This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Centenarians and supercentenarians: a black swan. Emerging social, medical and surgical problems

Marco Vacante1, Velia D’Agata2, Massimo Motta1, Giulia Malaguarnera3, Antonio Biondi4, Francesco Basile4, Michele Malaguarnera2*, Caterina Gagliano5, Filippo Drago2 and Salvatore Salamone2

Author Affiliations

1 Department of Senescence, Urological and Neurological Sciences, Cannizzaro Hospital Via Messina 829, 95125, University of Catania, Italy

2 Department of Biomedical Sciences, Via S. Sofia, 87, 95123, University of Catania, Italy

3 International PhD programme in Neurosciences, University of Catania, Italy

4 Department of General Surgery, Section of General Surgery and Oncology, Vittorio Emanuele Hospital, Via Plebiscito 628 University of Catania, 95123 Catania, Italy

5 Department of Ophtalmology, Via S. Sofia 78, 95123, University of Catania, Italy

For all author emails, please log on.

BMC Surgery 2012, 12(Suppl 1):S36  doi:10.1186/1471-2482-12-S1-S36

Published: 15 November 2012


The Black Swan Theory was described by Nassim Nicholas Taleb in his book “The Black Swan”. This theory refers to “high-impact, hard-to-predict, and rare events beyond the realm of normal expectations”. According to Taleb’s criteria, a Black Swan Event is a surprise, it has a major impact and after the fact, the event is rationalized by hindsight, as if it had been expected. For most of human history centenarians were a rare and unpredictable phenomenon. The improvements of the social-environmental conditions, of medical care, and the quality of life caused a general improvement of the health status of the population and a consequent reduction of the overall morbidity and mortality, resulting in an overall increase of life expectancy. The study of centenarians and supercentenarians had the objective to consider this black swan and to evaluate the health, welfare, social and economic consequences of this phenomenon.