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Between 1990 and 2015, the number of centenarians worldwide more than quadrupled. This study aimed to analyse the relationship between blood-based biomarkers and the likelihood of reaching 100\u00a0years of age in Catalonia (2015\u20132022), and to examine how biomarker variations during COVID-19 affected longevity. Using a retrospective cohort study based on primary care electronic health records from Catalonia, we compared centenarians with individuals aged 92 or older who died before reaching 100\u00a0years of age. We analysed anaemia, cholesterol, glycemia, kidney function, and liver function biomarkers. We employed multiple strategies to control for confounding including matching without replacement, adjusting for both observed confounders at both the individual and contextual level, and unobserved confounders, in particular spatial dependence. Our findings reveal that centenarians exhibit higher rates of chronic conditions, greater socioeconomic disadvantage, and increased neighbourhood inequality in urban areas. Biologically, longevity was linked to intermediate levels of ferritin and cholesterol, alongside lower glucose, creatinine, and uric acid levels. Glycaemic balance, indicated by HbA1c and fasting glucose, emerged as a key factor in survival to extreme old age. Additionally, biomarker improvements during the pandemic correlated with an increased likelihood of reaching centenarian age. These results emphasize the complex interplay between biological, behavioural, and contextual factors in determining longevity. While biomarkers provide valuable insights, they are insufficient indicators of healthy ageing. Future research should integrate multiple dimensions, among them, environmental, and social determinants for uncovering the mechanisms of longevity.<\/jats:p>","DOI":"10.1007\/s10522-025-10258-3","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T08:57:39Z","timestamp":1748249859000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Blood-based biomarkers in centenarians and non-centenarians: a matched, population-based retrospective cohort study using primary care records in Catalonia, Spain"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-6912","authenticated-orcid":false,"given":"Manuel A.","family":"Moreno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-4242","authenticated-orcid":false,"given":"Josep","family":"Vidal-Alaball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1882-0157","authenticated-orcid":false,"given":"Marc","family":"Saez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-690X","authenticated-orcid":false,"given":"Maria A.","family":"Barcel\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"issue":"1","key":"10258_CR1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1038\/s41591-019-0719-5","volume":"26","author":"S Ahadi","year":"2020","unstructured":"Ahadi S, Zhou W, Schussler-Fiorenza Rose SM, Sailani MR, Contrpois K, Avina M, Ashland M, Brunet A, Snyder M (2020) Personal aging markers and age types revealed by deep longitudinal profiling. 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The manuscript is an original contribution that has not been published before, whole or in part, in any format, including electronically. All authors will disclose any actual or potential conflicts of interest including any financial, personal, or other relationships with other people or organizations that could inappropriately influence or be perceived to influence their work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Data usage from the Information System for Research in Primary Care (Sistema d\u2019Informaci\u00f3 per al Desenvolupament de la Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria (SIDIAP)) is authorised by the Catalan Health Institute (Institut Catal\u00e0 de la Salut, ICS) and the Data Analysis Program for Health Research and Innovation (PADRIS, as it is known by its acronym in Spanish acronym). These public organisations ensure the protection of individuals\u2019 privacy through pseudo-anonymisation of the data. For linking with other public data sources, ICS or PADRIS serve as trusted third parties (TTPs) to perform the linkage process and provide the newly pseudo-anonymised dataset. In cases where access to personal data requires patient consent, the same TTPs are involved. SIDIAP does not provide re-identifiable information, implementing measures such as aggregations and deletions to maintain pseudo-anonymisation. All data management adheres to legal requirements, including the General Data Protection Regulation (EU) 2016\/679 and Organic Law 3\/2018 of 5 December, which safeguards personal data and digital rights. Secure servers were used for data storage, ensuring compliance with these regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As patient data extracted from the database were irreversibly pseudonymised and due to the retrospective nature of the study, the need to obtain informed consent was waived by the Ethics Committees of Fundaci\u00f3 Institut Universitari per a la Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"During the writing of the article the authors have not used any type of AI and AI-assisted technologies.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of generative AI and AI-assisted technologies"}}],"article-number":"115"}}