Johannes' death certificate lists "consumption" as the cause of death, which probably indicates TB. Family home: CM said that the family home in Skaarup was bought by his brother, Carl Emil, after the death of his father. The father had borrowed money against the home, so after his death the debt had to be re-paid or the family would lose the house. CM said that his mother stayed in that house until her death. Yes CM's father died in May 1905, and civil records show that ownership of the house passed to Carl Emil in 1906. The debt was to a nephew, which may help to explain the slight delay. CM's mother died in June 1924, and the house was sold to the next owner in the same year. Immigration to U.S. Age: 20 or 21. Year: 1902 or 1903. Sailed from Copenhagen on a ship called "The United States," arrived in NYC on Saturday of a holiday weekend (perhaps the 4th of July), stayed on Ellis Island 3 days, bound for Chicago to live with "some distant relatives" or "an uncle" named Niels Hansen.a Mostly CM's only error was that the holiday weekend was Labor Day, not July 4. CM's age was listed as 21 when his immigration was recorded at Ellis Island on Tuesday, September 8,1903, the day after Labor Day. His entry record confirms the name of the ship, his destination, and the name of his "uncle." Relatives in Chicago: CM said that the family of Niels Hansen had moved to Chicago just before his arrival in the U.S. because of a major flood that drove them from Kansas City. CM said that he began work as a tailor's apprentice in November of the year he turned 16. The apprenticeship lasted for 5 years. Yes History books mention an unusually large flood that inundated vast regions of Kansas City during May and June of 1903. Yes The 1901 Danish census lists CM's occupation as "tailor's apprentice" and indicates that he had moved from Skaarup (the village of his birth) to Skanderborg (a regional city) in 1898, thus at age 15 or 16. From U.S. immigration records, we know he left for the U.S. five years later, in 1903. CM said that he was employed by Continental Can Company for 21 years. Yes Company records show that CM worked at Continental Can from 1929 to 1950. Apprenticeship: Employment: age 31, from TB age 92, in Aarhus age 79, in Horsens The village of Skaarup is in the parish of Fruering. •CM showed some confusion about the name of Niels Hansen. He first called him "Hans Hansen" but later corrected himself. Apparently, he had two relatives in Chicago with similar names, which were easily confused (especially after 90 years). It appears that Niels Hansen was not a real uncle, but some distant relative whom we have not yet been able to identify based on Danish records. This general usage of the term "uncle" is not uncommon in either Danish or English. point during adult life, it is not at all plausible that the impostor could have possessed the detailed and accurate knowledge of CM's life and family that has emerged in our interviews with him. In these extensive interviews, we have found no errors or inconsistencies in his story, compared to the available documentary evidence, other than those reported in Table 2 (for example, the mistaken age at death for his brother Julius, or the confusion about the name of his "uncle," Niels Hansen), and it seems that these small errors can reasonably be attributed to lapses of Considering the consistency of the documentary evidence regarding CM's age and date of birth, and the high degree of agreement between the recorded evidence and CM's account of his life and family history, there appears to be no room to doubt the authenticity of this case. The consistency of the record until the time he left Denmark at age 21, as well as the absence of any evidence of younger siblings, is convincing proof that there could not have been a switch of identity during his early life. If someone other than CM had assumed his identity at some Vol. 36, No. 6,1996 785 memory. Therefore, we are convinced that CM is truly 114 years old. Significance of the Case The case of CM is significant because it appears to define (and redefine) the limits of male human longevity. Of course, more extreme cases of exceptional longevity have been documented for women. Most notably, at the age of 121 years, JC of Aries, France, appears almost certainly to be the oldest human alive today and quite possibly the oldest human to have ever lived (Robine & Allard, 1995). What evidence supports our assertion that CM may be the male version of JC? First, let us consider the question of whether CM, at 114 years old, may be the oldest living man in the world. It will not be possible to substantiate this claim beyond a shadow of a doubt. In most countries, inadequate recordkeeping makes it impossible to verify the ages of persons who make claims of exceptional longevity. Therefore, we cannot determine the age of the oldest persons living in a vast portion of the world today. Of necessity, our investigation will be limited to those parts of the world where accurate recordkeeping permits a reliable determination of the age of the oldest living individuals. By consulting with colleagues from various countries, we have been able to determine the ages of the oldest men in several countries. The most reliable records come from countries with complete population registers, such as the Scandinavian countries (Denmark, Sweden, Norway, and Finland) and Japan. According to reports available in late 1995, however, there were no living men older than 109 years in any of these countries (see Appendix, Note 5). In France, where an extensive study of centenarians has been carried out in recent years, there are only two documented cases of male supercentenarians (i.e., individuals at least 110 years old) in recent years. One of these men died at age 111 during December 1995; the other was still alive at last report and was to celebrate his 111th birthday in July 1996 (Jean-Marie Robine, personal communication, March 25, 1996). Thus, to our knowledge, CM is about 3 years older than the next oldest living man on the planet. Of course, it is always possible that there may be men in other parts of the world who are older than 114 years, but for lack of reliable administrative records we could never verify their age. It is worth noting that even in a country like the United States, complete and reliable birth registration is of relatively recent origin (U.S. vital registration became complete only in 1933, when Texas became the last state to join the system). Therefore, the opportunity to identify a person of extreme old age and to check rigorously the accuracy of the report is limited to a fairly small collection of countries. In the case of CM, we have enjoyed the good fortune that he was born in Denmark, where the tradition of detailed recordkeeping has helped us to verify his date of birth. To our knowledge, this is the first case of an immigrant supercentenarian where adequate documentation has been found in his country of birth. 786 It may be instructive to consider also the situation of China, with the world's largest national population. It is generally believed that age reporting is fairly reliable in China — especially among the Han majority, who comprise about 94% of the total — thanks in part to the use of the Chinese calendar and also to the social importance of a person's age (Coale, 1984). Recent tabulations of the 1990 Chinese census show that there are around 6400 centenarians in China, or about 5 per million population, which does not seem implausible (see Appendix, Note 6). Excluding all minority populations, where age reporting is thought to be less reliable, there were seven men with a recorded age of 113 or more in 1990 (Zeng Yi, personal communication, August 7, 1995). It is possible, of course, that some of these reports are genuine, but adequate verification is impossible given the absence of birth records or other corroborating evidence. On the basis of this limited investigation, is it reasonable to conclude that CM is without a doubt the oldest man in the world? Our answer is "no." It appears accurate, however, to state that he is the oldest living man whose age has been reliably verified. It also seems plausible that he may be the oldest man in the world for the following reasons. First, it is reasonable to expect that the oldest individuals would be found in the countries with the highest probabilities of survival especially at advanced ages. In most cases, the countries with the most reliable data (e.g., Japan, the Scandinavian countries, France) are also the countries with the world's lowest old-age mortality (see Appendix, Note 7). Therefore, our failure to find a living man in any of these countries who is as old as, or older than, CM suggests strongly that there may not be any such men in the entire world. Furthermore, the distance between CM and his closest known competitor, almost three years, also supports the belief that CM may indeed be the oldest man alive today. Next, let us consider the question of whether CM may be the oldest man who has ever lived. Here, obviously, the task is even more daunting than before, since all countries lack reliable records if we probe far enough into the distant past. Furthermore, false reports of super-longevity have been commonplace and, with the passing of time, become more and more difficult to disprove. Experienced students of this subject agree that, at least historically, the majority of claims of exceptional longevity have probably been false. For example, the number of centenarians reported in many countries, including the United States as recently as 1980, may be inflated by a factor of two or more (Kannisto, 1988; U.S. Bureau of the Census, 1987). In such cases, the ratio of fanciful to actual cases among supercentenarians (those over 110 years) is usually even higher (and in most cases is probably infinity). A number of detailed studies have investigated the accuracy (or rather, the inaccuracy) of various reported cases of exceptional longevity. In the last century, Thorns (1873) devoted an entire book to debunking a number of widely celebrated claims of The Gerontologist super-longevity in England. More recently, purported cases of individuals living to age 120,130, and beyond have been widely discussed and subsequently dismissed by the scientific community (Bennett & Carson, 1986; Mazess & Forman, 1979; Medvedev, 1974; Palmore, 1984; Thorson, 1995). The most heavily advertised of these cases were those from the state of Georgia (in the former USSR) and the village of Vilcabamba in Ecuador. In the case of Vilcabamba, the investigator from Harvard who had originally certified the "authenticity" of the reports later felt obliged to admit his error publicly (Leaf, 1981). The accuracy of reported age at death in several national statistical systems appears to have improved over time, although no country had fully reliable aggregate records before 1860 (Wilmoth & Lundstrom, 1996). In all countries today, it is necessary to conduct a thorough investigation of all reported supercentenarians before certifying their accuracy. Minimally, the person's stated age must be checked against birth records and other documents to demonstrate a consistency in the reported (or implied) date of birth. For a rigorous investigation, however, it is also necessary to consider (and to dismiss) the possibility that the observed individual could be an impostor who, for some reason, has assumed the identity of an older person who is now dead. Applying these standards, we are certain that CM is indeed 114 years old, but we have not found any other well documented cases of a man living to this age. Historically, the next oldest man (after CM) whose age appears to have been adequately verified was an Englishman named John Evans (JE), who died at the age of 112 years and 295 days in 1990 (Thatcher, 1992). The Office of Population Censuses and Surveys checked JE's age against his birth record. Although their investigation was by no means exhaustive, the plausibility of the case is also supported by the publicity that it received while JE was still living and by the apparent absence of challenges to its accuracy. At the age of 110, JE gave testimony in a court case involving a disputed right-of-way. The court relied upon JE's recollection of the historical basis of the right-of-way, since he was recognized as the only person with a knowledge of the situation who was old enough to remember that far into the past (A. Roger Thatcher, personal communication, August 3, 1995). If JE's age was misrepresented, the inaccuracy would likely have been exposed during the court case. We know of only two cases of men who reportedly lived more than 113 years where the authenticity of the case has been, and perhaps continues to be, accepted by some students of the subject. In both cases, however, we believe that the weight of the evidence suggests that the reports are more likely inaccurate than accurate. The best known is the case of a Japanese man, Shigechiyo Izumi (SI), whose age at death is still listed as the oldest ever in The Guinness Book of Records and has been cited frequently in the news media. It is claimed that Si's age was 120 years and 237 days at the time of his death in 1986. Vol.36, No. 6,1996 This case has now been rejected by almost all experts who are familiar with it, including the Japanese man who originally brought it to the attention of Guinness (Kannisto & Thatcher, 1993; Matsuzaki, 1988; Wilmoth & Lundstrom, 1996), and the common belief is that SI was in fact "only" 105 years old at the time of his death. The case of Pierre Joubert (PJ) of Quebec, who was reportedly age 113 years and 124 days when he died in 1814, has been less widely discussed. According to Bowerman (1939), the authenticity of this case was "vouched for by the statistician of the Canadian Census in 1878 after'a thorough investigation.'" Bowerman also cites Young (1905), who noted that "this laborious investigation appears to me to have been minutely and effectively completed." Both Bowerman and Young are respected authorities on the authenticity of early centenarians, although they appear to have been fooled in this situation. A more recent investigation based on genealogical records has revealed that the reputed super-longevity of Pierre Joubert was indeed a case of mistaken identity, whereby the deaths of father and son (both having the same name) were confused (Charbonneau, 1990). Conclusion We have concluded that CM is the first properly verified case of a 114-year-old man in human history. It is possible, of course, that there are other men who attained this age but escaped detection, perhaps because verification was impossible due to an absence of reliable administrative records. There is the risk that, as we improve our efforts to verify cases of exceptional longevity, we will create the appearance of an increase in their frequency or the illusion of an upward trend. These pitfalls cannot be avoided if we focus our attention only on case studies of extremely long-lived individuals. Therefore, the proper analysis of secular trends in extreme longevity must be carried out on fixed populations (Wilmoth & Lundstrom, 1996), with case studies merely supplementing the trend analysis. Still lacking in our overall investigation of this topic, however, is an adequate theoretical investigation of the relationship between the trend in extreme longevity for some subpopulation with a long series of reliable data (for example, the national populations of Sweden or Denmark) and the analogous trend for the entire world population. Case studies of the oldest humans who have ever lived are the empirical complement to such a theoretical analysis. References Bennett, N. C , & Carson, L. K (1986). Extraordinary longevity in the Soviet Union: Fact or artifact? The Gerontologist, 26, 358-361. Bowerman, W. C. (1939). Centenarians. Transactions — Actuarial Society of America, 40, 361-378., Charbonneau, H. (1990). Pierre Joubert a-t-il v6cu 113 ans? MGmoires de /a Soci6t6 C6n6alogique Canadienne-Franqaise, 41(1), 45-48. Coale, A. J. (1984). Rapid population change in China: 1952-1982. National Research Council Committee on Population and Demography, Report No. 27. Washington, DC: National Academy Press. Jeune, B. (1995). In search of the first centenarians. In B. Jeune & J. Vaupel 787 (Eds.), Exceptional longevity: From prehistory to the present. Odense, Denmark: Odense University Press. Kannisto, V. (1988). On the survival of centenarians and the span of life. Population Studies, 42(3), 389-406. Kannisto, V., & Thatcher, A. R. (1993, March). The plausibility of certain reported cases of extreme longevity. Paper presented at the Research Workshop on the Oldest-Old, Duke University, Durham, NC. Kannisto, V. (1994). Development of oldest-old mortality, 1950-1990: Evidence from 28 developed countries. Odense, Denmark: Odense University Press. Leaf, A. (1981). Statement regarding the purported longevous peoples of Vilcabamba. In H. J. Wershow (Ed.), Controversial issues in gerontology. New York: Springer. Manton, K. C , & Vaupel, J. W. (1995). Survival after the age of 80 in the United States, Sweden, France, England, and Japan. 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Received December 19, 1995 Accepted June 19, 1996 Appendix Notes 1. Two authors of this article are Danes and have spoken with CM in Danish. 788 2. The estimated mean adult height for Danish men of CM's generation is around 169 cm, with a standard deviation of about 6.5 cm (Jesper Boldsen, personal communication, 8/10/95). Thus, CM's adult height is approximately one standard deviation below the mean for men in his cohort, or around the 16th percentile. If we consider that a reasonable measurement error would be around 2 cm in either direction, then we would have argued by this criterion that any Danish man with a height between 160.6 and 164.6 cm would have possessed the necessary physical description. However, the probability that the height a randomly chosen (male) Dane from CM's generation would fall in this range is only around 12 percent. For men of a younger generation, who tend to be taller, a height in this range would be even less likely. 3. The minimum height required for conscription in the Danish army during this time was 160.8 cm (Jesper Boldsen, personal communication, 8/10/95). Assuming CM was fully grown at the time of the 1905 physical exam, CM's ultimate adult height was about 2 cm above this limit. It is clearly possible, however, that he was still below this limit some 4-5 years earlier, around the age of 18 or 19. 4. We know that CM's parents lived continuously in the parish of Fruering beginning in 1869. CM's oldest brother was born before his parents moved to Fruering. Afterwards, the birth registry in Fruering shows 5 children born to CM's parents, of which CM was the last. The Danish censuses of 1890 and 1901 also confirm that there were only 6 children in the family, and by 1901 CM's mother was 59 years old and thus surely past the age of reproduction. 5. This conclusion is based on our own investigation, supplemented by personal communications from Hans Lundstrom (8/4/95) and Shiro Horiuchi (12/2/95). 6. According to this estimate, the prevalence of centenarians in China is still below the level observed in a group of industrialized countries in 1960 (Kannisto, 1988), and well below the prevalence of around 50 centenarians per million observed in most industrialized countries today (Kannisto, 1994; Wilmoth, 1995). 7. Some authors contend that the United States has the lowest old-age mortality in the world (Manton & Vaupel, 1995), although there is no doubt that the quality of U.S. mortality data, at least at extreme ages, is inferior to the other countries cited here (Wilmoth & Lundstrom, 1996). The Gerontologist
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