title: Feelings of uselessness and 3-year mortality in an Italian community older people: the role of the functional status.
abstract: BACKGROUND
  Sense of self-worth influences the health status of the elderly and may be associated with mortality. The aim of the study was to investigate whether the association between subjective feelings of uselessness and mortality was confounded or modified by functional limitation in non-institutionalized older people.
  
  
  METHODS
  Participants were community-dwelling older people, aged 70 years and older, who lived in neighbourhoods of Massa and Carrara municipalities in northern Tuscany, Italy. At baseline, 2335 non-institutionalized older people were assessed with a short self-administered questionnaire; the analysis included 2132 older persons for whom vital statistical data were available after a 3-year follow-up.
  
  
  RESULTS
  The feeling of uselessness was associated with an increased mortality at the 3-year follow-up, but only in older people who reported disability problems (adjusted hazard ratio = 1.97, 95% confidence interval = 1.48-2.63, P < 0.0001).
  
  
  CONCLUSIONS
  People who reported disability problems and a feeling of uselessness may be vulnerable to an increased risk for poor health outcomes in later life. This study outlined the importance of enquiring about feelings of uselessness, which is a relational variable that is linked to both psychological and physical health status, especially in older people who need help in daily activities.
authors.affiliation: Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors.forename: Olivia
authors.initials: O
authors.lastname: Curzio
authors.affiliation: Geriatrics Department of Primary Health Care, Massa and Carrara Public Health Care System, Carrara, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Bernacca
authors.affiliation: Department of Primary Health Care, Massa and Carrara Public Health Care System, Carrara, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bianchi
authors.affiliation: Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council, Pisa, Italy.|G. Monasterio Foundation, Pisa, Italy.
authors.forename: Giuseppe
authors.identifier: http://orcid.org/0000-0002-7121-4677
authors.initials: G
authors.lastname: Rossi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D004644:Emotions; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009026:Mortality; D010549:Personal Satisfaction; D012649:Self Concept
keywords: cohort; feeling of uselessness; functional status; mortality; older people