The Nicoya region of Costa Rica: A high longevity island for elderly males

Data from a longitudinal follow up of 14,000 elderly Costa Ricans 1990-2011 show that the death rate ratio (DRR) among males of the Nicoya region is 0.72 (95% CI: 0.62 – 0.82) compared to the rest of Costa Rican males. The DRR for Nicoyan women is not significantly different from one. Accordingly, life expectancy at age 55 for Nicoyan men would be 31.1 years compared to the 26.0 years in Japan, the country with the highest life expectancy. We further explore genetic versus environmental determinants by examining differential effects by migration status: DRR of men born and living in Nicoya (relative to other Costa Ricans) is 0.56 (CI: 0.45 – 0.69), compared to the DRR of 0.87 of immigrants and of 1.10 of out-migrants. The Nicoyan advantage is concentrated in cardio-vascular mortality, with a DRR of 0.50 for non-migrant Nicoya men. Nicoyans do not show significant advantages in most traditional risk factors such as blood pressure or lipids, but do show advantages in three potential markers of stress: overnight urinary cortisol, serum Dehydroepiandrosterone sulfate (DHEAS), and Leukocyte Telomere Length. They also have significantly lower body weight, waist circumference, fasting glucose and disability (physical and cognitive) levels.