ADEQUACY OF CURRENT AND FUTURE INCOME AND ASSETS AND THE RISK OF MORTALITY IN A COHORT OF OLDER MEN – THE MANITOBA FOLLOW-UP STUDY

Abstract

Background: Income security is a determinant of health in most populations, but there is less evidence in very old men. Objective: To determine if self-reported current income adequacy or future expectation of income adequacy predicts death amongst older men. Design and Setting: We conducted an analysis of a prospective cohort of 3 983 men who have been followed since 1948. In 2006, 1001 men were alive, of whom 807 completed the annual survey without assistance. Two items in the 2006 survey were: “How well do you think your income and assets satisfy your current needs?” and “How well do you think your income and assets will satisfy your needs in the future?” We considered the categories: “very adequate, adequate and inadequate.” Time to death over the next 11 years was examined with the Cox proportional hazards models, and adjusted for age, marital status, and functional status. Results: The mean age in 2006 was 85 years old. The median follow-up time was 6.1 years, and 664 of the participants died. Satisfaction with current income did not predict mortality. Those with an expectation of inadequate future income had a higher risk of death: Hazard Ratio of 1.37 [(95%CI) 1.02, 1.84)] for “Not adequate” relative to “Very Adequate”. In models adjusted for age, marital status and functional status, this association was only marginally statistically significant (p=0.07). Conclusions: Perceived adequacy of future income predicts mortality in very old men. The effect may be confounded or mediated by functional decline.