The will-to-live and survival at old age: gender differences

In a previous study, the will-to-live (WTL) was presented as a parsimonious and easy to use indicator of well-being, perceived differently by men and women. This study evaluates the role of WTL in long-term survival of elderly men and women. In 1994, socio-demographic, psychosocial, and health characteristics were collected from a sample of 1,138 Israeli elderly persons (70+) by structured interviews. Data regarding survival were gathered 7.5 years later. Results indicated that WTL was significantly related to survival in univariate analyses. However, in multivariate Cox analyses, conducted separately on men and women, the will-to-live predicted survival only among women after adjusting for age, self-rated health (SRH) and psychosocial variables, so that the stronger the WTL, the higher the chances of survival for women. Age, WTL and SRH were the only statistically significant predictors of survival in women. Survival of men was predicted by age, daily functioning, SRH, working outside home or volunteering, and self-esteem. Our findings show that the WTL predicts long-term survival among elderly women, and therefore has a prognostic value. This strengthens its previously presented importance as a generalized indicator of well-being. These findings have practical implications for formal and informal caregivers.