Hopelessness predicts mortality in older Mexican and European Americans

Objective: The purpose of this study was to evaluate the relationship betwe en hopelessness and mortality in a biethnic cohort of older community-dwell ing Mexican Americans, the most rapidly growing segment of the elderly, and European Americans. Methods: A total of 795 persons aged 64 to 79 years co mpleted an English or Spanish Version of the 30-item Geriatric Depression S cale on entering the San Antonio Longitudinal Study of Aging, an epidemiolo gic survey, between 1992 and 1996. Women constituted 58% and Mexican Americ ans 54% of this randomly selected sample. Subjects who answered "no" to the item "Are you hopeful about the future?" were classified as hopeless. Resu lts: As of August 1999, 29% of the 73 hopeless subjects had died, compared with 11% of the hopeful, a highly significant difference. The mortality rat es for cardiovascular disease and cancer were significantly greater among t he hopeless subjects (7%) than among the hopeful (3%). Hopelessness predict ed all-cause mortality in a Cox proportional hazards model adjusted for age , ethnic background, current smoking status, number of comorbid medical con ditions, self-rated health, and frequency of social contacts (risk ratio = 2.23, 95% confidence interval = 1.33 to 3.76, p = .0026). Neither sex nor p robable depression was a significant predictor of mortality in this model. Conclusion: These findings, together with those of others, suggest that hop elessness is a significant predictor of mortality in older and middle-aged adults of various ethnic backgrounds. Further research is needed to evaluat e the mechanisms that underlie this phenomenon and the effects of treating hopelessness on the quality and duration of subjects' lives.