Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)
Identifieur interne : 002F52 ( Main/Corpus ); précédent : 002F51; suivant : 002F53Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)
Auteurs : Julin Benito-Len ; Elan D. Louis ; Jess Rivera-Navarro ; Mara Jos Medrano ; Saturio Vega ; Flix Bermejo-ParejaSource :
- Age and Ageing [ 0002-0729 ] ; 2010-05.
Abstract
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 0.17.7 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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DOI: 10.1093/ageing/afq028
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title><author><name sortKey="Benito Len, Julin" sort="Benito Len, Julin" uniqKey="Benito Len J" first="Julin" last="Benito-Len">Julin Benito-Len</name><affiliation><mods:affiliation>2 de Octubre, Madrid, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Louis, Elan D" sort="Louis, Elan D" uniqKey="Louis E" first="Elan D." last="Louis">Elan D. Louis</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Rivera Navarro, Jess" sort="Rivera Navarro, Jess" uniqKey="Rivera Navarro J" first="Jess" last="Rivera-Navarro">Jess Rivera-Navarro</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Medrano, Mara Jos" sort="Medrano, Mara Jos" uniqKey="Medrano M" first="Mara Jos" last="Medrano">Mara Jos Medrano</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Vega, Saturio" sort="Vega, Saturio" uniqKey="Vega S" first="Saturio" last="Vega">Saturio Vega</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Bermejo Pareja, Flix" sort="Bermejo Pareja, Flix" uniqKey="Bermejo Pareja F" first="Flix" last="Bermejo-Pareja">Flix Bermejo-Pareja</name><affiliation><mods:affiliation>2 de Octubre, Madrid, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:4EB8E03E64DA7993E5DEF97F89741E27350A9E7E</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1093/ageing/afq028</idno><idno type="url">https://api.istex.fr/document/4EB8E03E64DA7993E5DEF97F89741E27350A9E7E/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002F52</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title><author><name sortKey="Benito Len, Julin" sort="Benito Len, Julin" uniqKey="Benito Len J" first="Julin" last="Benito-Len">Julin Benito-Len</name><affiliation><mods:affiliation>2 de Octubre, Madrid, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Louis, Elan D" sort="Louis, Elan D" uniqKey="Louis E" first="Elan D." last="Louis">Elan D. Louis</name><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Rivera Navarro, Jess" sort="Rivera Navarro, Jess" uniqKey="Rivera Navarro J" first="Jess" last="Rivera-Navarro">Jess Rivera-Navarro</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Medrano, Mara Jos" sort="Medrano, Mara Jos" uniqKey="Medrano M" first="Mara Jos" last="Medrano">Mara Jos Medrano</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Vega, Saturio" sort="Vega, Saturio" uniqKey="Vega S" first="Saturio" last="Vega">Saturio Vega</name><affiliation><mods:affiliation></mods:affiliation></affiliation></author><author><name sortKey="Bermejo Pareja, Flix" sort="Bermejo Pareja, Flix" uniqKey="Bermejo Pareja F" first="Flix" last="Bermejo-Pareja">Flix Bermejo-Pareja</name><affiliation><mods:affiliation>2 de Octubre, Madrid, Spain</mods:affiliation></affiliation><affiliation><mods:affiliation></mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Age and Ageing</title><title level="j" type="abbrev">Age Ageing</title><idno type="ISSN">0002-0729</idno><idno type="eISSN">1468-2834</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-05">2010-05</date><biblScope unit="volume">39</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="366">366</biblScope><biblScope unit="page" to="373">373</biblScope></imprint><idno type="ISSN">0002-0729</idno></series><idno type="istex">4EB8E03E64DA7993E5DEF97F89741E27350A9E7E</idno><idno type="DOI">10.1093/ageing/afq028</idno><idno type="ArticleID">afq028</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-0729</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">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 0.17.7 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.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Julin Benito-Len</name><affiliations><json:string>The Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain</json:string><json:string>Centro de Investigacin Biomdica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain</json:string></affiliations></json:item><json:item><name>Elan D. Louis</name><affiliations><json:string>The G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA</json:string><json:string>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA</json:string><json:string>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA</json:string><json:string>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA</json:string></affiliations></json:item><json:item><name>Jess Rivera-Navarro</name><affiliations><json:string>Department of Social Sciences, University of Salamanca, Salamanca, Spain</json:string></affiliations></json:item><json:item><name>Mara Jos Medrano</name><affiliations><json:string>Unit of Vascular Risk Factors, National Center for Epidemiology, ISCIII, Madrid, Spain</json:string></affiliations></json:item><json:item><name>Saturio Vega</name><affiliations><json:string>Arvalo Health Center, Arvalo, vila, Spain</json:string></affiliations></json:item><json:item><name>Flix Bermejo-Pareja</name><affiliations><json:string>The Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain</json:string><json:string>Centro de Investigacin Biomdica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Research Paper</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>elderly</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>epidemiology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>quality of life</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>morale</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mortality</value></json:item></subject><language><json:string>eng</json:string></language><abstract>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 0.17.7 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.</abstract><qualityIndicators><score>8.01</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1368</abstractCharCount><pdfWordCount>4978</pdfWordCount><pdfCharCount>33072</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>211</abstractWordCount></qualityIndicators><title>Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title><genre><json:string>research-article</json:string></genre><host><volume>39</volume><pages><last>373</last><first>366</first></pages><issn><json:string>0002-0729</json:string></issn><issue>3</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-2834</json:string></eissn><title>Age and Ageing</title></host><categories><wos><json:string>GERIATRICS & GERONTOLOGY</json:string></wos></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1093/ageing/afq028</json:string></doi><id>4EB8E03E64DA7993E5DEF97F89741E27350A9E7E</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/4EB8E03E64DA7993E5DEF97F89741E27350A9E7E/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/4EB8E03E64DA7993E5DEF97F89741E27350A9E7E/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/4EB8E03E64DA7993E5DEF97F89741E27350A9E7E/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>OUP</p></availability><date>2010-03-17</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title><author><persName><forename type="first">Julin</forename><surname>Benito-Len</surname></persName><affiliation>2 de Octubre, Madrid, Spain</affiliation><affiliation></affiliation></author><author><persName><forename type="first">Elan D.</forename><surname>Louis</surname></persName><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation></author><author><persName><forename type="first">Jess</forename><surname>Rivera-Navarro</surname></persName><affiliation></affiliation></author><author><persName><forename type="first">Mara Jos</forename><surname>Medrano</surname></persName><affiliation></affiliation></author><author><persName><forename type="first">Saturio</forename><surname>Vega</surname></persName><affiliation></affiliation></author><author><persName><forename type="first">Flix</forename><surname>Bermejo-Pareja</surname></persName><affiliation>2 de Octubre, Madrid, Spain</affiliation><affiliation></affiliation></author></analytic><monogr><title level="j">Age and Ageing</title><title level="j" type="abbrev">Age Ageing</title><idno type="pISSN">0002-0729</idno><idno type="eISSN">1468-2834</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2010-05"></date><biblScope unit="volume">39</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="366">366</biblScope><biblScope unit="page" to="373">373</biblScope></imprint></monogr><idno type="istex">4EB8E03E64DA7993E5DEF97F89741E27350A9E7E</idno><idno type="DOI">10.1093/ageing/afq028</idno><idno type="ArticleID">afq028</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010-03-17</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>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 0.17.7 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.</p></abstract><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>elderly</term></item><item><term>epidemiology</term></item><item><term>quality of life</term></item><item><term>morale</term></item><item><term>mortality</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-03-17">Created</change><change when="2010-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/4EB8E03E64DA7993E5DEF97F89741E27350A9E7E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="publisher-id">ageing</journal-id><journal-id journal-id-type="hwp">ageing</journal-id><journal-title>Age and Ageing</journal-title><abbrev-journal-title abbrev-type="pubmed">Age Ageing</abbrev-journal-title><issn pub-type="ppub">0002-0729</issn><issn pub-type="epub">1468-2834</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/ageing/afq028</article-id><article-id pub-id-type="publisher-id">afq028</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Paper</subject></subj-group></article-categories><title-group><article-title>Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</article-title><alt-title alt-title-type="left-running">J. Benito-León <italic>et al</italic>.</alt-title><alt-title alt-title-type="right-running">Low morale and mortality in elderly people</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Benito-León</surname><given-names>Julián</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Louis</surname><given-names>Elan D.</given-names></name><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref><xref ref-type="aff" rid="af5">5</xref><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Rivera-Navarro</surname><given-names>Jesús</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib><contrib contrib-type="author"><name><surname>Medrano</surname><given-names>María José</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Vega</surname><given-names>Saturio</given-names></name><xref ref-type="aff" rid="af9">9</xref></contrib><contrib contrib-type="author"><name><surname>Bermejo-Pareja</surname><given-names>Félix</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>The Department of Neurology</addr-line>, <institution>University Hospital ‘12 de Octubre’</institution>, <addr-line>Madrid</addr-line>, <country>Spain</country></aff><aff id="af2"><label>2</label><institution>Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)</institution>, <addr-line>Madrid</addr-line>, <country>Spain</country></aff><aff id="af3"><label>3</label><addr-line>The G.H. Sergievsky Center, College of Physicians and Surgeons</addr-line>, <institution>Columbia University</institution>, <addr-line>New York, NY</addr-line>, <country>USA</country></aff><aff id="af4"><label>4</label><addr-line>Department of Neurology, College of Physicians and Surgeons</addr-line>, <institution>Columbia University</institution>, <addr-line>New York, NY</addr-line>, <country>USA</country></aff><aff id="af5"><label>5</label><addr-line>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons</addr-line>, <institution>Columbia University</institution>, <addr-line>New York, NY</addr-line>, <country>USA</country></aff><aff id="af6"><label>6</label><addr-line>Department of Epidemiology, Mailman School of Public Health</addr-line>, <institution>Columbia University</institution>, <addr-line>New York, NY</addr-line>, <country>USA</country></aff><aff id="af7"><label>7</label><addr-line>Department of Social Sciences</addr-line>, <institution>University of Salamanca</institution>, <addr-line>Salamanca</addr-line>, <country>Spain</country></aff><aff id="af8"><label>8</label><addr-line>Unit of Vascular Risk Factors, National Center for Epidemiology</addr-line>, <institution>ISCIII</institution>, <addr-line>Madrid</addr-line>, <country>Spain</country></aff><aff id="af9"><label>9</label><institution>Arévalo Health Center</institution>, <addr-line>Arévalo, Ávila</addr-line>, <country>Spain</country></aff><author-notes><corresp>Address of the correspondence to: J. Benito-León, Avda. de la Constitución 73, portal 3, 7° Izquierda, E-28821 Coslada, Madrid, Spain. Tel: (+34) 916695467; fax: (+34) 913908600. Email:
<email>jbenitol@meditex.es</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>17</day><month>3</month><year>2010</year></pub-date><volume>39</volume><issue>3</issue><fpage>366</fpage><lpage>373</lpage><history><date date-type="received"><day>21</day><month>8</month><year>2009</year></date><date date-type="rev-recd"><day>15</day><month>12</month><year>2009</year></date><date date-type="accepted"><day>3</day><month>2</month><year>2010</year></date></history><permissions><copyright-statement>© The Author 2010. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement><copyright-year>2010</copyright-year><copyright-holder>Oxford University Press</copyright-holder></permissions><abstract><p><bold>Objective:</bold> the study aimed to assess the association between morale and mortality.</p><p><bold>Design:</bold> we used data from the Neurological Disorders in Central Spain (NEDICES), a population-based study.</p><p><bold>Subjects:</bold> 2,516 older persons (mean age 75.7 years) participated in the study.</p><p><bold>Methods:</bold> Cox models were used to estimate risk of mortality. Morale was assessed using the Philadelphia Geriatric Center Morale Scale.</p><p><bold>Results:</bold> 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 (<italic>P</italic> < 0.001) and RR in participants with moderate scores = 1.47 (<italic>P</italic> < 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 (<italic>P</italic> <0.05) and moderate scores = 1.16 (not significant) were compared to the reference group.</p><p><bold>Conclusion:</bold> 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.</p></abstract><kwd-group><title>Keywords</title><kwd>elderly</kwd><kwd>epidemiology</kwd><kwd>quality of life</kwd><kwd>morale</kwd><kwd>mortality</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES)</title></titleInfo><name type="personal"><namePart type="given">Julin</namePart><namePart type="family">Benito-Len</namePart><affiliation>2 de Octubre, Madrid, Spain</affiliation><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elan D.</namePart><namePart type="family">Louis</namePart><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jess</namePart><namePart type="family">Rivera-Navarro</namePart><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mara Jos</namePart><namePart type="family">Medrano</namePart><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Saturio</namePart><namePart type="family">Vega</namePart><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Flix</namePart><namePart type="family">Bermejo-Pareja</namePart><affiliation>2 de Octubre, Madrid, Spain</affiliation><affiliation></affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2010-05</dateIssued><dateCreated encoding="w3cdtf">2010-03-17</dateCreated><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>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 0.17.7 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.</abstract><subject><genre>Keywords</genre><topic>elderly</topic><topic>epidemiology</topic><topic>quality of life</topic><topic>morale</topic><topic>mortality</topic></subject><relatedItem type="host"><titleInfo><title>Age and Ageing</title></titleInfo><titleInfo type="abbreviated"><title>Age Ageing</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0002-0729</identifier><identifier type="eISSN">1468-2834</identifier><identifier type="PublisherID">ageing</identifier><identifier type="PublisherID-hwp">ageing</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>39</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>366</start><end>373</end></extent></part></relatedItem><identifier type="istex">4EB8E03E64DA7993E5DEF97F89741E27350A9E7E</identifier><identifier type="DOI">10.1093/ageing/afq028</identifier><identifier type="ArticleID">afq028</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author 2010. 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