Symptom experience and subsequent mortality: results from the West of Scotland Twenty-07 study

Elliott, A.M., Hannaford, P.C., Smith, B.H., Wyke, S. and Hunt, K. (2006) Symptom experience and subsequent mortality: results from the West of Scotland Twenty-07 study. BMC Health Services Research, 6(158), pp. 1-9. (doi: 10.1186/1472-6963-6-158)

Abstract

Background Associations between symptom experience and mortality have rarely been investigated. One study has suggested that the number of symptoms people experience may be an important predictor of mortality. This novel and potentially important finding may have important implications but needs to be tested in other cohorts. Methods 858 people aged around 58 years were interviewed by nurses in 1990/1 as part of the West of Scotland Twenty-07 Study. They were asked about the presence of symptoms in the last month from a checklist of 33 symptoms. Measures of morbidity included symptom type (respiratory, musculoskeletal, gastrointestinal, mental health, neurological, systemic) and symptom summary measures looking at the number and impact of symptoms (total number; number participants tended to have; number participants did not tend to have; number which restricted usual activities; number which led to GP consultation). Hazard ratios for thirteen-year all-cause mortality were calculated for symptom types, symptom summary measures, and self-assessed health with and without adjustment. Results On unadjusted analysis, and after adjusting for gender, socio-economic status and smoking, mortality was elevated in individuals reporting respiratory, systemic and mental health symptoms. After additional adjustment for chronic conditions and self-assessed health, only the association between mental health symptoms and mortality remained significant. On unadjusted analysis, and after adjusting for gender, socio-economic status and smoking, mortality was elevated in individuals with many (≥ 6) symptoms in four of the symptom summary measures examined. These relationships were no longer significant after additional adjustment for chronic conditions and self-assessed health. A clear trend of increasing mortality as self-assessed health became poorer was observed. This pattern remained statistically significant after adjustment for gender, socio-economic status, smoking, chronic conditions and the total number of symptoms experienced. Conclusion Symptoms often thought of as minor may have important consequences later in life especially for those reporting mental health-related symptoms or those experiencing many symptoms. In this study however, self-assessed health appeared to be a better predictor of mortality than the type or number of symptoms experienced, even when the tendency to have and impact of the symptoms were taken into account.

• Item Type: Articles
• Additional Information: The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1472-6963/6/158/prepub
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wyke, Professor Sally and Hunt, Professor Kathryn
• Authors: Elliott, A.M., Hannaford, P.C., Smith, B.H., Wyke, S., and Hunt, K.
• Subjects: R Medicine > RA Public aspects of medicine; R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU; College of Social Sciences
• Journal Name: BMC Health Services Research
• Publisher: BioMed Central
• ISSN (Online): 1472-6963
• Published Online: 11 December 2006
• Copyright Holders: Copyright © 2006 BioMed Central Ltd.
• First Published: First published in BMC Health Service Research 6(158):158-167
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher