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General thoughts of death and mortality: findings from the Komo-Ise cohort, Japan

Published online by Cambridge University Press:  14 August 2018

A. Stickley ,
C. F. S. Ng ,
C. Watanabe ,
Y. Inoue ,
A. Koyanagi  and
S. Konishi
A. Stickley*
Affiliation:
The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, 141 89, Sweden Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
C. F. S. Ng
Affiliation:
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
C. Watanabe
Affiliation:
Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
Y. Inoue
Affiliation:
Carolina Population Center, The University of North Carolina at Chapel Hill, 123 West Franklin St, Chapel Hill, NC 27516, USA
A. Koyanagi
Affiliation:
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
S. Konishi
Affiliation:
Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195, USA
*
Author for correspondence: Andrew Stickley, E-mail: [email protected]
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Abstract

Aims

Death ideation (thinking about/wishing for one's own death, thinking that one would be better off dead) is linked to an increased mortality risk. However, comparatively little is known about more general thoughts of death (GTOD) where no wish to die or life value is expressed. This study examined whether GTOD predicted mortality in a community-based cohort of older adults.

Methods

Data came from the Komo-Ise cohort study in Gunma prefecture, Japan. The analytic sample comprised 8208 individuals (average age 61.3 (range 47–77)) who were asked in wave 2 of the study in 2000 if they had ‘Thought about death more than usual, either your own, someone else's or death in general?’ in the past 2 weeks. Death data were obtained from the municipal resident registration file. Cox proportional hazards regression analysis was used to examine associations.

Results

During the follow-up period (2000–2008), there were 672 deaths. In a model adjusted for baseline covariates, GTOD were significantly associated with all-cause mortality (hazards ratio 1.66, 95% confidence interval 1.20–2.29). Stratified analyses showed an association between GTOD and mortality in men, older subjects (⩾70 years), married individuals and those with higher social support.

Conclusions

GTOD are associated with an increased mortality risk among older citizens in Japan. Research is now needed to determine the factors underlying this association and assess the clinical relevance of screening for GTOD in older individuals.

Keywords

DeathepidemiologyJapanmortality
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 6 , December 2019 , pp. 662 - 669
Copyright
Copyright © Cambridge University Press 2018 

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