Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)

• Published in: Age and ageing Vol. 39; no. 3; pp. 366 - 373
• Main Authors: Benito-León, Julián, Louis, Elan D., Rivera-Navarro, Jesús, Medrano, María José, Vega, Saturio, Bermejo-Pareja, Félix
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2010; Oxford Publishing Limited (England)
• Subjects: Aged; Aged, 80 and over; Cause of Death; Comorbidity; Demographic aspects; Elderly; Elderly people; Epidemiology; Female; Follow-Up Studies; Geriatric Assessment; Health aspects; Humans; Male; Morale; Morality; Mortality; Older people; Proportional Hazards Models; Prospective Studies; Psychiatric Status Rating Scales; Psychological aspects; Quality of Life; Reference groups; Relative risks; Research Paper; Risk Factors; Socioeconomic Factors; Spain; Spain - epidemiology; Surveys and Questionnaires; Spain; USA, Pennsylvania, Philadelphia
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afq028

Objective: the study aimed to assess the association between morale and mortality. Design: we used data from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Subjects: 2,516 older persons (mean age 75.7 years) participated in the study. Methods: Cox models were used to estimate risk of mortality. Morale was assessed using the Philadelphia Geriatric Center Morale Scale. Results: 489 (21.8%) participants died over a median follow-up of 5.9 years (range 0.1–7.7 years), including 253 (21.8%) deaths among 1,163 participants with low morale scores, 168 (19.3%) among 870 participants with moderate scores and 68 (14.1%) among participants with high scores. In an unadjusted Cox model, relative risk (RR) of mortality in participants with low morale scores = 1.69 (P < 0.001) and RR in participants with moderate scores = 1.47 (P < 0.01) were compared to the reference group (participants with high scores). In a Cox model that adjusted for a variety of demographic factors and co-morbidities, RR of mortality in participants with low morale scores = 1.35 (P <0.05) and moderate scores = 1.16 (not significant) were compared to the reference group. Conclusion: low morale may be an independent predictor of mortality in the elderly. By assessing morale, practitioners might be better positioned to identify patients with poorer prognoses.