High morale is associated with increased survival in the very old

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Abstract
Background: high morale is defined as future-oriented optimism. Previous research suggests that a high morale independently predicts increased survival among old people, though very old people have not been specifically studied. Objective: to investigate whether high morale is associated with increased survival among very old people. Subjects: the Umeå 85+/GErontological Regional DAtabase-study (GERDA) recruited participants aged 85 years and older in northern Sweden and western Finland during 2000–02 and 2005–07, of whom 646 were included in this study. Methods: demographic, functional- and health-related data were collected in this population-based study through structured interviews and assessments carried out during home visits and from reviews of medical records. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. Results: the 5-year survival rate was 31.9% for participants with low morale, 39.4% for moderate and 55.6% for those with high morale. In an unadjusted Cox model, the relative risk (RR) of mortality was higher among participants with low morale (RR = 1.86, P < 0.001) and moderate morale (RR = 1.59, P < 0.001) compared with participants with high morale. Similar results were found after adjustment for age and gender. In a Cox model adjusted for several demographic, health- and function-related confounders, including age and gender, mortality was higher among participants with low morale (RR = 1.36, P = 0.032) than those with high morale. There was a similar but non-significant pattern towards increased mortality in participants with moderate morale (RR = 1.21, P value = 0.136). Conclusion: high morale is independently associated with increased survival among very old people.

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