A new blue zone? exceptional late-life survival in Bolotana, Sardinia.

Abstract

Background: Exceptional longevity in Sardinia has historically been associated with the original Sardinian Blue Zone. We investigated whether Bolotana, a small mountain municipality outside that area, exhibits a distinct late-life survival profile.

Methods: Using validated civil and parish records, we constructed sex-specific partial period life tables for 2021-2025. Late-life survival was defined as survival from age 70 onward and assessed through remaining life expectancy at age 70 (e₇₀) and conditional survival from age 70 to 100 [S_(70→100)]. Estimates were compared descriptively with Nuoro Province, Sardinia, and Italy, the original Sardinian Blue Zone, and published international benchmark. Statistical uncertainty was evaluated using parametric Poisson bootstrap. Sensitivity analyses included 2020-2025 and a period-matched 2015-2019 analysis.

Results: In 2021-2025, e₇₀ was 16.02 years in men (95% CI, 14.55-17.79) and 20.85 years in women (19.42-22.43); S_(70-100) was 4.92% (1.58-12.76) and 13.83% (7.33-23.75), respectively. Female estimates _(70-100) exceeded contemporary values for Nuoro Province, Sardinia, and Italy. Among international benchmarks, Bolotana women ranked second only to Hong Kong for both indicators, and S_(70→100) was more than three times that of U.S. women. Inclusion of 2020 to address the potential effects of COVID-19 produced modest reductions, whereas the period-matched 2015-2019 analysis yielded a less pronounced late-life survival profile, particularly for survival to age 100.

Conclusion: Bolotana exhibited a distinctive, predominantly female pattern of exceptional late-life survival and may be considered a candidate longevity blue zone. However, the magnitude of this advantage varied by calendar period. Longer observation and continued demographic validation, are required before Bolotana can be considered an established longevity blue zone.