Journal Article

Negative Affect and Mortality in Older Persons

Robert S. Wilson, Julia L. Bienias, Carlos F. Mendes de Leon, Denis A. Evans and David A. Bennett

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 158, issue 9, pages 827-835
Published in print November 2003 | ISSN: 0002-9262
Published online November 2003 | e-ISSN: 1476-6256 | DOI:
Negative Affect and Mortality in Older Persons

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The authors examined the relation of negative affect to mortality in the Religious Orders Study, a longitudinal cohort study of older persons, between 1994 and 2002. Participants were 851 Catholic clergy members without dementia at baseline (mean age, 75.4 (standard deviation, 6.9) years; 68% women). They completed standard measures of depressive symptoms, proneness to anxiety and anger, and patterns of anger expression at baseline and then underwent annual clinical evaluations for a mean of 4.7 (standard deviation, 2.7) years. The association of each scale with mortality was examined in proportional hazards models adjusted for age, sex, education, measures of cognitive function, lower limb function, chronic illness, smoking, alcohol, and obesity. During follow-up, 164 persons died. Measures of internally experienced negative affect, such as depressive symptoms and suppressed anger, were related to mortality, but measures of externally directed negative affect, such as the tendencies to be angry with others and to express anger overtly, were not. Persons with a high score (90th percentile) on a summary measure of internally experienced negative affect were nearly twice as likely to die as persons with a low score (10th percentile). The results suggest that negative affect in older persons, especially internally experienced distress, is associated with an increased mortality risk.

Keywords: aging; anger; anxiety; depression; mortality; prospective studies; survival analysis; Abbreviations: CES-D, Center for Epidemiologic Studies Depression; CI, confidence interval; SD, standard deviation.

Journal Article.  6364 words. 

Subjects: Public Health and Epidemiology

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