We observed a higher rate of SA in males relative to females in our cohort, results that have not been consistently observed in previous literature. Studies in the MacArthur Studies of Successful Aging observed that males were more likely to have better physical performance at baseline in a cohort of 70-79-year-olds with high function, consistent with our observations (Seeman et al. 1994). The studies by McLaughlin et al. of adults aged 65 and older, however, observed the opposite association between SA and gender (McLaughlin et al. 2010). A possible explanation for these differences is the definition of SA used. We attempted to use a definition as comprehensive as possible, integrating factors pertaining to physical and cognitive function, social engagement, and health, whereas other studies often used only one or two of these components. Another possible explanation for the larger number of SA males relative to females could be the effect of marital status on successful aging which has previously been indicated (Li et al. 2006). Our sample also had a greater proportion of successfully aged men (52% of men SA vs. 17% of women SA) who were currently married (78% of men currently married vs. 45% of women currently married).(2019) The relationship between gender, marriage, and SA has not been consistent across studies, with the majority finding no association; however, it merits further study. AGE: influences on measures of lower-extremity function in older male twins. J Gerontol A Biol Sci Med Sci: B. Cellini E, Nacmias B, Olivieri F, Ortenzi L, Tedde A, Bagnoli S, Petruzzi C, Franceschi C, Sorbi S (2018) Cholesteryl ester transfer protein (CETP) IV polymorphism and longevity in Italian centenarians. Mech Ageing Dev: 169-174. Cheng Q, Zhao Y, Lawson WE, Polosukhin VV, Johnson JE, Blackwell TS, Gailani D (2018) The effects of intrinsic pathway protease deficiencies on plasminogen-deficient mice. Blood: 3742-3750. Chung WH, Dao RL, Chen LK, Hung SI (2018) The role of genetic variants in human longevity. Ageing Res Rev (Suppl): S23-S32. Deelen J, Beekman M, Uh HW, Helmer Q, Kuningas M, Christiansen L, Kremer D, van der Breggen R, Suchiman HE, Lakenberg N, van den Akker EB, Passtoors WM, Tiemeier H, van Heemst D, de Craen AJ, Rivadeneira F, de Geus EJ, Perola M, van der Ouderaa FJ, Gunn DA, Boomsma DI, Uitterlinden AG, Christensen K,
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Breitner JC (2000) Performance characteristics of a two-stage dementia screen in a population sample. J Clin Epidemiol: 199-205. Kleiman RJ, Kimmel LH, Bove SE, Lanz TA, Harms JF, Romegialli A, Miller KS, Willis A, des Estages S, Kuhn M, Schmidt CJ (2011) Chronic suppression of phosphodiesterase A alters striatal expression of genes responsible for neurotransmitter synthesis, neurotransmission, and signaling pathways implicated in Huntington's disease. J Pharmacol Exp Ther: 378-389. Kleindorp R, Flachsbart F, Puca AA, Malovini A, Schreiber S, Nebel A (2011) Candidate gene study of FOXO3A, FOXO4A, and FOXO6 reveals no association with human longevity in Germans. Aging Cell: 618-621. Further study in this sample is needed to identify functional variations in genes such as QKI, PDE10A, and other genes in the region that might be responsible for promoting SA in these individuals. Acknowledgments We acknowledge the Vanderbilt CHGR DNA Resources core for processing some of the samples. Some of the samples used in thisL. D'Agostino RB Sr., Fitzpatrick AL, Franceschini N, Glazer NL, Gudnason V, Hofman A, Kaplan R, Karasik D, Kelly-Hayes M, Kiel DP, Launer LJ, Marciante KD, Massaro JM, Miljkovic I, Nalls MA, Hernandez D, Psaty BM, Rivadeneira F, Rotter J, Seshadri S, Smith AV, Taylor KD, Tiemeier H, Uh HW, Uitterlinden AG, Vaupel JW, Walston J, Westendorp RG, Harris TB, Lumley T, van Duijn CM and Murabito JM (2011) A meta-analysis of four genome-wide association studies of survival to age years or older: the cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. J Gerontol A Biol Sci Med Sci: 66(8): 851-861.

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