Sex differences in the prevalence and determinants of death anxiety among community-dwelling older adults in China: a cross-sectional study.

BACKGROUND

Death anxiety levels among older adults may differ by sex and are influenced by distinct factors. This study examined the levels of death anxiety and its determinants among older Chinese adults, with a focus on sex differences.

METHODS

A multistage sampling method was used to recruit 559 older adults aged 60 years and above who completed a questionnaire survey. Death anxiety was assessed using the Templer Death Anxiety Scale (T-DAS). Factors influencing death anxiety were identified using a multiple linear regression model.

RESULTS

The average death anxiety scores among men and women were 5.48 ± 3.64 and 6.70 ± 3.70, respectively. Among both men and women, residence [men: rural area (β = 1.087, p = 0.018); women: rural area (β = 2.176, p < 0.001)], the number of outpatient visits in the past year [men: 1 (β = 1.906, p < 0.001), ≥ 2 (β = 2.027, p < 0.001); women:1 (β = 1.612, p = 0.001), ≥ 2 (β = 2.160, p < 0.001)], satisfaction with family relationships [men: satisfied ( β= -1.994, p = 0.001); women: satisfied (β = -1.728, p < 0.001)], and the experience of having seen articles or programmes related to the topic of death in the media [men: yes (β = 1.938, p < 0.001); women: yes (β = 0.911, p = 0.048)] were associated with death anxiety score. Per capita monthly income of the household (1,001 to 3,000 Chinese Yuan: β = 1.188, p = 0.025), and the number of hospitalisations in the past year (≥ 2: β = 1.237, p = 0.046) were associated with death anxiety score only among men. Conversely, educational level (junior high school and above: β = -1.436, p = 0.012) was associated with death anxiety score only among women.

CONCLUSIONS

Older women exhibited significantly higher death anxiety levels than men. Determinants of death anxiety varied by sex. Therefore, these factors should be considered in future interventional measures.