BARCELONA — Older individuals who have experienced three or more major life stressors — such as loss of a partner, death of a child, or changing residence — are at greater risk of death than people with fewer of these events, researchers said here.
When Femke Rutters, PhD, a postdoctoral fellow at VU University Medical Center in Amsterdam, compared outcomes of people who experienced stressful events with those of people who experienced no life stressors over an average of 15 years, she found no significant difference for those with one or two events, but a 29% increase in the risk of mortality (95% CI 1.01-1.65) if a person experienced three life stressors, and a 51% increased risk of mortality (95% CI 1.15-1.99) if a person experienced more than three events.
“Having three or more stressful life events is associated with a significantly increased risk for all-cause mortality, cardiovascular mortality, and cancer mortality in our elderly population-based cohort,” Rutters said at her poster discussion presentation during the annual meeting of the
She and her colleagues attempted to prove their hypothesis by utilizing data accrued in the population-based <a “=”” href=”http://www.medpagetoday.com/MeetingCoverage/EASD/” target=”_blank”>European Association for the Study of Diabetes.
The life stressors she included in her study were:
- Serious illness of a child
- Problems with children
- Death of a child
- Problems with a partner
- Death of a partner
- Death of a relative
- Financial problems
- Death of a friend
- Moving to a new home
- Ending an intense relationship
She told MedPage Today, “Everything you experience as stress is psychosocial stress, whether it is real or imaginary. Real might be being driven over by a bus, or imaginary might be being in front of an audience and giving a presentation. Our hypothesis is that when psychosocial stress is chronic people develop changes in their lifestyle which then leads to developing chronic metabolic diseases like obesity, type 2 diabetes and cardiovascular disease. And with these diseases people have a higher risk of dying.”
She and her colleagues attempted to prove their hypothesis by utilizing data accrued in the population-based Hoorn study. Rutters explained that most studies that scrutinized stressors in life tended to use patient-based cohorts; the Hoorn study gave the researchers an opportunity to use a population-based cohort.
In the study, the researchers included 2,385 subjects; 46% were male and the mean age at baseline was 62 years. The average follow-up was 15 years. During that period, Rutters reported that 834 of the subjects died, including 239 who died of cancer and 235 who succumbed to cardiovascular disease.
When they looked at life stressors and mortality, they found that 510 persons said they experienced none of the 10 major life events, and over the course of the follow-up, 159 of them died. Of the 853 people who listed one major life event, 276 died — a crude nonsignificant 4% increased risk of all-cause mortality compared with those having no life stressors.
Of the 588 individuals who experienced two life stressors, 213 died, translating to a crude 21% increased risk that also failed to achieve statistical significance. The researchers identified 257 people who experienced three life stressors, and 101 of them died, a crude 50% increase in all-cause mortality that was significant. They also reported that 177 persons experienced four or more life events, and 78 of that group died, translating to a crude all-cause mortality increase was 60% higher than those with no life stressors, also significant.
When the researchers adjusted for age and sex, the significant findings held for those with three or more events. When the figures were also adjusted for glycemic parameters, type 2 diabetes prevalence, body mass index, hypertension and cardiovascular disease prevalence, significance remained for those with four or more life stressor events — a 38% increased risk (95% CI 1.0-1.8), Rutters said.
“We think that our study shows that most people can handle one or two life stressors, but the accumulation of events is more than they can handle, and that manifests itself in chronic disease and in mortality,” she said.
“What we see here is that the brain is connected to the rest of the body, and what impacts the brain can have an effect on disease states,” said Norbert Hermanns, PhD, professor of psychology at the University of Bamberg in Germany.
Hermanns, who moderated the poster session, told MedPage Today, “This is an interesting study that supports a lot of what we believe about how life stressors can influence overall health.”