Changes in Psychosocial Conditions and Eventual Mortality in Community-residing Elderly People

We evaluated the association between changes in psychosocial conditions (assessed in 1992 and 1998) and subsequent mortality through 2001 among 741 Japanese elderly people living in a city located on Osaka in 1992. After adjustment for potential predictors of mortality, the relative risk of mortality, compared with subjects who continued to participate in social activities, was 1.44 (95% confidence interval [CI]: 0.47-4.40), 4.03 (95% CI: 2.11-7.67), and 2.31 (95% CI: 1.28-4.17) for those who started, discontinued, and did not participate at any time, respectively. The multivariate-adjusted relative risk of mortality, compared with those who did not find human relationships difficult in either survey, was 0.88 (95% CI: 0.26-3.05) for those who did not find such relationships difficult in the second survey, 1.73 (95% CI: 1.03-2.88) for those who occasionally found them difficult, and 6.62 (95% CI: 2.43-18.03) for those who continuously did so. The multivariate-adjusted relative risk of mortality, relative to those who consistently considered life worth living (Ikigai), was 0.72 (95% CI: 0.28-1.87), 2.22 (95% CI: 1.44-3.42), and 1.46 (95% CI: 0.65-3.31) for those who found, lost, and did not find life worth living in either survey, respectively. Deterioration in psychosocial conditions as well as continuously poor psychosocial conditions may be an important determinant of mortality risk for elderly people.