All-cause mortality and multimorbidity in older adults: The role of social support and loneliness

Olaya, Beatriz; Domènech‐Abella, Joan; Moneta, María Victoria; Lara, Elvira; Caballero, Francisco Félix; Rico-Uribe, Laura Alejandra; Haro, Josep María

doi:10.1016/j.exger.2017.10.001

Cited by 74 publications

(65 citation statements)

References 30 publications

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“…We selected covariates considered potentially important predictors for multimorbidity and HRQOL . These included age, race, body mass index, smoking status, geographic region, alcohol intake, coffee intake, marital status, and living alone.…”

Section: Methodsmentioning

confidence: 99%

“…We selected covariates considered potentially important predictors for multimorbidity and HRQOL. [22][23][24][25][26][27] These included age, race, body mass index, smoking status, geographic region, alcohol intake, coffee intake, marital status, and living alone. Additionally, in NHS, religious service attendance was available and adjusted for due to its strong inverse association with suicide mortality.…”

Section: Covariate Assessmentmentioning

confidence: 99%

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Multimorbidity and Mental Health‐Related Quality of Life and Risk of Completed Suicide

Wei

Mukamal

2018

J American Geriatrics Society

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Background Physical functioning indexed multimorbidity is strongly associated with long‐term mortality, but its role in poor mental health has not been quantified. Methods A total of 252 002 community‐dwelling adults in the Nurses’ Health Study (NHS), NHS II, and Health Professionals Follow‐up Study (HPFS) prospective cohorts reported physician‐diagnosed diseases and the Short Form‐36 over 8 years and had 24‐year follow‐up for suicide mortality. We quantified multimorbidity using a multimorbidity‐weighted index (MWI). We used multivariable‐adjusted proportional hazards models with competing risks for suicide mortality and mixed‐effects models to estimate mental health‐related quality of life (HRQOL). Results Multimorbidity was associated with an increased risk of suicide mortality in an approximately linear manner, with roughly two‐ to threefold higher risk in adults with the highest vs lowest quartile MWI in adjusted models: NHS hazard ratio (HR) = 3.01 (95% confidence interval [CI] = 1.48‐6.11); NHS II HR = 3.04 (95% CI = 1.82‐5.09); HPFS HR = 1.74 (95% CI = 1.08‐2.81). Greater MWI was associated with worse mental HRQOL 8 years later across all scales and the mental component summary (MCS) in a dose‐response manner. This association was attenuated but persisted after adjustment for baseline mental HRQOL and other covariates. Adults with the highest quartile MWI had lower MCS in adjusted models compared with those with the lowest quartile MWI: NHS ß = −0.61 (95% CI = −0.78 to −0.44); NHS II ß = −1.25 (95% CI = −1.44 to −1.06). Conclusion Multimorbidity is associated with substantially higher suicide mortality risk and worse mental HRQOL across all available scales, even when indexed to physical functioning. These results highlight the substantial mental health burden imposed by multimorbidity at all ages and sexes. J Am Geriatr Soc 67:511–519, 2019.

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Section: Methodsmentioning

confidence: 99%

Section: Covariate Assessmentmentioning

confidence: 99%

Multimorbidity and Mental Health‐Related Quality of Life and Risk of Completed Suicide

Wei

Mukamal

2018

J American Geriatrics Society

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“…Social and religious factors that result in greater social support, community involvement, and access to material and psychological help may also differ between Adventists and others . These factors can reduce stress and provide options for assistance that may also affect mortality . There is less evidence that they would affect cancer incidence.…”

Section: Discussionmentioning

confidence: 99%

“…39 These factors can reduce stress and provide options for assistance that may also affect mortality. 40,41 There is less evidence that they would affect cancer incidence.…”

Section: Discussionmentioning

confidence: 99%

Lower rates of cancer and all‐cause mortality in an Adventist cohort compared with a US Census population

Fraser

Cosgrove

Mashchak

et al. 2019

Cancer

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Background Previous research suggests that Adventists, who often follow vegetarian diets, live longer and have lower risks for many cancers than others, but there are no national data and little published comparative data for black subjects. Methods This study compared all‐cause mortality and cancer incidence between the nationally inclusive Adventist Health Study 2 (AHS‐2) and nonsmokers in US Census populations: the National Longitudinal Mortality Study (NLMS) and its Surveillance, Epidemiology, and End Results substudy. Analyses used proportional hazards regression adjusting for age, sex, race, cigarette smoking history, and education. Results All‐cause mortality and all‐cancer incidence in the black AHS‐2 population were significantly lower than those for the black NLMS populations (hazard ratio [HR] for mortality, 0.64; 95% confidence interval [CI], 0.59‐0.69; HR for incidence, 0.78; 95% CI, 0.68‐0.88). When races were combined, estimated all‐cause mortality was also significantly lower in the AHS‐2 population at the age of 65 years (HR, 0.67; 95% CI, 0.64‐0.69) and at the age of 85 years (HR, 0.78; 95% CI, 0.75‐0.81), as was cancer mortality; this was also true for the rate of all incident cancers combined (HR, 0.70; 95% CI, 0.67‐0.74) and the rates of breast, colorectal, and lung cancers. Survival curves confirmed the mortality results and showed that among males, AHS‐2 blacks survived longer than white US subjects. Conclusions Substantially lower rates of all‐cause mortality and cancer incidence among Adventists have implications for the effects of lifestyle and perhaps particularly diet on the etiology of these health problems. Trends similar to those seen in the combined population are also found in comparisons of black AHS‐2 and NLMS subjects.

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“…8,39 The mortality rates observed in the current study are lower than other reported estimates from the literature 8,38,39 and lower than age-and sex-specific estimates of mortality from the Canadian general population. 40 Lower mortality in the study population may be driven by underlying geographic variability in mortality rates that contribute to the Canadian population estimate and the established longevity benefits of companionship, 41,42 as cohabiting with another adult was a criterion for cohort entry in both study cohorts.…”

Section: Discussionmentioning

confidence: 99%

The clinical and economic burden among caregivers of patients with Alzheimer's disease in Canada

Szabo¹,

Lakzadeh²,

Cline

et al. 2019

Int J Geriat Psychiatry

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Objective To estimate the clinical and direct medical economic burden among Alzheimer disease (AD) caregivers using real‐world, longitudinal patient‐level data in Canada. Methods/Design This retrospective observational study assessed the clinical and direct medical economic burden among individuals who cohabitate with AD patients (“AD caregiver cohort”) compared with older adults who were cohabiting with another adult without dementia (“comparison cohort”) using real‐world data from the Southwestern Ontario database, a representative Canadian electronic health record (EHR) longitudinal EHR. Results The AD caregiver cohort (n = 2749; mild AD: n = 2254, moderate AD: n = 302, and severe AD, n = 193) had a similar or higher level of clinical and economic burden than the comparison cohort (n = 12 152). The overall AD cohort and caregivers of patients with mild AD had a similar clinical burden to the comparison cohort. Those caregiving for more severely affected AD patients had an increased risk of comorbidities and required more medication, physician attention, and hospital encounters compared with caregivers of less severe AD patients and the comparison cohort. Mean annual costs were higher among the AD caregiver cohort than the comparison cohort, and those caregiving for moderate and severe AD patients incurred the highest costs. Overall mortality was higher in the AD caregiver cohort compared with the comparison cohort. Conclusions Caregivers of patients with mild AD had a similar clinical and direct economic burden to older adults who were not dementia caregivers, whereas the burden among caregivers of moderate and severe AD patients was much greater.

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All-cause mortality and multimorbidity in older adults: The role of social support and loneliness

Cited by 74 publications

References 30 publications

Multimorbidity and Mental Health‐Related Quality of Life and Risk of Completed Suicide

Multimorbidity and Mental Health‐Related Quality of Life and Risk of Completed Suicide

Lower rates of cancer and all‐cause mortality in an Adventist cohort compared with a US Census population

The clinical and economic burden among caregivers of patients with Alzheimer's disease in Canada

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