The association between psychosocial status and mortality in older adults: evidence from the English Longitudinal Study of Ageing
Objectives
To evaluate the effect of psychosocial status on mortality risk among non-institutionalised older adults in England, controlling for selected demographic, health and lifestyle factors.
Participants
Cohort of 11 392 participants born on or before 29 February 1952 who responded to Wave 1 of the English Longitudinal Study of Ageing (ELSA), collected in 2002, and who participated in the Health Survey for England (HSE) survey in years 1998, 1999, or 2001.
Methods
The following three measures of psychosocial health, which were assessed at Wave 1, were included in the analysis: CASP-19, a measure of quality of life in early old age; the 12 item General Health Questionnaire (GHQ-12); and the Center for Epidemiologic Studies Depression Scale (CES-D). The number of negative statements agreed with or positive statements disagreed with were totalled separately for each of the three measures, resulting in scores in the range 0 to 19 for CASP-19, 0 to 12 for GHQ-12, and 0 to 8 for CES-D. Mortality status up to December 2006, as reported by ELSA in the Index file, was obtained from the Office for National Statistics. Logistic regression modelling was performed separately for each of the three measures, controlling for the following variables assessed at Wave 1: age, sex, marital status, highest educational qualification, smoking status, alcohol consumption, and self reported long-standing illness, disability and infirmity. The analysis was then replicated with a latent construct measured by CASP-19, GHQ-12, and CES-D.
Results
A total of 703 participants had died up to December 2006. The mean scores for participants who were identified as alive compared with participants who had died, for the three psychosocial measures, were: CASP-19 (3.75 and 6.02 respectively, p<0.001); GHQ-12 (1.24 and 2.12 respectively, p<0.001); and CES-D (1.53 and 2.44 respectively, p<0.001). Logistic regression analyses revealed that, after controlling for demographic, health, and lifestyle factors, CASP-19 (odds ratio (OR) = 1.10, 95% CI 1.07 to 1.13), GHQ-12 (OR 1.09, 95% CI 1.05 to 1.12), and CES-D (OR 1.13, 95% CI 1.09 to 1.18) all remained significant predictors of death by December 2006. Similar results were obtained using the latent construct.
Conclusion
ELSA offers a unique opportunity to investigate how demographic, health and lifestyle factors influence the ageing process within England. This analysis has established that there is an association between mood and mortality in older adults and suggests that an intervention trial mediating mood is worthwhile.
