Abstract
Perhaps nowhere in the field of human ageing is the difference between men and women more lopsided than survival to extreme age. 85% of centenarians are women and just 15% are men. Though far fewer, men appear to be more functionally fit compared to women. This apparent paradox is likely due to men having substantially higher mortality risk associated with age-related diseases so that those who survive to very old ages do so because they are a cohort of select survivors, especially relative to women. Numerous hypotheses have been proposed for underlying systemic and cellular mechanisms for why women age so differently from men, but thus far there are no clear answers. Findings from the New England Centenarian Study and studies supporting the grandmother hypothesis suggest that women are responsible for the evolution of longevity-associated genes which enable us to live 30–40 years beyond the cessation of reproduction.