Self-rated health (SRH) is one of the most frequently used indicators in health and social research. Its robust association with mortality in very different populations implies that it is a comprehensive measure of health status and may even reflect the condition of the human organism beyond clinical diagnoses. Yet the biological basis of SRH is poorly understood. We used data from three independent European population samples (N approx. 15,000) to investigate the associations of SRH with 150 biomolecules in blood or urine (biomarkers). Altogether 57 biomarkers representing different organ systems were associated with SRH. In almost half of the cases the association was independent of disease and physical functioning. Biomarkers weakened but did not remove the association between SRH and mortality. We propose three potential pathways through which biomarkers may be incorporated into an individual’s subjective health assessment, including (1) their role in clinical diseases; (2) their association with health-related lifestyles; and (3) their potential to stimulate physical sensations through interoceptive mechanisms. Our findings indicate that SRH has a solid biological basis and it is a valid but non-specific indicator of the biological condition of the human organism.

Chronic conditions and multimorbidity in population aged 90 years and over: associations with mortality and long-term care admission The need for long-term care (LTC) rises during the last years or months of life. Time spent in LTC during the end of life seems to have increased, possibly since people are living longer and suffering from more chronic conditions than before [11]. In younger old people, dementia and Parkinson's disease, as well as multimorbidity, have been associated with the need for LTC [12, 13]. Prior research is scarce on chronic conditions or multimorbidity as predictors of LTC use in the oldest old population. The study examines to what extent chronic conditions and multimorbidity predict mortality and LTC admission in the population aged 90 and over, and assesses the population attributable fractions of mortality and LTC admission for individual chronic conditions. Methods Sample The data were based on four cross-sectional waves of the Vitality 90+ Study conducted in 2001, 2003, 2007 and 2010 [14]. Each study year the mailed survey included both community-dwelling and institutionalized residents aged 90 years and over in the city of Tampere, Finland (in 2017 with 231,853 inhabitants, of whom 19% were aged over 65 and 0.9% aged over 90 [15]). The response rate varied between 79% and 86%. Due to high mortality, most participants (n = 1,650) responded to only one survey. Of the remainder, 1,004 participated in two surveys, 176 three surveys and 32 all four surveys. The sample used in the analysis concerning mortality included 2,862 participants (79.5% women). The LTC analysis used a subsample of 1,954 respondents living in their own homes at baseline. Proxy answers were included for participants who could not answer the questionnaire themselves.

We found socioeconomic differences in functional ability, comorbidity, and self-rated health in nonagenarians. Our findings suggest that social disparity in health and functioning exists in very old age.

Successful aging, measured using physical, psychological, and social dimensions, predicts the length of future life in nonagenarians.

Mortality in the very old is rapidly declining in many countries, but development and change in health and functioning in this age group is poorly understood. In the Vitality 901 Study, we investigated functional status, multimorbidity, and self-rated health (SRH) in nonagenarians in 2001, 2003, 2007, and 2010 in one geographic area of Finland. At each time, all inhabitants aged 90 years and older were included, and the response rate was high. We found minor improvement over time in independence in performing activities of daily living (ADL), no change in mobility or chronic conditions, and declining SRH. During the study period, both survival until the age of 90 years and the life expectancy at the age of 90 years clearly increased. Longer lives in very old age are likely to include both healthy and disabled years, and the number of those in need of help will grow. Studies of the oldest old are challenging because of poor health, cognitive problems, and a high rate of institutionalization; but more information on their health trends is urgently needed. ANNUAL REVIEW OF GERONTOLOGY AND GERIATRICS