Multiple Factors Contribute To Death In Men And Women Over Age 65

February 25, 1998

Older adults rarely die from only one cause, rather their deaths result from a number of underlying factors, often associated with lifelong habits. Researchers at the Johns Hopkins School of Public Health today released a report on the traits that contribute to mortality in older adults. They included low income level, smoking patterns, being male, lower exercise, and disability. Overall, they found that, except for congestive heart failure, objective, quantitative measures of disease were better predictors of mortality than was clinical history of disease. Their findings appeared in the February 25, 1998 issue of the Journal of the American Medical Association (JAMA.)

Lead author Linda Fried, MD, professor, medicine and epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, said, "Death frequently results from multiple causes. It is important to identify individual risks which independently or jointly cause death in older people."

The researchers surveyed 5,201 men and women ages 65 to 101 in Maryland, California, North Carolina and Pennsylvania over a five year period. During that time, 646 or 12 % of the participants died and overall women had a two-fold survivorship compared to men. Death rates declined with increasing education and income. Those who were high-school educated and had incomes under $50,000 had the highest rates. Those who had smoked for 50 or more years had double the risk of those who smoked for 26 years or less. Moderate to vigorous physical activity was protective.

Many of the 20 factors identified to predict mortality are modifiable. These include health habits of exercise and smoking. Clinically, objective measures of the severity of chronic diseases were significant predictors of mortality, and the levels of disease at which mortality risk rises may provide goals for therapy. Most older persons die as a consequence of a combination of factors but this study suggests that if disease and health factors are improved, people might live considerably longer.


This study was supported by the National Heart, Lung, and Blood Institute.

Johns Hopkins University Bloomberg School of Public Health

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