Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T19:35:39.325Z Has data issue: false hasContentIssue false

The relationship between worthlessness and mortality in a large cohort of Chinese elderly men

Published online by Cambridge University Press:  18 October 2010

Samuel Y. Wong*
Affiliation:
School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
Jason C. Leung
Affiliation:
Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR
Jean Woo
Affiliation:
Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong SAR Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR
*
Correspondence should be addressed to: Professor Samuel Y.S. Wong, 4/F, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Phone: +852 2252-8774; Fax: +852 2606-3500. Email: [email protected].

Abstract

Background: This study explored the relationship between “worthlessness” and all cause non-suicide mortality in Chinese elderly men.

Methods: Data from interviews of 1999 men aged 65 years and over were collected. Clinically significant depressive symptoms were measured using the validated Chinese version of Geriatric Depression Scale. “Worthlessness” was defined by one of the 15 questions from the Geriatric Depression Scale with a yes/no response. All-cause mortality over six years was collected using data from the National Death Registry with adjudication by 4-monthly telephone interviews. Two men were excluded after suicide death.

Results: Age-adjusted mortality rates at five years were 44.3 and 23.9 per 1,000 person years for those who felt “worthless” and those did not, respectively. The adjusted relative risk for all-cause mortality associated with feeling worthless was 1.34 (95% CI: 1.02–1.76) after adjusting for potential confounders that included age, marital status, education, smoking, alcohol consumption, number of chronic diseases, self-rated health, body mass index, cognitive status, physical activity, occupation and maximum lifetime income. There was no statistically significant association between other depressive symptoms or overall depression and mortality.

Conclusion: Worthlessness may be independently associated with all-cause mortality in Chinese elderly men.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

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

Chang, A. M. and Mackenzie, A. E. (1998). State self-esteem following stroke. Stroke, 29, 23252328.Google Scholar
Everson, S. et al. (1996). Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosomatic Medicine, 58, 113121.Google Scholar
Everson-Rose, S. A., House, J. S. and Mero, R. P. (2004). Depressive symptoms and mortality risk in a national sample: confounding effects of health status. Psychosomatic Medicine, 66, 823830. doi:10.1097/01.psy.0000145903.75432.1f.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Fredman, L. et al. (1989). The association between depressive symptoms and mortality among older participants in the epidemiologic catchment area-piedmont health survey. Journal of Gerontology, 44, S149156. doi:10.1093/geronj/44.4.S149Google Scholar
Fung, L. C., Lui, M. H., and Chau, J. P. (2006). Relationship between self-esteem and the occurrence of depression following a stroke. Journal of Clinical Nursing, 15, 505506.Google Scholar
Idler, E. L. and Benyamini, Y. (1997). Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 2137.CrossRefGoogle ScholarPubMed
Katzman, R. et al. (1988). A Chinese version of the Mini-mental State Examination; impact of illiteracy in a shanghai dementia survey. Journal of Clinical Epidemiology, 41, 971978. doi:10.1016/0895-4356(88)90034-0Google Scholar
Kutner, N. G., Brogan, D. and Fielding, B. (1997). Physical and psychosocial resource variables related to long-term survival in older dialysis patients. Geriatric Nephrology and Urology, 7, 2328.CrossRefGoogle ScholarPubMed
Lai, D., Tong, H., Zeng, Q. and Xu, W. (2010). The factor structure of a Chinese Geriatric Depression Scale-SF: use with lone elderly Chinese in Shanghai, China. International Journal of Geriatric Psychiatry, 25, 503510.Google Scholar
Lam, C. L. K., Tse, E. Y. Y. and Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Quality of Life Research, 14, 539547.Google Scholar
Leary, M. R. and MacDonald, G. (2003). Individual differences in self-esteem: a review and theoretical integration. In Leary, M. R. and Tangney, J. P. (eds.), Handbook of Self and Identity. New York: Guilford Press.Google Scholar
Lee, H. B., Chiu, H. F. K., Kowk, W. Y. and Leung, C. M. (1993). Chinese elderly and the GDS short form: a preliminary study. Clinical Gerontologist, 14, 3742.Google Scholar
Murphy, J. M., Monson, R. R., Olivier, D. C., Sobol, A. M. and Leighton, A. H. (1987). Affective disorders and mortality: a general population study. Archives of General Psychiatry, 44, 473480.Google Scholar
Penninx, B. W. J. H., Geerlings, S. W., Deeg, D. J. H., van Eijk, J. T. M., van Tilburg, W. and Beekman, A. T. F. (1999). Minor and major depression and the risk of death in older persons. Archives of General Psychiatry, 56, 889895. doi:10.1001/archpsyc.56.10.889Google Scholar
Schulz, R., Beach, S. R., Ives, D. G., Martire, L. M., Ariyo, A. A. and Kop, W. J. (2000). Association between depression and mortality in older adults: the Cardiovascular Health Study. Archives of Internal Medicine, 160, 17611768.Google Scholar
Stamatakis, K. A., Lynch, J., Everson, S. A., Raghunathan, T., Salonen, J. T. and Kaplan, G. A. (2004). Self-esteem and mortality: prospective evidence from a population-based study. Annals of Epidemiology, 14, 5865. doi:10.1016/S1047-2797(03)00078-4.CrossRefGoogle ScholarPubMed
Stern, S. L., Dhanda, R. and Hazuda, H. P. (2001). Hopelessness predicts mortality in older Mexican and European Americans. Psychosomatic Medicine, 63, 344351.CrossRefGoogle ScholarPubMed
Tarlow, E. and Haaga, D. (1996). Negative self-concept: specificity to depressive symptoms and relation to positive and negative affectivity. Journal of Research in Personality, 30, 120127.Google Scholar
Vickery, C., Sherer, M., Evans, C., Gontkovsky, S. and Lee, J. (2008). The relationship between self-esteem and functional outcome in the acute stroke rehabilitation setting. Rehabilitation Psychology, 53, 101109.Google Scholar
Vogt, T., Pope, C., Mullooly, J. and Hollis, J. (1994). Mental health status as a predictor of morbidity and mortality: a 15-year follow-up of members of a health maintenance organization. American Journal of Public Health, 84, 227231. doi:10.2105/AJPH.84.2.227Google Scholar
Wassertheil-Smoller, S. et al. (1996). Change in depression as a precursor of cardiovascular events. Archives of Internal Medicine, 156, 553561.Google Scholar
Whooley, M. A. and Browner, W. S. (1998). Association between depressive symptoms and mortality in older women. Archives of Internal Medicine, 158, 21292135.Google Scholar
Wong, S. Y. S. et al. (2005). Depression and bone mineral density: is there a relationship in elderly Asian men? Results from Mr. Os (Hong Kong). Osteoporosis International, 16, 610615.Google Scholar
Wong, S., Mercer, S., Leung, J. and Woo, J. (2009). The relationship between clinically relevant depressive symptoms and episodes and duration of all cause hospitalization in southern Chinese elderly. Journal of Affective Disorders, 113, 272278.Google Scholar
Woo, J., Lynn, H., Leung, J. and Wong, S. Y. S. (2008). Self-perceived social status and health in older Hong Kong Chinese women compared with men. Women's Health, 48, 209234.Google Scholar
Wulsin, L. R., Vaillant, G. E. and Wells, V. E. (1999). A systematic review of the mortality of depression. Psychosomatic Medicine, 61, 617.Google Scholar