The relationship between worthlessness and mortality in a large cohort of Chinese elderly men

Background: This study explored the relationship between "worthlessness" and all cause non-suicide mortality in Chinese elderly men. Methods: Data from interviews of 1999 men aged 65 years and over were collected. Clinically significant depressive symptoms were measured using the validated Chinese version of Geriatric Depression Scale. "Worthlessness" was defined by one of the 15 questions from the Geriatric Depression Scale with a yes/no response. All-cause mortality over six years was collected using data from the National Death Registry with adjudication by 4-monthly telephone interviews. Two men were excluded after suicide death. Results: Age-adjusted mortality rates at five years were 44.3 and 23.9 per 1,000 person years for those who felt "worthless" and those did not, respectively. The adjusted relative risk for all-cause mortality associated with feeling worthless was 1.34 (95% CI: 1.02-1.76) after adjusting for potential confounders that included age, marital status, education, smoking, alcohol consumption, number of chronic diseases, self-rated health, body mass index, cognitive status, physical activity, occupation and maximum lifetime income. There was no statistically significant association between other depressive symptoms or overall depression and mortality. Conclusion: Worthlessness may be independently associated with all-cause mortality in Chinese elderly men.