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Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys

Published online by Cambridge University Press:  23 September 2014

Richard A. Burns ,
Peter Butterworth ,
Colette Browning ,
Julie Byles ,
Mary Luszcz ,
Paul Mitchell ,
Jonathan Shaw  and
Kaarin J. Anstey
Richard A. Burns*
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University Canberra, ACT, Australia
Peter Butterworth
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University Canberra, ACT, Australia
Colette Browning
Affiliation:
School of Primary Health Care, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, VIC, Australia
Julie Byles
Affiliation:
Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
Mary Luszcz
Affiliation:
Flinders Centre for Ageing Studies and Department of Psychology, Flinders University, Adelaide, SA, Australia
Paul Mitchell
Affiliation:
Centre for Vision Research, Westmead Millennium Institute and Department of Ophthalmology, The University of Sydney, Sydney, NSW, Australia
Jonathan Shaw
Affiliation:
Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
Kaarin J. Anstey
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University Canberra, ACT, Australia
*
Correspondence should be addressed to: Dr Richard A. Burns, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Building 62A, Eggleston Road, Canberra 0200, ACT, Australia. Phone: +61-2-6125-3132; Fax: +61-2-6125-1558. Email: [email protected].
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Abstract

Background:

Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk.

Methods:

Participants (N = 14,019; women = 91%), including eventual decedents (n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk.

Results:

For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01; p < 0.001); more substantive was the risk of low physical health (HR = 1.04; p < 0.001). No mediation effects were observed.

Conclusions:

Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.

Keywords

death and dyingdepressionepidemiologygender differenceslongitudinal studies
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 739 - 746
Copyright
Copyright © International Psychogeriatric Association 2014 

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