Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T16:02:04.416Z Has data issue: false hasContentIssue false
  • English
  • Français

General thoughts of death and mortality: findings from the Komo-Ise cohort, Japan

Published online by Cambridge University Press:  14 August 2018

A. Stickley ,
C. F. S. Ng ,
C. Watanabe ,
Y. Inoue ,
A. Koyanagi  and
S. Konishi
A. Stickley*
Affiliation:
The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, 141 89, Sweden Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
C. F. S. Ng
Affiliation:
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
C. Watanabe
Affiliation:
Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
Y. Inoue
Affiliation:
Carolina Population Center, The University of North Carolina at Chapel Hill, 123 West Franklin St, Chapel Hill, NC 27516, USA
A. Koyanagi
Affiliation:
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
S. Konishi
Affiliation:
Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195, USA
*
Author for correspondence: Andrew Stickley, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims

Death ideation (thinking about/wishing for one's own death, thinking that one would be better off dead) is linked to an increased mortality risk. However, comparatively little is known about more general thoughts of death (GTOD) where no wish to die or life value is expressed. This study examined whether GTOD predicted mortality in a community-based cohort of older adults.

Methods

Data came from the Komo-Ise cohort study in Gunma prefecture, Japan. The analytic sample comprised 8208 individuals (average age 61.3 (range 47–77)) who were asked in wave 2 of the study in 2000 if they had ‘Thought about death more than usual, either your own, someone else's or death in general?’ in the past 2 weeks. Death data were obtained from the municipal resident registration file. Cox proportional hazards regression analysis was used to examine associations.

Results

During the follow-up period (2000–2008), there were 672 deaths. In a model adjusted for baseline covariates, GTOD were significantly associated with all-cause mortality (hazards ratio 1.66, 95% confidence interval 1.20–2.29). Stratified analyses showed an association between GTOD and mortality in men, older subjects (⩾70 years), married individuals and those with higher social support.

Conclusions

GTOD are associated with an increased mortality risk among older citizens in Japan. Research is now needed to determine the factors underlying this association and assess the clinical relevance of screening for GTOD in older individuals.

Keywords

DeathepidemiologyJapanmortality
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 6 , December 2019 , pp. 662 - 669
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edn. Virginia, AR: APA.Google Scholar
Ardelt, M (2003) Effects of religion and purpose in life on elders’ subjective well-being and attitudes toward death. Journal of Religious Gerontology 14, 55–77.Google Scholar
Arndt, J, Vail, KE 3rd, Cox, CR, Goldenberg, JL, Piasecki, TM and Gibbons, FX (2013) The interactive effect of mortality reminders and tobacco craving on smoking topography. Health Psychology 32, 525–532.Google Scholar
Barth, J, Schumacher, M and Herrmann-Lingen, C (2004) Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic Medicine 66, 802–813.Google Scholar
Becker, CB (1999) Aging, dying, and bereavement in contemporary Japan. International Journal of Group Tensions 28, 59–83.Google Scholar
Bogers, IC, Zuidersma, M, Boshuisen, ML, Comijs, HC and Oude Voshaar, RC (2013) Determinants of thoughts of death or suicide in depressed older persons. International Psychogeriatrics 25, 1775–1782.Google Scholar
Boyle, PA, Barnes, LL, Buchman, AS and Bennett, DA (2009) Purpose in life is associated with mortality among community-dwelling older persons. Psychosomatic Medicine 71, 574–579.Google Scholar
Brunner, J, Bronisch, T, Pfister, H, Jacobi, F, Höfler, M and Wittchen, HU (2006) High cholesterol, triglycerides, and body-mass index in suicide attempters. Archives of Suicide Research 10, 1–9.Google Scholar
Chopik, WJ (2017) Death across the lifespan: age differences in death-related thoughts and anxiety. Death Studies 41, 69–77.Google Scholar
Cohen, CI, Colemon, Y, Yaffee, R and Casimir, GJ (2008) Racial differences in suicidality in an older urban population. The Gerontologist 48, 71–78.Google Scholar
Ein-Dor, T, Hirschberger, G, Perry, A, Levin, N, Cohen, R, Horesh, H and Rothschild, E (2014) Implicit death primes increase alcohol consumption. Health Psychology 33, 748–751.Google Scholar
Fanous, AH, Prescott, CA and Kendler, KS (2004) The prediction of thoughts of death or self-harm in a population-based sample of female twins. Psychological Medicine 34, 301–312.Google Scholar
Gesser, G, Wong, PT and Reker, GT (1987–88) Death attitudes across the life-span: the development and validation of the death attitude profile (DAP). Omega 18, 113–128.Google Scholar
Goldenberg, JL and Arndt, J (2008) The implications of death for health: a terror management health model for behavioral health promotion. Psychological Review 115, 1032–1053.Google Scholar
Hayes, J, Schimel, J, Faucher, EH and Williams, TJ (2008) Evidence for the DTA hypothesis II: threatening self-esteem increases death-thought accessibility. Journal of Experimental Social Psychology 44, 600–613.Google Scholar
Hioki, A and Tanaka, T (2004) Views of old age and death held by working-age men and women and their relationship to health-related behavior. Journal of Epidemiology 14, 23–31.Google Scholar
Infurna, FJ, Gerstorf, D, Ram, N, Schupp, J and Wagner, GG (2011) Long-term antecedents and outcomes of perceived control. Psychology and Aging 26, 559–575.Google Scholar
Iwasaki, M, Otani, T, Ohta, A, Yosiaki, S, Kuroiwa, M and Suzuki, S (2002a) Rural-urban differences in sociodemographic, social network and lifestyle factors related to mortality of middle-aged Japanese men from the Komo-Ise cohort study. Journal of Epidemiology 12, 93–104.Google Scholar
Iwasaki, M, Otani, T, Sunaga, R, Miyazaki, H, Xiao, L, Wang, N, Yosiaki, S and Suzuki, S (2002b) Social networks and mortality based on the Komo-Ise cohort study in Japan. International Journal of Epidemiology 31, 1208–1218.Google Scholar
Kalish, RA and Reynolds, DK (1977) The role of age in death attitudes. Death Education 1, 205–230.Google Scholar
Kessler, RC and Ustun, TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.Google Scholar
Khang, YH, Kim, HR and Cho, SJ (2010) Relationships of suicide ideation with cause-specific mortality in a longitudinal study of South Koreans. Suicide and Life-Threatening Behavior 40, 465–475.Google Scholar
Kim, ES, Strecher, VJ and Ryff, CD (2014) Purpose in life and use of preventive health care services. Proceedings of the National Academy of Sciences of the USA 111, 16331–16336.Google Scholar
Kotter-Grühn, D, Grühn, D and Smith, J (2010) Predicting one's own death: the relationship between subjective and objective nearness to death in very old age. European Journal of Ageing 7, 293–300.Google Scholar
Kriegsman, DM, Penninx, BW, van Eijk, JT, Boeke, AJ and Deeg, DJ (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology 49, 1407–1417.Google Scholar
Manzoli, L, Villari, P, Pirone, GM and Boccia, A (2007) Marital status and mortality in the elderly: a systematic review and meta-analysis. Social Science and Medicine 64, 77–94.Google Scholar
Mazzella, F, Cacciatore, F, Galizia, G, Della-Morte, D, Rossetti, M, Abbruzzese, R, Langellotto, A, Avolio, D, Gargiulo, G, Ferrara, N, Rengo, F and Abete, P (2010) Social support and long-term mortality in the elderly: role of comorbidity. Archives of Gerontology and Geriatrics 51, 323–328.Google Scholar
Mellqvist Fässberg, M, Östling, S, Braam, AW, Bäckman, K, Copeland, JR, Fichter, M, Kivelä, SL, Lawlor, BA, Lobo, A, Magnússon, H, Prince, MJ, Reischies, FM, Turrina, C, Wilson, K, Skoog, I and Waern, M (2014) Functional disability and death wishes in older Europeans: results from the EURODEP concerted action. Social Psychiatry and Psychiatric Epidemiology 49, 1475–1482.Google Scholar
Mirowsky, J (1997) Age, subjective life expectancy, and the sense of control: the horizon hypothesis. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 52, S125–S134.Google Scholar
Muramatsu, N and Akiyama, H (2011) Japan: super-aging society preparing for the future. The Gerontologist 51, 425–432.Google Scholar
O'Connell, H, Chin, AV, Cunningham, C and Lawlor, BA (2004) Recent developments: suicide in older people. British Medical Journal 329, 895–899.Google Scholar
Ono, Y, Tanaka, E, Oyama, H, Toyokawa, K, Koizumi, T, Shinohe, K, Satoh, K, Nishizuka, E, Kominato, H, Nakamura, K and Yoshimura, K (2001) Epidemiology of suicidal ideation and help-seeking behaviors among the elderly in Japan. Psychiatry and Clinical Neurosciences 55, 605–610.Google Scholar
Paykel, ES, Myers, JK, Lindenthal, JJ and Tanner, J (1974) Suicidal feelings in the general population: a prevalence study. British Journal of Psychiatry 124, 460–469.Google Scholar
Roberts, RE, Kaplan, GA, Shema, SJ and Strawbridge, WJ (2000) Are the obese at greater risk for depression? American Journal of Epidemiology 152, 163–170.Google Scholar
Robles, TF, Slatcher, RB, Trombello, JM and McGinn, MM (2014) Marital quality and health: a meta-analytic review. Psychological Bulletin 140, 140–187.Google Scholar
Rosengren, A, Orth-Gomér, K, Wedel, H and Wilhelmsen, L (1993) Stressful life events, social support, and mortality in men born in 1933. British Medical Journal 307, 1102–1105.Google Scholar
Routledge, C and Juhl, J (2010) When death thoughts lead to death fears: mortality salience increases death anxiety for individuals who lack meaning in life. Cognition & Emotion 24, 848–854.Google Scholar
Rurup, ML, Deeg, DJ, Poppelaars, JL, Kerkhof, AJ and Onwuteaka-Philipsen, BD (2011 a) Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis 32, 194–203.Google Scholar
Rurup, ML, Pasman, HR, Goedhart, J, Deeg, DJ, Kerkhof, AJ and Onwuteaka-Philipsen, BD (2011 b) Understanding why older people develop a wish to die: a qualitative interview study. Crisis 32, 204–216.Google Scholar
Scocco, P and De Leo, D (2002) One-year prevalence of death thoughts, suicide ideation and behaviours in an elderly population. International Journal of Geriatric Psychiatry 17, 842–846.Google Scholar
Shiner, B, Riblet, N, Westgate, CL, Young-Xu, Y and Watts, BV (2016) Suicidal ideation is associated with all-cause mortality. Military Medicine 181, 1040–1045.Google Scholar
Skoog, I, Aevarsson, O, Beskow, J, Larsson, L, Palsson, S, Waern, M, Landahl, S and Ostling, S (1996) Suicidal feelings in a population sample of nondemented 85-year-olds. American Journal of Psychiatry 153, 1015–1020.Google Scholar
Sone, T, Nakaya, N, Ohmori, K, Shimazu, T, Higashiguchi, M, Kakizaki, M, Kikuchi, N, Kuriyama, S and Tsuji, I (2008) Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study. Psychosomatic Medicine 70, 709–715.Google Scholar
Traphagan, JW (2004) Interpretations of elder suicide, stress, and dependency among rural Japanese. Ethnology 43, 315–329.Google Scholar
Vandervoort, D (1999) Quality of social support in mental and physical health. Current Psychology 18, 205–222.Google Scholar
Van Orden, KA, Simning, A, Conwell, Y, Skoog, I and Waern, M (2013) Characteristics and comorbid symptoms of older adults reporting death ideation. American Journal of Geriatric Psychiatry 21, 803–810.Google Scholar
Van Wijngaarden, E, Leget, C and Goossensen, A (2015) Ready to give up on life: the lived experience of elderly people who feel life is completed and no longer worth living. Social Science and Medicine 138, 257–264.Google Scholar
Wang, N, Iwasaki, M, Otani, T, Hayashi, R, Miyazaki, H, Xiao, L, Yosiaki, S, Suzuki, S, Koyama, H and Sakamaki, T (2005) Perceived health as related to income, socio-economic status, lifestyle, and social support factors in a middle-aged Japanese. Journal of Epidemiology 15, 155–162.Google Scholar
Supplementary material: File

Stickley et al. supplementary material

Stickley et al. supplementary material 1

Download Stickley et al. supplementary material(File)
File 111.9 KB