Long-lived individuals, such as centenarians, may harbor genetic or environmental advantages important for healthy aging. Populations with high prevalence of such individuals offer fertile ground for such research. However, precise phenotypes are required, particularly accurate age. Okinawa has among the world's highest reported prevalence of centenarians but, despite extensive study, no systematic validation of centenarian prevalence has been published. Therefore, we performed comprehensive age validation of a subset (8%) of the total centenarian population and assessed the reliability of the age registration system. Self-reported age was validated with several common methods and found to correlate well with documented age. Demographic methods, including assessment of age heaping, maximum age at death, centenarian proportions, and male to female ratios of centenarians indicate that the age registration system is reliable. We conclude that the high reported centenarian prevalence in Okinawa is valid and warrants further study for its genetic and environmental correlates.
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