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Hopelessness Linked to Higher Risk of Mortality
By: Reuters Health

A lack of hope for the future is associated with a higher death rate among older men and women, a team of researchers report.

"Our findings confirm and extend the results of previous studies suggesting that, in a US sample comprising older women and men of Mexican and European origin, hopelessness is associated with an increased risk of...mortality,'' according to Dr. Stephen L. Stern, a psychiatrist at the University of Texas Health Science Center in San Antonio, and colleagues.

The study, which was funded by the National Institutes of Health, was published in the journal Psychosomatic Medicine.

The researchers sought to explore whether feelings of hopefulness act as a key to survival and whether those who lack hope are at higher risk of death.

From 1992 to 1996, Stern's team asked 795 men and women aged 64 to 79 in San Antonio how they felt about the future and whether or not they were ``hopeful about the future.'' About half of the study participants were European-Americans and half were first, second or third generation Mexican-Americans.

Around 9% of the respondents answered no, they had no hope about the future, while the remaining 91% said that they did have hope about the future.

Mexican-American men were twice as likely to report feeling hopeless as European-American men, with 12% of the Mexican-American men saying they were hopeless compared with only 6% of the European-American men. Men and women were equally likely to report hopelessness.

When tracked an average of 5 years later by reviewing death certificates in 1999, the researchers found that 29% of the people who said they felt hopeless had subsequently died, compared to only 11% of those who said they were hopeful.

None of the study participants had committed suicide, but had primarily died from either cancer or from heart disease.

The investigators measured whether depression among people who felt hopeless was responsible for their higher death rate. After adjusting for other risk factors, they found that depression was not associated with mortality. But people who suffered from both depression and hopelessness may be at the greatest risk of mortality, the report indicates.

The researchers theorized that hopeless people might have higher death rates because they may suffer from biochemical abnormalities, such as decreased immune function or abnormal platelet function.

The study was limited in that it only measured hopelessness with a simple yes or no answer, the authors note. It also did not examine the reasons why people said they were hopeless.

Stern and colleagues conclude that because this question may provide relevant information about a patient's risk of death, doctors should consider asking it during a checkup. '''Are you hopeful about the future?' might be a useful screening question to include in the evaluation of older patients,'' they write.

SOURCE: Psychosomatic Medicine 2001;63:344-351.

Reuters Health