Individuals between the ages of 60 and 69 years, especially those with less money or education, reported poorer mental health, according to results published in JAMA Network Open.

A team of researchers from the Stanford University School of Medicine in Palo Alto, California, the University of Pennsylvania in Philadelphia, and Columbia University Mailman School of Public Health in New York City analyzed data from the Behavioral Risk Factor Surveillance System, a telephone survey conducted by state health departments with the support of the Centers for Disease Control and Prevention.

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The study sample included 2,432,609 respondents who were older than 60 years. For the study period of 2003 to 2017, the sample demographics included 62% women, 41% with an annual household income less than $35,000, and 10% with less than a high school education. Randomly selected participants were asked questions about their general, physical, and mental health status. Based on the past 30 days, respondents indicated how many days they would classify their health as “not good.”

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While general and physical health remained stable or were improved in all age groups 65 years and older, a decrease in mental health, measured as days per month with illness, occurred in all age groups: 60 to 64 years (2.9 days in 2003 and 3.6 days in 2017), 65 to 69 years (2.3 days in 2003 and 3.0 days in 2017), and 70 to 74 years (2.2 days in 2003 and 2.4 days in 2017).

Individuals aged 60 to 69 years were found to have a significant decrease in mental health over the 2003 to 2017 period, with a 3.5% rise in the number of poor mental health days per year (t = 14.01; P <.001). [KT1] [WU2] Although little difference was seen between men and women, income and education played a critical role in determining mental health status. The number of days of poor mental health for those with household incomes less than $35,000 per year was 2.9 days in 2003 and 4.1 days in 2017. Respondents with no high school diploma reported 3.6 poor mental health days in 2003 and 4.4 days in 2017.

The study authors noted that the pattern of poor mental health trajectories in older adults is mirrored in younger adults, ages 35 to 59 years, suggesting that these trends may be related to declining economic opportunity in the late 2000s. They concluded that decreases in mental health “may be because the effects of labor market conditions continue as cohorts age, especially for populations with low income and low levels of education, who exhibit both the highest burden as well as the greatest deterioration of mental health over time.”  They also wrote, “These trends will likely have important implications for future life expectancy, disability, and the capacity of older persons to engage productively in society.”


Rehkopf DH, Furstenberg FF, Rowe JW. Trends in mental and physical health-related quality of life in low-income older persons in the United States, 2003 to 2017. JAMA Netw Open. 2019;2(12):e1917868.