title: Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys.
abstract: BACKGROUND
  Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk.
  
  
  METHODS
  Participants (N = 14,019; women = 91%), including eventual decedents (n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk.
  
  
  RESULTS
  For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01; p < 0.001); more substantive was the risk of low physical health (HR = 1.04; p < 0.001). No mediation effects were observed.
  
  
  CONCLUSIONS
  Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.
authors.affiliation: Centre for Research on Ageing,Health and Wellbeing,The Australian National University Canberra,ACT,Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Burns
authors.affiliation: Centre for Research on Ageing,Health and Wellbeing,The Australian National University Canberra,ACT,Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Butterworth
authors.affiliation: School of Primary Health Care,Faculty of Medicine,Nursing & Health Sciences,Monash University,Melbourne,VIC,Australia.
authors.forename: Colette
authors.initials: C
authors.lastname: Browning
authors.affiliation: Research Centre for Gender,Health and Ageing,University of Newcastle,Newcastle,NSW,Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Byles
authors.affiliation: Flinders Centre for Ageing Studies and Department of Psychology,Flinders University,Adelaide,SA,Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Luszcz
authors.affiliation: Centre for Vision Research,Westmead Millennium Institute and Department of Ophthalmology,The University of Sydney,Sydney,NSW,Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Baker IDI Heart and Diabetes Institute,Melbourne,VIC,Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaw
authors.affiliation: Centre for Research on Ageing,Health and Wellbeing,The Australian National University Canberra,ACT,Australia.
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000401:mortality*; D009017:Morbidity; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors
keywords: longitudinal studies