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Relationships of disability, health management and psychosocial conditions to cause-specific mortality among a community-residing elderly people.

To examine the factors associated with cause-specific mortality, a cohort of 1,405 randomly selected elderly people aged 65 years and over living in Settsu, Osaka Prefecture, was followed up for 54 months. Multivariate analysis using Cox proportional hazards model identified male sex, age, disability, medical treatment, and no participation in social activities as independent factors for overall mortality. Use of health checks and daily health enhancing practices showed an independent negative association with overall mortality. As for cause-specific mortality, male sex was a constant factor for the three major causes of death: cancer, heart disease and stroke. Advanced age and no participation in social activities showed a close association with heart disease mortality, while disability and medical treatment were independent factors for death caused by stroke and cancer, respectively. Use of health checks and daily health enhancing practices exhibited a strong negative association with all three major causes of death. The same tendencies were seen after those who reported undergoing medical treatment for the index diseases of heart disease and stroke at entry were excluded. These results suggest that predictive factors for mortality vary for specific causes of death, but that health promoting measures contribute to a reduction in mortality related to three major causes of death, thus resulting in a decrease in overall mortality among the elderly.