ABSTRACT
Background: Although numerous predictors of mortality hazard in later life have been identified, the precise relationship between life satisfaction and mortality hazards among elderly people remains unclear.
Purpose: The purpose of this study was to examine and compare the relationship between life satisfaction and mortality hazards among elderly people in the United Kingdom and Taiwan.
Methods: Data were derived from the 1989 surveys of the Nottingham Longitudinal Study of Activity and Ageing (NLSAA) and the Survey of Health and Living Status of the Elderly in Taiwan (SHLSET). Following data harmonization, the samples included 690 individuals from the NLSAA and 1,438 individuals from SHLSET. Cox proportional hazards regression was used to determine the relationship between life satisfaction in 1989 and 14-year mortality hazard among elderly people in the two samples, first, in unadjusted models and then adjusting covariates for demographic, physical health, psychological health, and social engagement.
Results: Higher life satisfaction was significantly associated with a reduced 14-year mortality hazard in unadjusted models in both the United Kingdom (hazard ratio = 0.990; 95% confidence interval [0.986, 0.995], p < .001) and Taiwan (hazard ratio = 0.994, 95% confidence interval [0.990, 0.997], p < .001). After adjusting for demographic, physical health, psychological health, and social engagement variables, life satisfaction remained significantly associated with mortality hazard in the United Kingdom, but not in Taiwan.
Conclusions: This research confirms previous research showing higher life satisfaction as associated with improved survival among elderly people in the United Kingdom. Contrary to expectation, life satisfaction was not a predictor for mortality outcomes in the Taiwan sample when physical, psychological, and social predictors were included, although a baseline assessment showed that life satisfaction is important to predicting long-term survival among community-dwelling elderly people in both countries. The observed association between life satisfaction and mortality hazards may be attributed to common underlying causes such as self-rated health integration and/or health problems. Improving life satisfaction by promoting agents of health or other aspects of well-being and quality of life could have important long-term benefits for elderly people.