All-cause mortality over a three-year period among community-dwelling older adults in Southern Brazil

Abstract

Objective: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. Methods: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016–2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). Results: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 – 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 – 6.2), widowhood (HR = 2.2; 95%CI 1.4 – 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 – 4..6), current smoking (HR = 2.1; 95%CI 1.2 – 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 – 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 – 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 – 5.7). Conclusion: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.

Employment in old age and all‐cause mortality: A systematic review

“…Five studies involved selected communities, 15,17,22,24,27 and the others used a nationwide sample for analysis 14,16,18–21,23,25,26 . Eight articles were published before 2000, 14,17,1921,25–27 and the other six were published after 2001 15,16,18,22–24 . The baseline data of 13 studies were collected before 2000 14,16–27 …”

“…Other studies separately used housework in the exposure variable: three studies treated housework as working status, 17,25,26 while one study allocated housewives to the same group comprising unemployed and retired 18 . Regarding all‐cause mortality, 12 studies referred to official records such as the National Death Index and pension payment record 14–16,18–23,25–27 . The other two studies revisited or mailed participants to assess whether they were still alive 17,24 …”

“…15 Eight of 14 studies were derived from Asian countries. [16][17][18][19][22][23][24]27 Five studies involved selected communities, 15,17,22,24,27 and the others used a nationwide sample for analysis. 14,16,[18][19][20][21]23,25,26 Eight articles were published before 2000, 14,17,1921,[25][26][27] and the other six were published after 2001.…”

“…This resulted in 11 articles with three additional eligible articles identified by reviewing papers citing the 11 selected articles. In total, 14 articles were considered suitable for the analysis 14–27 …”

“…Table 1 summarizes the designs of the 14 studies, including the study country, publication year, exposure variable, outcome variable, covariates, follow‐up period and statistical approach. Of 14 articles, four were from Japan, 22–24,27 three from the United States, 14,25,26 two from Taiwan 16,19 and Israel, 20,21 and one from Thailand, 17 South Korea 18 and Brazil 15 . Eight of 14 studies were derived from Asian countries 16–19,22–24,27 .…”