Self-rated Health, Mortality, and Chronic Diseases in Elderly Men

Abstract

The value of self-rated health in predicting mortality and the incidence of chronic diseases was studied in a cohort of 783 elderly Dutch men in the Zutphen Study. In 1985, 48% of the men felt "healthy," while 12% felt "moderately healthy" or "not healthy." As of 1990, 23% of the 783 men had died. Survival analysis showed that self-rated health was highly predictive of subsequent 5-year mortality from all causes (p < 0.001). When adjusted for the presence of major chronic diseases, age, medication use, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, serum cholesterol, education, marital status, and family history of chronic diseases, the relative risk for "moderately healthy" or "not healthy" men compared with "healthy" men was 2.7 (95% confidence interval (CI) 1.8-4.3). Analysis of cause-specific mortality revealed that self-rated health was associated with cardiovascular mortality (crude relative risk (RR) = 2.7), but this finding resulted mainly from confounding by baseline prevalence of cardiovascular diseases (adjusted RR = 1.9, 95% CI 0.9-3.8). However, self-rated health was an independent risk factor for cancer mortality (adjusted RR = 4.2, 95% CI 1.9-9.4) and mortality due to other causes (adjusted RR = 3.0, 95% CI 1.2-7.8). Self-rated health did not independently predict the incidence of chronic diseases. This suggests that self-rated health especially affects fatality from chronic diseases rather than their onset, and this issue should be pursued further.

Self-rated health and cancer risk – a prospective cohort study among Danish women

“…As previous studies suggested that poor SRH may reflect subclinical disease and underlying biological and psychological changes [6,9], we introduced a two-year time lag in follow-up for cancer between 1999 and 2001 to avoid potential reverse causation. This changed our results in the direction of a null finding.…”

“…In a Dutch study (1993) of 783 men, only 60 cases of cancer were diagnosed during follow-up, which limits the weight of the evidence from this study. Furthermore, there was no adjustment for physical activity, which is an important risk factor for cancer [9]. In a longitudinal study in the USA (2012), with 4770 participants, recall bias and misclassification of the outcome may have been present due to self-reported onset of cancer.…”

Cognitive Functioning and Health as Determinants of Mortality in an Older Population

“…Health measures were selected because they encompass a broad range of health aspects. Moreover, the questions on self-rated health (29), functional limitations (11,17), medication use (29), and the presence of chronic diseases (30) as well as tests of lung function (31) and physical performance (32) have been shown to be associated with mortality in older adults.…”

Age, time, and cohort effects on functional status and self-rated health in elderly men.

“…'1 It is important to note that an average decline in functional status has its specific dynamics; in most studies, a large proportion of the elderly are found to remain stable in their functional status, a smaller proportion decline, and an even smaller, but not unimportant, proportion improve in functional status.7'8'1 [1][2][3][4][5][6][7][8][9][10][11][12][13] Self-rated health is also reported to deteriorate with advancing age, with the same underlying dynamics as the deterioration of functional status,14-l6 but it is less clear whether this relationship holds into old age. Some studies have reported better health ratings among the old-old than among the young-old.…”