Perceived age as a predictor of old age mortality: a 13-year prospective study

OBJECTIVES: To examine whether in older people perceived age is associated with risk of total mortality independent of chronological age. DESIGN: Prospective population-based study (Evergreen project) with mortality surveillance for 13 years after the baseline. SETTING: Face-to-face interview among community-dwelling residents of the city of Jyväskylä, Finland. SUBJECTS: 395 men and 770 women aged 65-84 years at baseline. MEASURES: Perceived physical age and perceived mental age were rated either as younger, the same or older in comparison with subject's chronological age. Death dates were received from the official register of the province of Central Finland. Confounders used were chronological age, education in years, number of long-term illnesses, self-rated health, depression score (Beck's 13-item depression scale), and cognitive status. RESULTS: Mortality rates per 1,000 person-years from the older to younger perceived physical age category were 99, 65 and 59 in men, and 81, 54 and 36 in women. In the perceived mental age categories, correspondingly, mortality rates were 139, 63 and 64 in men, and 82, 55 and 44 in women. The fully adjusted relative risk (RR) of death over 13 years with the perceived younger physical age category as referent was 1.42 (95% CI 1.00-2.02) in the older category and 1.28 (1.03-1.60) in the same age category (P=0.049). The crude RR of mortality for perceived mental age categories was 1.56 (1.09-2.23) in the older and 1.10 (0.92-1.31) in the same age as compared with the younger category (P=0.046). Adding cognitive status into the model diminished the predictive value of the model (P=0.545). CONCLUSIONS: Perceived age predicted worsening of health as described as mortality. Perceived age may indicate general well-being and faith in the future, potentially reflecting changes in health.