The relationship of Type A behavior and its components to all-cause mortality in an elderly subgroup of men from the Western Collaborative Group Study

Abstract

This study examined prospectively the relationship of Type A behavior and its components to all-cause mortality in 1,118 men (age 60 to 86) who participated in a 27-year follow-up examination of the Western Collaborative Group Study. Global Type A/B behavior was assessed in these subjects using a modified version of the Structured Interview. Additional psychological data that related to this construct were obtained from self-report questionnaires. The relationship of these data, controlling for other biological risk factors, to 6-year all-cause mortality was investigated by means of a tree-structured survival analysis (TSSA). Using age, Type A behavior, Cook-Medley hostility, ever smoking, and cancer status at follow-up, TSSA identified 6 subgroups that differed in survival rates and associated risk factor profiles. The most favorable survival was experienced by 2 subgroups, one composed of older Type A subjects who scored the lowest on anger-hostility and depression, the other consisting entirely of Type B subjects who had never smoked. The worst survival was experienced by subjects with diagnosed cancer at the 27-year follow-up, and intermediate survival rates were experienced by 3 subgroups that differed markedly on age, smoking, Type A/B behavior, and Cook-Medley hostility. The present study is the first to characterize Type A's with favorable and unfavorable survival rates among the elderly.