Stressful life-events exposure is associated with 17-year mortality, but it is health-related events that prove predictive

School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK.
British Journal of Health Psychology (Impact Factor: 2.7). 12/2007; 13(Pt 4):647-57. DOI: 10.1348/135910707X258886
Source: PubMed


Despite the widely-held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life-events exposure and death. The present analyses examined the association between overall life-events stress load, health-related and health-unrelated stress, and subsequent all-cause mortality.
This study employed a prospective longitudinal design incorporating time-varying covariates.
Participants were 968 Scottish men and women who were 56 years old. Stressful life-events experience for the preceding 2 years was assessed at baseline, 8-9 years and 12-13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time-varying covariates were applied. We adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure.
Overall life-events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17-year mortality. Health-related event numbers and impact scores were strongly predictive of mortality. This was not the case for health-unrelated events.
The frequency of life-events and the stress load they imposed were associated with all-cause mortality. However, it was the experience and impact of health-related, not health-unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.

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    • "These dissimilarities might be the result of different study populations. Compared to the Hoorn study, the cohort used by Phillips et al., 2008 was smaller (n < 1000), younger at baseline and noted fewer deaths (n < 250 participants); therefore , our study has greater power to detect effects (Phillips et al., 2008). Finally, we observed an association between the number of life events, behavioral factors and prevalent morbidities. "
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    ABSTRACT: psychosocial stress holds negative consequences for physical health. Experiencing stressful life events may lead to mortality, by inducing behavioural changes and morbidities. In our current study, we will evaluate whether in the general population (the number of) stressful life events are associated with all-cause and cause-specific mortality, and whether this relationship is mediated by behavioural changes and morbidities.
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    • "However, we followed Phillips&apos; et al. (2008) suggestion that health-related stress items should not be included when predicting health outcomes. Thus, three classes, or patterns, of SLE change were then used to predict mortality. "
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    ABSTRACT: We investigated whether hassles mediated the effect of life events on mortality in a sample of 1293 men (Mage=65.58, SD=7.01), participants in the VA Normative Aging Study. We utilized measures of stressful life event (SLE) and hassles from 1989 to 2004, and men were followed for mortality until 2010. For life events and hassles, previous research identified three and four patterns of change over time, respectively, generally indicating low, moderate, and high trajectories, with one moderate, non-linear pattern for hassles (shallow U curve). Controlling for demographics and health behaviors, we found that those with moderate SLE trajectories (38%) more likely to die than those with low SLE trajectories, HR=1.42, 95% CI [1.16, 3.45]. Including the hassles classes showed that those with the moderate non-linear hassle trajectory were 63% more likely to die than those with low hassle trajectory, HR=1.63, 95% CI [1.19, 2.23], while those with consistently high hassle trajectory were over 3 times more likely to die, HR=3.30, 95% CI [1.58, 6.89]. However, the HR for moderate SLE trajectory decreased only slightly to 1.38, 95% CI [1.13, 1.68], suggesting that the two types of stress have largely independent effects on mortality. Research is needed to determine the physiological and behavioral pathways through which SLE and hassles differentially affect mortality.
    Full-text · Article · Jul 2014 · Experimental Gerontology
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    • "However, there are inconsistent results in the literature on the relationship between stress and mortality. While some studies have found that high levels of stressful life events do predict mortality [21] [22], this may be restricted primarily to health-related stressful life events [23]. Other studies have found no relationships between life events and mortality [24], and one found an inverse association [25]. "
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    ABSTRACT: We examined long-term patterns of stressful life events (SLE) and their impact on mortality contrasting two theoretical models: allostatic load (linear relationship) and hormesis (inverted U relationship) in 1443 NAS men (aged 41-87 in 1985; M = 60.30, SD = 7.3) with at least two reports of SLEs over 18 years (total observations = 7,634). Using a zero-inflated Poisson growth mixture model, we identified four patterns of SLE trajectories, three showing linear decreases over time with low, medium, and high intercepts, respectively, and one an inverted U, peaking at age 70. Repeating the analysis omitting two health-related SLEs yielded only the first three linear patterns. Compared to the low-stress group, both the moderate and the high-stress groups showed excess mortality, controlling for demographics and health behavior habits, HRs = 1.42 and 1.37, ps <.01 and <.05. The relationship between stress trajectories and mortality was complex and not easily explained by either theoretical model.
    Full-text · Article · Sep 2011 · Journal of aging research
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