Heart Disease Risk Factors as Determinants of Dependency and Death in an Older Cohort

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Abstract
Rates of death and dependency were determined for 621 men and women aged 65 years or more, living in an upper-middle-class community in Southern California. Between 1972 and 1986, 44% of the men and 27% of the women died; as expected, mortality rates increased with age and were higher in men than women at all ages. Dependency, defined as service use (institutional or community based), also increased with age but differed little by sex (56% of men and 53% of women). In multivariate analysis, predictors of death and dependency were age, presence of chronic disease and (in women) lack of siblings. After exclusion of those with chronic disease, obesity, marriage, and alcohol use were also associated with reduced risk in men (although the association with alcohol use was not significant). Only 29% of men and 14% of women died without some period of dependency. This dependency was most common in the year before death; less than 20% were dependent for 2 or more years prior to death. Dependency before death increased with age in men but not in women.