Abstract
Disability and multimorbidity increase with aging and constitute a challenge for the health system. However, different individuals display different aging trajectories, and understanding the underlying relationships between lifespan and disease is fundamental for identifying the different patterns in human lifespan. A previous study explored associations between lifespan and age of onset of diseases of different organ systems, prevalence of escapers, and percentage of life free of disease (health span), comparing them between genders in Catalonian population. In this retrospective study, we analyzed a cohort of 41,063 old individuals (20,722 men, with a mean lifespan of 79 years [50–109], and 20,341 women, with a mean lifespan of 84 years [50–109]) deceased between 2014 and 2019 in Gipuzkoa (Basque Country, Spain) taken from the Basque Health Service electronic health records data lake and analyzed and contrasted the above cited characteristics. Longevity, defined by age above the mean lifespan of the population, showed a protective effect against developing diseases, with higher lifespans delaying the onset of all diseases both at single and multisystemic levels. Furthermore, individuals with the lowest and highest lifespans were the ones presenting the healthier profiles, with fewer systems altered. There were specific differences according to sex, with women exhibiting decreased mortality risk despite having greater multimorbidity and men having less multimorbidity. In addition, men reached the highest lifespans with a smaller number of comorbidities. These results define the aging trajectories of the Basque population, extend the characterization of the human aging, and provide insight into sex-specific differences in multimorbidity and survival risk.