Self-reported walking difficulty predicts late-life mortality in Finnish war veterans: results from the Veteran 1992 Project Survey

Abstract

Objectives: To determine risk factors and their combinations that predict late-life mortality.

Design: Postal questionnaire.

Setting: Veteran 1992 Project Survey.

Participants: Finnish Second World War veterans living in Finland (177,989 men, 48,745 women), with a participation rate of 93%.

Measurements: Main outcomes were total, cardiovascular disease (CVD), and accident and violence (AAV) mortality. Absolute 10-year mortality risks for total mortality with combinations of different risk factors were calculated.

Results: The strongest predictor of total mortality was self-reported walking difficulty (hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.71-1.76 in men without disability, HR = 1.62, 95% CI = 1.58-1.67 in men with disability, HR = 1.61, 95% CI = 1.57-1.65 in women). The highest HRs of CVD mortality were for self-reported walking difficulty among men without disability (HR = 1.98, 95% CI = 1.95-2.02) and among men with disability (HR = 1.88, 95% CI = 1.82-1.94). In women, the highest HR for CVD mortality was for multimorbidity (HR = 1.87, 95% CI = 1.79-1.96). For AAV mortality, the highest HRs were for falls in men and age in women. A combination of walking difficulty and multimorbidity had the highest absolute 10-year mortality risk for total mortality (0.730 in men without disability, 0.729 in men with disability, 0.487 in women).

Conclusion: Self-reported walking difficulty was the most important predictor of total mortality in all veteran groups and for CVD mortality in men. The study demonstrates the importance of self-reported walking difficulty and multimorbidity as markers of high mortality risk in Finnish war veterans.

Keywords: Finnish veterans; predictors of mortality; walking difficulty.