Simons LA. McCallum J. Friedlander Y. Simons J. Institution
University of New South Wales Lipid Research Department, St Vincent's Hospital, Sydney, NSW.
Predictors of mortality in the prospective Dubbo study of Australian elderly.
Australian & New Zealand Journal of Medicine. 26(1):40-8, 1996 Feb. Abstract
BACKGROUND: A prospective study in non-institutionalised Australian elderly 60 years and over commenced in Dubbo, NSW in 1988. AIM: To examine clinical and socio-demographic predictors of all-causes mortality. METHODS: The data were derived from a community-based sample comprising 1236 men and 1569 women followed for a median period of 62 months. RESULTS: Two hundred and thirty five men (19%) and 184 women (12%) died, 46% of male and 53% of female deaths respectively related to cardiovascular disease. In a proportional hazards model, the significant predictors of mortality were: older age, being married (relative risk [RR] = 0.71 for men, 0.74 for women), current smoking for men (RR = 3.11), taking more than three alcoholic drinks per day for men (RR = 0.37), prior coronary heart disease for men (RR = 1.36), severe hypertension for women (RR = 1.99), use of anti-hypertensive medication for men (RR = 1.74), diabetes for men (RR = 1.62), poor-fair self-rated health for women (RR = 1.74) and physical disability for men (RR = 1.72). Serum cholesterol was associated with mortality in a 'J-shaped' relationship in men and in a reciprocal relationship in women. Blood pressure predicted mortality in an incremental fashion below 75 years, but in older subjects lower pressure was associated with excess mortality. CONCLUSION: Some
predictors of mortality in the well elderly have been identified and a more extended period of follow-up will possibly resolve contradictory findings in some areas.