title: Intimations of mortality: perceived age of leaving middle age as a predictor of future health outcomes within the Whitehall II study.
abstract: OBJECTIVE
  to determine the association between the subjective rate of ageing and future health outcomes.
  
  
  METHODS
  prospective cohort study (Whitehall II study). At the third phase of the study (1991-1993), participants were asked at what age they think most people leave middle age. Participants were followed until the end of phase 5 (1997-2000), so that mean length of follow-up was 7 years.
  
  
  METHODS
  London based office staff in 20 civil service departments.
  
  
  METHODS
  5,262 male and 2,277 female civil servants aged 40-60.
  
  
  METHODS
  validated new cases of coronary heart disease and health function, measured by the SF-36 General Health Survey, at phase 5.
  
  
  RESULTS
  perceived age of leaving middle age increased with age, self-rated health and grade of employment, and was higher in women. Adjusting for age and sex, people who believed middle age ends < or =60 years, compared to > or =70 years, were at higher risk for coronary heart disease (HR=1.43, 95% CI=1.05-1.94), fatal coronary heart disease and non-fatal myocardial infarction (HR=1.52, 0.95-2.42), and poor physical (OR=1.29, 1.10-1.50) and mental (OR=1.25, 1.07-1.45) functioning during follow-up. Adjustment for self-rated health, employment grade, health behaviours, social networks, control and baseline health status, respectively, did not eliminate these associations.
  
  
  CONCLUSIONS
  the reported age at which middle age ends predicts future health outcomes. We hypothesise that perceived end of middle age acts as a general summary of the subjective rate of ageing.
authors.affiliation: International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. kuper.hannah@lshtm.ac.uk
authors.forename: Hannah
authors.initials: H
authors.lastname: Kuper
authors.forename: Michael
authors.initials: M
authors.lastname: Marmot
mesh_terms: D000328:Adult; D000375:Aging; D001290:Attitude; D003327:Coronary Disease; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors