The MALVA (MAntova LongeVA) study: an investigation on people 98 years of age and over in a province of Northern Italy Paola Gueresi a,g, * , Leonarda Troiano b , Nadia Minicuci c , Massimiliano Bonafe ´ d,g , Gabriella Pini d , Gianfranco Salvioli e , Cesare Carani e , Luigi Ferrucci f , Liana Spazzafumo f , Fabiola Olivieri f , Giulia Cavrini a , Davide Valentini a , Claudio Franceschi d,f,g a Department of Statistical Sciences “Paolo Fortunati”, University of Bologna, Via Belle Arti 41, Bologna, Italy b Department of Biomedical Sciences, Section of General Pathology, University of Modena and Reggio Emilia, Modena, Italy c National Research Council, Institute of Neuroscience, Section of Padova, Aging Unit, Padova, Italy d Department of Experimental Pathology, University of Bologna, Bologna, Italy e Institute of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy f Italian National Research Centers on Aging (INRCA), Ancona and Firenze, Italy g Interdepartmental Center on Biocomplexity "L. Galvani", Bologna, Italy Received 16 July 2003; accepted 27 August 2003 Abstract The MALVA (MAntova LongeVA) study aims at investigating the socio-demographic, clinical and genetic characteristics of all subjects over 98 years of age residing in the province of Mantova (Northern Italy). In this paper we present the study protocol and the main demographic results. Absolute number, prevalence ratio and female/male ratio of the subjects aged 98 þ and of the centenarians in the Mantova province (370,645 inhabitants at 31st December 1997) were checked at the baseline of the study (31st March 1998) as well as in the two years preceding and following the study. A total of 117 subjects aged 98 þ (including 39 centenarians) were traced at 31st March 1998; the prevalence ratio was 31.6 per 100000 (12.1 for centenarians), and the female/male ratio was 6.3 (6.5 for centenarians). The distribution of the oldest old according to places of birth and residence was non-homogeneous across the provincial territory. Seventy-seven subjects (66% of the identified subjects) were enrolled in the study and administered a protocol including an interview about socio-economic conditions, lifetime habits and pathological and pharmacological case histories, as well as medical examination, performance-based tests and blood sample collection. Data on the socio-demographic characteristics and the health status of very old people in the province of Mantova are discussed and compared to findings from previous studies on Italian centenarians. q 2003 Elsevier Inc. All rights reserved. Keywords: Centenarians; Health status; Demography 1. Introduction In economic-developed countries a progressive increase of life expectancy has been occurring since about the mid of 19th century (Oeppen and Vaupel, 2002), and this phenomenon is particularly evident in the oldest old (Caselli et al., 2000). In particular, it has been estimated that the number of centenarians approximately doubled every 10 years since 1960, owing to the increased survival of people over 80 years of age (Vaupel and Jeune, 1995). A variety of factors, including the improving of nutrition, work activity, health service and medicine among others, contributed to this remarkable demographic phenomenon. However, the geographical distribution and the health status of the oldest old, as well as their economical and social conditions, have been addressed by few studies (Samuels- son et al., 1997; Andersen-Ranberg et al., 2001; Evert et al., 2003). In particular, to our knowledge, the relationship between the distribution of centenarians in a defined territory and the socio-geographical, historical and demo- graphical characteristics of the area in which they live has been largely neglected. Indeed, nonagenarians and cente- narians appear to be a unique model to investigate 0531-5565/$ - see front matter q 2003 Elsevier Inc. All rights reserved. doi:10.1016/j.exger.2003.08.006 Experimental Gerontology 38 (2003) 1189–1197 www.elsevier.com/locate/expgero * Corresponding author. Tel.: þ 39-051-2098242; fax: þ 39-051-232153. E-mail address: gueresi@stat.unibo.it (P. Gueresi).