Excess risk of early death in the elderly attributable to activities of daily living, mental status and traditional risk factors: The Shibata Elderly Cohort Study with a 20‐year follow up

Abstract

Background: A prospective cohort study with a 20‐year follow‐up was conducted to examine the association of the ability to perform activities of daily living (ADL) and other risk factors with the risk of subsequent all‐cause mortality in an elderly Japanese population. Methods: Cohort members were 705 men and 964 women aged 65 years and older at the time of the baseline examination in 1976–1977. Results: Disability in the performance of ADL and other risk factors (i.e. bad self‐rated health, low dementia score, decreased pleasure, low morale, and being prone to tears) were significantly associated with an increased risk of subsequent 20‐year all‐cause mortality. The summary population attributable risks of the level of disability in performance of ADL and other risk factors (25.8%, 17.4%, and 6.2% for the follow‐up periods of 0–5, 0–10, and 0–20 years, respectively) were almost of the same magnitude as those of the selected traditional risk factors of mean blood pressure, triceps skinfold thickness and current smoking (24.0%, 18.5%, and 8.6%, respectively). Conclusion: The association of both disability in performing ADL and other risk factors with mortality was as great as those of selected traditional risk factors when assessed in terms of both relative risk and population attributable risk.