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Coherence associated with lower mortality rates among elderly

High sense-of-coherence scores are associated with lower mortality rates and less functional decline, even among very elderly patients and independent of multimorbidity, depression, cognition, disability and sociodemographic characteristics, according to data published in the Annals of Family Medicine.

“Older people very often suffer from multiple chronic diseases,” Pauline Boeckxstaens, MD, PhD, of the department of family medicine and primary health care at Ghent University, in Belgium, and colleagues wrote. “The relationships between multimorbidity and adverse outcomes such as disability, mortality, hospitalization and functional decline, however, are far from linear.”

To determine whether a high sense-of-coherence (SOC) score protects from negative health outcomes in elderly patients with multiple chronic diseases, the researchers conducted a population-based cohort study among 29 Belgian primary care practices, including 567 patients aged 80 years and older.

The researchers plotted the highest tertile of SOC scores in Kaplan-Meier curves representing 3-year mortality and time to first hospitalization. In addition, they used Cox proportional hazard regression and multiple logistic regression analyses, adjusted for sociodemographic characteristics, depression, cognition, disability and multimorbidity, to study the association between SOC and mortality, hospitalization and decline in activities of daily living.

According to the researchers, patients with high SOC scores displayed a higher cumulative survival than others (Log rank = .004), independent of other characteristics (adjusted HR = 0.62; 95% CI, 0.38-1; P = .049). In addition, a high SOC was protective against a decline in daily living activities, independent of covariates (adjusted HR = 0.56; 95% CI, 0.31-1; P = .05).

“Our findings counter the argument that SOC would be merely the inverse of depression and suggest the importance of further research into patients’ strengths and not merely their limitations and vulnerability,” Boeckxstaens and colleagues wrote. “Whether the SOC will evolve to a clinically applicable concept is yet unclear.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.