Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up

Abstract

Background: Despite a non-specific nature of self-rated health (SRH), it seems to be a strong predictor of mortality. The aim of this study is to assess the association of SRH and objective health status (OH) with all-cause mortality in 70-year-old community-dwelling older people in Finland. Methods: A prospective study with 5-, 10-and 27-year follow-ups. SRH (n = 1008) was assessed with a single question and OH (n = 962) by the Rockwood's Frailty Index (FI). To assess the association of SRH and OH with mortality, Cox regression model was used. Results: Of the 1008 participants, 138 (13.7%), 319 (31.6%), and 932 deceased (86.3%) during the 5-, 10-and 27-year follow-ups, respectively. In unadjusted models, subjects with poor SRH had almost eightfold risk for mortality compared to those with good SRH during the 5-year follow-up; among those with poor OH, the risk was fourfold compared to those with good OH. In the 10-year-follow up, both poor SRH and poor OH predicted about fourfold risk for mortality compared to those with good health. During the 27-year follow-up, OH was a stronger predictor of mortality than SRH. Poor SRH, compared to good SRH, showed 95% sensitivity and 34% specificity for 5-year mortality; corresponding figures for OH were 54 and 80%, respectively. Conclusions: Single-item SRH seems to be able to capture almost the same as OH in predicting a short-term (less than 10 years) mortality risk among older adults in clinical settings. The use of SHR may also enhance the focus on patient-centered care.

Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults

“…However, the rate of mortality among the UH was still the highest and the AP was still significant after 18 years. This suggests that for mortality, the combination of poor objective and poor subjective health is still notable after 18 years, the result being similar to previous studies with follow-up times of 18 [ 26 ], and 27 years [ 24 ].…”

“…In earlier studies, the existence of registered illnesses has been shown to predict mortality during a shorter follow-up period [ 14 ]. Also, SRH predicted short-term mortality better than long-term [ 24 , 25 ]. In our study, being objectively and subjectively unhealthy was associated with poor survival even after 18 years.…”

“…It is expectable that the individual’s poor subjective health adds to the poor objective health because the mere existence of an illness does not take into account its severity or induced disability. A recent study emphasizes incorporating SRH into the assessment of an older individual’s health as it seems to predict short-term (less than 10 years) mortality almost as well as objective health measured by frailty [ 24 ].…”

Association between Regular Exercise and Self-Rated Health and Sleep Quality among Adults in Japan during the COVID-19 Pandemic

“…In addition, a healthy lifestyle plays an important role in subjective outcomes. Self-rated health (SRH) is a good predictor of morbidity and mortality [ 6 , 7 , 8 ]. Regular exercise is associated with good SRH during normal social conditions [ 9 ].…”

Life Satisfaction and the Relationship between Mild Cognitive Impairment and Disability Incidence: An Observational Prospective Cohort Study

“…Potential confounders of life satisfaction included age, sex, medication use, grip strength, MMSE, GDS, Walk Score, loneliness, self-rated health, and physical and social activities) [ 50 , 51 ]. Loneliness was measured using a single question from a three-item loneliness scale [ 52 ], “I feel isolated from others.” Self-rated health was measured using a single question, “In general, how would you rate your health?” with the following response options: good, rather good, poor, and very poor [ 53 ]. Physical activity was assessed at baseline by asking participants about their participation in the following activities during the past year: walking, cycling, jogging, swimming, muscle training, yoga, gymnastics, dancing, hiking, playing golf, playing grand golf, or ball exercise.…”