Stressful life-events exposure is associated with 17-year mortality, but it is health-related events that prove predictive

Objectives Despite the widely-held view that psychological stress is a major cause of poor health, few studies have examined the relationship between stressful life-events exposure and death. The present analyses examined the association between overall life-events stress load, health-related and health-unrelated stress, and subsequent all-cause mortality.

Design This study employed a prospective longitudinal design incorporating time-varying covariates.

Methods Participants were 968 Scottish men and women who were 56 years old. Stressful life-events experience for the preceding 2 years was assessed at baseline, 8–9 years and 12–13 years later. Mortality was tracked for the subsequent 17 years during which time 266 participants had died. Cox's regression models with time-varying covariates were applied. We adjusted for sex, occupational status, smoking, BMI, and systolic blood pressure.

Results Overall life-events numbers and their impact scores at the time of exposure and the time of assessment were associated with 17-year mortality. Health-related event numbers and impact scores were strongly predictive of mortality. This was not the case for health-unrelated events.

Conclusions The frequency of life-events and the stress load they imposed were associated with all-cause mortality. However, it was the experience and impact of health-related, not health-unrelated, events that proved predictive. This reinforces the need to disaggregate these two classes of exposures in studies of stress and health outcomes.