Does life satisfaction predict five-year mortality in community-living older adults?

Abstract

Objectives: Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death.

Method: 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible–Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death.

Results: 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity.

Conclusion: LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

Keywords:

• life satisfaction
• subjective well-being
• mortality
• Terrible–Delightful Scale

Acknowledgements

The authors would like to thank the other MSHA and CSHA investigators, and in particular Audrey Blandford. We would also especially like to thank the participants and their caregivers.

Additional information

Funding

The Manitoba Study of Health and Aging (MSHA) was funded primarily by Manitoba Health, with additional funding provided through the Canadian Study of Health and Aging by the Seniors Independence Research Program of the National Health Research and Development Program of Canada (Project No. 6606-3954-MC[S]).The Manitoba Study of Health and Aging (MSHA-2) was funded primarily by Manitoba Health's Health Communities Development Fund with additional funding provided through the Canadian Study of Health and Aging by the Seniors Independence Research Program of the National Health Research and Development Program of Health Canada (Project No. 6606-3954-MC[S]). The endorsement from these agencies is implied.