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Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study
Julián Benito-León1, Elan D Louis, Jesús Rivera-Navarro
1The Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain. jbenitol@meditex.es
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.
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