Abstract
OBJECTIVESSelf-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably.METHODSThis study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status.RESULTSFor cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2).CONCLUSIONSSelf-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.
Highlights
IntroductionThe patient loses the ability to perform daily activities, and a heavier burden of psychological and physical care is placed on the patient’s family or caregiver [2]
This study verified whether the predictive power of self-rated health varied according to cognitive impairment, in line with the currently increasing number of cognitively impaired individuals due to aging
The results showed that, for cognitively intact individuals and for all participants, the hazard ratio (HR) of those who responded bad or very bad for self-rated health was significantly higher than that for those with very good self-rated health, regardless of the model used
Summary
The patient loses the ability to perform daily activities, and a heavier burden of psychological and physical care is placed on the patient’s family or caregiver [2]. The number of dementia patients is rapidly increasing worldwide due to aging of the population. In 2017 in Korea, the number of dementia patients among individuals aged ≥ 65 years was approximately 0.7 million (10.0%), which is anticipated to increase to approximately 3.02 million (16.1%) by 2050 [3,4]. There is an urgent need for a valid health assessment tool and intervention for the population without the ability to take care of themselves due to cognitive impairment caused by conditions such as dementia
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