Health Reports: Predictors of death in seniors

1994/95 to 2002/03

Senior women who suffered from psychological or financial stresses in 1994/95 were far more likely to die over the next eight years than those who did not have such problems, according to a new study.

The study's key finding was the importance of psychological distress as a predictor of death among women aged 65 or older. Psychological distress includes frequent feelings of sadness, worthlessness or hopelessness.

The analysis followed a group of about 2,400 seniors between 1994/95 and 2002/03 using data from the National Population Health Survey. These data were linked to information from the Canadian Mortality Database to examine the group's characteristics reported in 1994/95 with their vital status eight years later.

Psychological distress was a major factor for women, even when the study took into account other factors such as age, family and financial stress, level of education, major chronic diseases, smoking, weight and use of alcohol.

This finding corroborates previous research indicating the independent contribution of psychosocial factors to mortality. The results suggest that an individual's mental health, specifically psychological distress, can influence survival.

Among men aged 65 or older, the relationship between psychological distress and death was initially similar to that of women. However, the strength of the association diminished when chronic diseases were taken into account. In other words, for men, chronic diseases tended to offset the impact of the stress.

The stronger impact of psychological distress among women may result from their higher levels of distress. It might also indicate that men are more vulnerable to the effects of chronic, degenerative conditions, notably heart diseases and cancer.

Men with low education and those who were widowers were more likely to have died, compared with those who had higher levels of education and who were married.

Psychological distress strongly associated with death

Psychological distress was strongly associated with death. Of those seniors reporting high levels of psychological distress in 1994/95, about 62% of men and 44% of women had died eight years later. This compares with 37% of men and 25% of women at lower levels of distress.

Chronic disease more important for men

Among senior men, psychological distress remained positively associated with mortality even when age, financial and family stress, education and marital status were taken into account. But the impact of psychological distress was no longer statistically significant when the study took chronic diseases into account.

Low education, widowhood risk factors

For both sexes, the likelihood of dying during the eight-year period was higher among seniors who had not completed secondary education, compared with those who had.

In men, but not women, source of income was also a predictor of death. Those who relied on government pensions, income supplements or social assistance were more likely to have died than those who had other sources of income.

Men who were widowed had higher odds of dying than did those who were married or living with a partner. The protective impact of marriage for men with respect to mortality has been widely observed.

As expected, the study found that several health-related behaviours were related to the likelihood of dying. For example, chances rose among those who used to smoke or who were physically inactive.

The study also found that seniors who were underweight in 1994/95 were almost twice as likely to have died during the eight-year period. This may be an indicator of poor health and advanced age.

Definitions, data sources and methods: survey number 3225.

The article "Predictors of death in seniors" (82-003-SIE) is now available for free online. This study is one of five articles in the latest edition of the How Healthy are Canadians? series, an annual supplement to Health Reports (82-003-XIE, $17/$48; 82-003-XPE, $22/$63).

For more information, or to enquire about the concepts, methods or data quality of "Predictors of death in seniors," contact Kathryn Wilkins (613-951-1769; Kathryn.Wilkins@statcan.gc.ca), Health Statistics Division.

This year's annual report contains four other articles, which are also available for free online today (82-003-SIE). "Healthy living among seniors" demonstrates the importance of positive health behaviours, such as exercising regularly and eating fruit and vegetables. It also found that seniors who feel connected to their communities and those without a lot of stress in their lives are more likely to be in good health. For information about this release, contact Margot Shields (613-951-4177; Margot.Shields@statcan.gc.ca), Health Statistics Division.

"Dependency, chronic conditions and pain in seniors" found that dependence on others for help with dressing and bathing and with managing finances and running errands is often related to the pain that accompanies a chronic condition rather than the disease itself. Pain management can help delay or prevent debilitating effects and prolong independence. For information about this release, contact Jungwee Park (613-951-4598; Jungwee.Park@statcan.gc.ca), Health Statistics Division.

"Successful aging in health care institutions" concludes that many seniors who live in long-term care facilities feel positively about their health. Positive self-perceived health was related to participation in social and recreational activities and with having a close relationship with at least one staff member of the institution. For information about this release, contact Pamela L. Ramage-Morin (613-951-1760; Pamela.Ramage-Morin@statcan.gc.ca), Health Statistics Division.

The article "Seniors' health care use" (82-003-SIE, free) was released on February 7. A print compendium (82-003-SPE; $22), Health at Older Ages, will be available in March.