Age and Gender Differences in the Relationship Between Self-rated Health and Mortality Among Middle-aged and Elderly People in Taiwan—Results of a National Cohort Study

Abstract

Summary Background Self-rated health (SRH) is known to be a valid indicator for the prediction of mortality among middle-aged and older adults, but findings regarding age and gender differences are inconsistent. This study aimed to determine the association of SRH with subsequent mortality risk among middle-aged and elderly people in Taiwan. Methods This study was based on data from the “Taiwan Longitudinal Survey on Aging” (TLSA). A total of 2553 men and 2192 women aged ≥ 50 years of age comprised the major analytic cohort (mean age, 66.8 ± 9.1 years). SRH was categorized into good, fair, and poor health. Cox regression methods were used to examine the association between SRH and mortality. Results During the follow-up period (median: 10.1 years), 1644 deaths occurred. Participants with poor SRH were at higher risk of mortality [relative risk (RR), 1.35 95% confidence interval (CI), 1.16–1.55)] than those with good SRH. This SRH-mortality association was more pronounced among men (RR, 1.56, 95% CI, 1.30–1.87) than women (RR, 1.01, 95% CI, 0.80–1.27). The associations decreased with increasing age. The SRH-mortality associations were significant for the oldest age group among men, but among women, there was no significant SRH-mortality association across all age groups. Conclusion Low SRH was associated with increased risk of mortality among middle-aged and older adults. The association varied across different age and gender groups. The association was strongest in the group of men aged 50–59 years. The factors that might explain the differences in the associations warrant further research.