Self-rated health status as a predictor of death, functional and cognitive impairment: a longitudinal cohort study

Abstract

Understanding the prognostic capacity of a simple measure of self-rated health (SRH) by older people becomes increasingly important as the population ages. SRH has been shown to predict survival, functional status and service use. The relationship with cognitive impairment has not been widely investigated. This paper investigates SRH as a predictor of death, functional impairment (inability to perform activities of daily living) and cognitive impairment (MMSE < 18) over a 10-year follow-up of participants in the MRC Cognitive Function and Ageing Study. A stratified random sample of 13,004 people aged 65 or over resident in five areas in England and Wales were interviewed. Analysis used data from interviews at baseline, 2, 6 and 10 year follow-up. Hazard ratios for risk of death, functional and cognitive impairment were estimated, unadjusted and adjusted for potential confounding baseline factors. Of the 13,004 participants recruited, 6,882 had died by 10 years and 1,252 and 481 new cases of functional and cognitive impairment respectively were recorded. SRH was associated with a higher risk of death, functional and cognitive impairment. The associations remained after adjustment for age, gender, functional ability and MMSE at baseline: comparing those who rated their health as excellent and good, hazard ratios for risk of death, functional and cognitive impairment were 0.8 (95% CI 0.8-0.9), 0.6 (95% CI 0.5-0.7) and 0.7(95% CI 0.5-0.9), respectively. In-depth qualitative study designs are needed to investigate why the meaning older people give to their health status predicts long-term outcomes.

Self-perceived Mental Health Status and Uptake of Fecal Occult Blood Test for Colorectal Cancer Screening in Canada: A Cross-Sectional Study

“…28 Self-reported health has also been shown to be highly correlated with overall health outcomes and can be considered to provide a valid measurement of mental health disorders. 29 Potential confounders included in the current analysis were age (5-year age groupings), gender (males vs. females), level of education completed (less than secondary education, secondary education, completion or vs. some/completed post-secondary education), race (White vs. non-White), and immigration status (yes vs. no).…”

Home-care clients’ need for help, and use and costs of services

“…Divan et al (1997) showed that living alone predicted the use of home help, while low functional ability predicted the use of healthcare services (see also Larsson et al 2006;van Campen and van Gameren 2005;Kadushin 2004;van Campen and Woittiez 2003). Other factors found to be connected with the need for and use of services are female gender, selfrated health, comorbidity, recent inpatient care and feelings of loneliness (Bond et al 2006;Fortinsky et al 2004;Hellström et al 2004;Lee and Mills 2000;Crets 1996;Wallace and Hirst 1996;Rannhoff and Laake 1995). However Algera et al's literature review (2004) revealed contradictory results on the association between client characteristics and need for care and the use of services.…”

Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers

“…As there is no recovery from the disease, overall health-related quality of life (HRQoL) is a concern amongst health care experts. The perceived self-assessed health status is considered to be a predictor of mortality and morbidity [3,4]. Adolescent patients with T1DM are challenged to cope with diverse short-and long-term complications of the disease.…”