Negative Self-perceived Health Research Articles

Association between sleep problems and self-perception of health among community-dwelling older adults: Data from the 2019 national health survey

BackgroundSleep problems in the older adults are often linked to their self-perceived health status, significantly affecting their overall well-being. Investigating this relationship is essential to understand how sleep impacts health perception in older adults and to develop targeted strategies to improve their quality of life and health outcomes. The objective was to verifying the association between sleep problems and negative self-perception of health in community-dwelling older adults. MethodsCross-sectional study, with data from 43,554 older adults participants of the National Health Survey (PNS-2019). The exposure variable was self-report of sleep problems in the last 15 days (difficulty in falling asleep, waking up frequently at night, or sleeping more than usual) and the study endpoints were self-perception of health (positive/negative). Associations were checked using multivariable logistic regression. ResultsOlder adults with sleep problems were 1.92 (95 %CI 1.77; 2.08) more likely to have a negative self-perception of health when compared to older adults without sleep problems. ConclusionsThese findings reinforce the need for programs aimed at reducing sleep problems in older adults, since these are associated with negative self-perceptions of health. A better understanding of these associations may help health care professionals to better control sleep disturbances as well as their outcomes.

Prevalência e fatores associados à fragilidade em pessoas idosas hipertensas por meio da Escala de Fragilidade de Edmonton e Índice de Vulnerabilidade Clínico Funcional-20

Abstract Objective To assess the prevalence of frailty and compare the variables associated with frailty in Brazilian community-dwelling older adults with hypertension using the Edmonton Frail Scale (EFS) and the Clinical Functional Vulnerability Index-20 (IVCF-20). Methods This is a cross-sectional analytical study conducted with community-dwelling older adults with hypertension aged ≥60 years residing in the city of Montes Claros, Minas Gerais, Brazil. Sample selection followed a probabilistic cluster sampling model. Data were collected between November 2016 and February 2017 through in-home questionnaire administration. Demographic, socioeconomic, and clinical-care variables were analyzed. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios. Results A total of 281 older adults with hypertension participated in the study. The overall prevalence of frailty as assessed by the EFS was 31.3%, and by the IVCF-20 was 22.1%. Variables that were statistically associated with frailty in older adults with hypertension, as determined by both the EFS and IVCF-20 simultaneously, were: advanced age (80 years or older), comorbidities such as rheumatoid arthritis/osteoarthritis, stroke, negative self-perception of health, falls, and hospitalizations in the last 12 months. Only by the EFS, variables associated with frailty included less than 4 years of education, absence of religious practice, and lack of personal income. Meanwhile, according to the IVCF-20, only monthly family income was associated with frailty. Conclusion It was found that frailty assessed by EFS and IVCF-20 exhibits similarity; however, EFS is more sensitive. These findings underscore the imperative for healthcare professionals to early identify frailty.

Health indicators in Brazil and Spain: strategies for health promoting universities.

The study aims to identify and compare health indicators collected by national research in Spain and in Brazil that can generate action strategies for health promoting universities. This is an epidemiological, descriptive, cross-sectional study that uses the database of the Secretariat of Health Surveillance of the Brazilian Ministry of Health and the database of the National Statistics Institute of Spain. Based on the National Health Promotion Policy, the analyzer axis prioritizes defined themes; percentage of physical exercise, daily smokers, sedentary lifestyle, obesity and self-perception of health status were evaluated. The data were collected from 2014 to 2020. In Brazil, physical exercise is the highest percentage indicator, whereas in Spain, sedentary lifestyle is the highest. Regarding the age group, Brazil presented the lowest prevalence of daily smokers in the age group from 18 to 24, with little increase in older age groups; in Spain, older age groups presented the highest rates of sedentary lifestyle and obesity. In 2020, 4.5% of Brazilians reported a negative self-perception of health and in Spain 6.6%. The indicators 'physical exercise', 'daily smokers' and 'sedentary lifestyle' presented better results in Brazil than in Spain. Brazil presents a better perspective on health when compared with Spain, as the results showed that older ages present higher rates of sedentary lifestyle and obesity. Our study results also show that Brazilians report better self-perception in health, which can be interpreted by health promotion strategies.

Sintomas Depressivos e Uso de Álcool e Maconha em Adolescentes

Abstract Risk behaviors are common in adolescence and demonstrates an association with depressive symptoms. Considering the psychological health implications of this phase in adult life, the aim of this study was to verify associations between depressive symptoms and consumption of alcohol and marijuana, self-injurious behavior, health self-perception, life satisfaction, anxiety symptoms and suicidal ideation in adolescents. A total of 298 adolescents, aged 12 to 14 years (61.1% girls), participated in the study. The measures were the translated Health Behavior in School-aged Children questionnaire (HBSC - BR) and the Children’s Depression Inventory (CDI). The chi-square test, student’s t test and binomial logistic regression (p<0.05) were used. Depressive symptoms were associated with anxiety symptoms and self-injury. Higher risk for alcohol use and consumption, self-injury, negative health self-perception, anxiety and depression related to females. The findings of this population suggest worrying health outcomes, especially for girl.

Use of integrative and complementary health practices by Brazilian population: results from the 2019 National Health Survey

BackgroundIn 2006, Brazil implemented the National Policy on Integrative and Complementary Practices of the SUS. and in 2015, the Brazilian Ministry of Health issued a reinforcement to this policy to increase access to integrative and complementary health practices (ICHP). In this study, we described the prevalence of ICHP in Brazilian adults according to their sociodemographic characteristics, self-perceived health, and chronic diseases.MethodsThis is a nationally representative cross-sectional survey including 64,194 participants from the 2019 Brazilian National Health Survey. Types of ICHP were categorized according to their purposes: health promotion (Tai chi/Lian gong/Qi gong, yoga, meditation, and integrative community therapy) or therapeutic practices (acupuncture, auricular acupressure, herbal treatment and phytotherapy, and homeopathy). Participants were classified as non-practitioners and practitioners, who in turn were grouped according to use of ICHP in the last 12 months: only used health promotion practices (HPP); only used therapeutic practices (TP); used both (HPTP). Multinomial logistic regressions were performed to estimate the associations of ICHP with sociodemographic characteristics, self-perceived health status, and chronic diseases.ResultsBrazilian adults showed an ICHP use prevalence of 6.13% [95%CI = 5.75–6.54]. Compared to non-practitioners, women and middle-aged adults were more likely to use any ICHP. Afro-Brazilians were less likely to use both HPP and HPTP, whereas Indigenous people were more likely to use both HPP and TP. We found a positive gradient of association among participants with higher income and educational attainment and access to any ICHP. People from rural areas and those with negative self-perceived health were more likely to use TP. Participants with arthritis/rheumatism, chronic back problems, and depression were more likely to use any ICHP.ConclusionsWe found that 6% of Brazilian adults reported using ICHP in the previous 12 months. Women, middle-aged individuals, chronic patients, people with depression, and wealthier Brazilians are more likely to use any type of ICHP. Of note, rather than suggesting to expand the offer of these practices in the Brazilian public health system, this study diagnosed Brazilians’ behavior of seeking for complementary healthcare.

Factors associated with frailty syndrome in older adults with three- and four-criteria clustering

This study aimed to identify the main clusters of diagnostic criteria pertaining to frailty syndrome as well as the factors associated with the occurrence of frailty without diagnostic criteria clusters and with clusters of three and four criteria. This is a cross-sectional study, carried out with 216 older adults. In order to determine the dependent variable, a combination of the following criteria for frailty syndrome diagnostic criteria was used: unintentional weight loss, exhaustion, muscle weakness, a low level of physical activity, and a slow gait speed. There were different clusters of Frailty Syndrome diagnostic criteria and were associated with Frailty with clustering of three criteria, age group ≥80 years and negative self-perception of health and Frailty with clustering of four criteria, age group ≥80 years and polypharmacy use. Age, self-perception of health, and polypharmacy can be assessed to target different intervention plans in the frail older adult population.

Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study.

Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.

Fatores associados à prática de atividade física entre universitários durante o isolamento social- pandemia covid-19

Abstract This study sought to analyze the practice of physical activity (PA) among university students, during the COVID-19 pandemic, and associated factors. This is a cross-sectional study with an analytical approach, carried out with 857 university students enrolled in higher education institutions in Montes Claros, in the state of Minas Gerais. Data collection was carried out using the Google forms, which was shared via social networks, containing questions regarding sociodemographic profile, physical activity, clinical factors, and behavioral and health habits. A descriptive exploratory analysis of the data was carried out, with frequency distribution of the study variables. Subsequently, bivariate analyses were performed and the associated variables with up to a level of 20% (p ≤ 0.20) were selected for multiple analysis using Poisson Regression. The prevalence non-practice of PA during the pandemic was of 56.8% among college students. Variables, such as being with a partner (PR=1.28), presence of respiratory diseases (PR=1.17), negative self-perception of health (PR=1.37), increased consumption of ultra-processed foods (PR=1.29), and presence of depression (PR=1.21), showed statistically significant associations with the practice of physical activity. We concluded that the non-practice of PA in university students during the social isolation caused by the COVID-19 pandemic is associated with marital status, presence of respiratory diseases, negative self-perception of health, increased consumption of ultra-processed foods, and presence of depression.

Association among oral health and academic performance: a longitudinal study in a university in Southern Brazil

This longitudinal study aimed to investigate the association between self-perceived oral health, oral-health-related quality-of-life (OHRQoL), toothache, and university students' academic performance or dropout. A cohort of 2,089 students from 64 different courses at a public university in southern Brazil was interviewed in 2016 regarding their self-perceived oral health (Locker instrument; dichotomized into good/poor), OHRQoL (Oral Impacts on Daily Performances instrument, OIDP) and having had any toothache over the last 6 months (yes/no). After three years (2020), the academic records of 1,870 of these students were assessed, their average grade over all courses evaluated, and their dropout status was determined. Multivariable linear or logistic regression adjusting for gender, skin color, age, family income and maternal education was used to associate oral health variables (self-perceived oral health, OIDP, toothache) and academic performance or dropout. In 2016, 28.6% reported negative self-perceived oral health through the Locker instrument and 31.4% had toothache in the last 6 months. Over the next three years, 36.2% had dropped out. In multivariable regression, toothache in the last 6 months had a decrease of 0.32 (β -0.32, CI95% -0.59; -0.04) points in the final grade and were 35% (OR 1.35 CI95% 1.08; 1.69) more likely to dropout than students without toothache. In conclusion, this study showed that worse oral health conditions may be associated with worse academic performance or dropping out.

Does Physical Activity Reduce the Risk of Perceived Negative Health in the Smoking Population?

Smoking is associated with poor health status. Increased prevalence of multiple diseases has been found in populations of smokers and ex-smokers. Physical activity (PA) could reduce the negative effects of smoking. To analyze the relationships between smoking and self-perceived health and between PA level and self-perceived health, according to the relationship with smoking in the Spanish population. To calculate the risks of perceiving negative health in relation to smoking, according to the PA level of the population. A higher level of PA reduces the risk of perceiving negative health in the Spanish smoking population. Cross-sectional study with data from 17,708 participants, 15-69 years old, interviewed in the Spanish National Health Survey 2017. Intergroup differences were studied. Odds ratios (OR) and relative risks (RR) and their confidence intervals (95% CI) were calculated for negative self-perceived health. A Spearman's rho correlation study was performed between the variables of interest. Dependency relationships were found between self-perceived health and PA levels, in both genders and in different relationships with smoking (x2 < 0.001). Inactivity was related to higher prevalences of negative health perception (p < 0.05) in all groups analyzed. Inactive smokers (OR: 6.02. 95% CI: 3.99-9.07. RR: 5.24. 95% CI: 3.56-7.73) presented increased risks of negative health perception compared to people with low/medium PA levels, similarly found in other relationships with tobacco. Increasing the PA level of the smoking population could reduce the negative effects on their perceived health. Medium and high PA levels reduce the risk of negative health perception in the Spanish population, both in smokers, ex-smokers, and non-smokers.

Physical Activity Level, Depression, Anxiety, and Self-Perceived Health in Spanish Adults with Migraine: A Cross-Sectional Study.

Of all neurological disorders, migraine is the second most prevalent in the world and the most disabling, affecting approximately 15% of the general population. It is characterized by recurrent headaches, along with other symptoms and comorbidities such as depression and anxiety, compromising the sufferer's perception of health. Physical activity is a preventive treatment for migraine and its comorbidities. The aim is to analyze the relationship between migraine and physical activity levels (PAL) in the adult Spanish population, as well as PAL and depression, anxiety, and self-perceived health (SPH) in people with migraine. A cross-sectional study was conducted including 17,137 participants, 1972 with migraine, using data from the Spanish National Health Survey. Non-parametric statistical tests were performed: z-test for independent proportions (to analyze intergroup differences) and chi-square test (to analyze dependence between categorical variables). Migraine was related to PAL (p < 0.001). Inactive people had a higher prevalence of migraine than active and very active people (p < 0.05). PAL was related to depression, anxiety, SPH, and analgesic use in people with migraine (p < 0.001). Inactive people had a higher prevalence of depression, anxiety, analgesic use, and negative SPH than active and very active people (p < 0.05). Increasing PA in the population could reduce the prevalence of migraine. In people with migraine, inactivity could worsen SPH and increase depressive and anxious symptoms.

A comparative analysis of health status of international migrants and local population in Chile: a population-based, cross-sectional analysis from a social determinants of health perspective

BackgroundDuring recent decades intraregional migration has increased in Latin America. Chile became one of the main receiving countries and hosted diverse international migrant groups. Evidence have suggested a healthy migrant effect (HME) on health status, but it remains scarce, controversial and needs to be updated. This study performed a comprehensive analysis verifying the existence of HME and its association with social determinants of health (SDH).MethodsWe analyzed data from the Chilean National Socioeconomic Characterization Survey (CASEN, version 2017). Unadjusted prevalence of health status indicators such as negative self-perceived health, chronic morbidity, disability, and activity limitations were described in both international migrants and local population. Adjusted associations between these outcomes and sets of demographics, socioeconomic, access to healthcare, psychosocial and migration-related SDH were tested using multivariate logistic regression in each population. The HME for each health outcome was also tested using multivariate logistic regression and sequentially adjusting for each set of SDH (ref = Chilean).ResultsInternational migrants had lower unadjusted prevalence of all health indicators compared to Chileans. That is, unadjusted analysis revealed an apparent HME in all health outcomes. Age, unemployment, and health care system affiliation were associated with health outcomes in both populations. Psychosocial determinants were both risk and protective for the analysed health outcomes. After adjustment for each set of SDH, the immigrant health advantage was only significant for chronic morbidity. Being migrant was associated with 39% lower odds of having chronic diseases compared to locals (OR: 0.61; 95% CI: 0.44–0.84; P = 0.0003). For all other outcomes, HME disappeared after adjusting by SDH, particularly unemployment, type of health system and psychosocial factors.ConclusionsTesting the HME in Chile revealed an advantage for chronic morbidities that remained significant after adjustment for SDH. This analysis shed light on health disparities between international migrants and local population in the Latin American region, with special relevance of unemployment, type of health system and psychosocial SDH. It also informed about differential exposures faced during migration process that could dissolve the HME over time. Evidence from this analytical approach is useful for informing health planning and intersectoral solutions from a SDH perspective.

Piora da fragilidade em pessoas idosas comunitárias com hipertensão e fatores associados

Abstract Objective To estimate the prevalence and factors associated with the worsening of frailty in older people with arterial hypertension. Methods Quantitative, longitudinal, prospective and analytical study. Carried out in community-dwelling hypertensive older people from Minas Gerais. Sampling was probabilistic, by clusters in two stages. Data collection took place at the older people's homes in two moments. Demographic, socioeconomic and clinical-assistance variables were analyzed. Frailty was measured by the Edmonton Frailty Scale. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios. Results 281 older people participated in the study, 23.1% showed a worsening of their state of frailty. The prevalence of frailty increased from 38.0% in the base year to 31.2% in the first wave. The worsening of frailty was associated with negative self-perception of health, polypharmacy and hospitalization in the last 12 months. Conclusion There was a transition between states of frailty. An important contingent of the older people showed worsening frailty.

Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study.

To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities. Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables. Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community. The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.

Práticas de autocuidado em saúde entre pessoas idosas com morbidade da comunidade

to describe sociodemographic and health characteristics of older adults with morbidity, identify self-care practices and verify the association of sociodemographic variables with those related to health and self-care practices. a quantitative, analytical and cross-sectional household survey, developed in the urban area in the countryside of Minas Gerais, from 2017 to 2018. A total of 796 older adults were assessed using validated instruments, such as Geriatric Depression Scale: short form, Brazilian Questionnaire for Functional and Multidimensional Assessment, International Physical Activity Questionnaire, Instrument for Assessing Attitude Towards Taking Medications. Multiple logistic regression (p<0.05) was used. negative self-perceived health was associated with low income and education. As for self-care in health, being physically active associated with the age group 60 |-| 79 years and higher education. sociodemographic variables such as sex, age group, income, education, marital status, housing arrangement were related to health status and self-care practice.

Factors Associated With Psychosocial Illness Impact Among Black/African American and Hispanic Older Women Living With HIV.

In 2018, one in six newly diagnosed individuals with HIV in the United States were adults aged 50 years and older, 24% were women, and 60% were Black/African American and Hispanic (42% and 18%, respectively). This study aims to examine the factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women living with HIV. Guided by the socioecological model, a secondary data analysis design with cross-sectional data that included 138 Black/African American and Hispanic women aged 50 years and older was conducted. Higher levels of avoidant coping, depressive symptoms, negative self-perception of health, and decreased social support were significant factors associated with HIV psychosocial illness impact among this sample. Findings from this study can contribute to identifying solutions to prevent and decrease these negative factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women.

Negative self-perceived health in mothers of children and adolescents during the COVID-19 pandemic

Introduction: The COVID-19 pandemic represents a major stressful event, drastically affecting the population's quality of life. In this context, self-perception of health stands out as an indicator of health itself, and is increasingly used in epidemiological studies given its validity and reliability. It is strongly associated with the real state of people's health, incorporating their physical, cognitive and emotional aspects, as well as a sense of well-being and satisfaction with life. The individual's perception of feeling sick does not come only from the physical sensations of pain and discomfort, but, above all, from the social and psychological consequences of ill health. Thus, women in particular, due to their social roles and the intensification of their workload, which has been accentuated in the pandemic context, have a higher prevalence of negative self-perception of health, justifying the importance of the study. Objectives: To assess the prevalence of negative self-perception of health in mothers during the pandemic and to relate it to sociodemographic and health variables. Methodology: Cross-sectional study, carried out in the second half of 2020, with 822 mothers (aged ≥ 18 years) of children and adolescents, who answered an online questionnaire containing sociodemographic and health variables. Self-perceived health was classified as positive (very good and good) or negative (regular, bad, and very bad). Chi-square and Mann-Whitney tests were used for the analyses. Results: The mothers' mean age was 37.1 years, with 46.8% showing negative self-perception of health. Women who identified with a number of factors (had no partner; had completed ≤ 11years of schooling; were younger; slept fewer hours a night; were unemployed; felt overwhelmed in caring for their children; and suffered violence during the pandemic) had a significantly higher proportion of negative self-perception of health. Discussion and conclusion: The results of our study suggest worrying evidence of mothers' negative psychological response to the COVID-19 pandemic, since the high prevalence of negative self-perceived health may be associated with higher levels of depression, stress and anxiety. Thus, throughout the care process, attention should be paid to the biopsychosocial nature of the phenomena that make up the illness process, especially among the vulnerable population in question. Understanding and monitoring the health and quality of life of mothers during and after the pandemic is essential for carrying out preventive care and health promotion interventions and actions in primary healthcare settings in order to create and optimize policies aimed at managing the effects of this public health issue.

Trajectories of phenotypical frailty over a decade in young–old community-dwelling adults: results from the Lc65+ study

BackgroundFew studies have examined the frailty trajectories of young–old adults using Fried frailty phenotype. Dropouts due to death were rarely taken into account. This longitudinal study aimed to identify trajectories...

Iniquidades socioeconômicas na saúde bucal de estudantes universitários do sul do Brasil

Objective: To identify the magnitude of the association between dental caries experience and negative self-perception of oral health with socioeconomic determinants. Methods: Cross-sectional study conducted with data from a prospective cohort with university students entering the Federal University of Pelotas (UFPel) in 2016. Data were collected through a self-administered questionnaire, including demographic, socioeconomic and psychosocial characteristics. The outcomes of the present study were experience of self-reported caries (history of caries disease) and self-perceived oral health (positive versus negative). Results: A total of 3,237 students joined, of which 2,089 (64.5%) agreed to participate in the study. The Poisson regression model known that university students with an income of R $ 1001 to 5000.00 and R $ 5001 or more primary, respectively, a prevalence ratio (PR) 14% (PR=0,86; 95%CI 0,80-0,92) and 18% (PR=0,82; 95%IC 0,74 a 0,90) lower of caries experience, as well as individualizing mothers had completed high school prevalence a 14% (PR= 0,86; 95%CI 0,80 a 0,92) lower prevalence and complete higher education 19% (PR= 0,81; 95%CI 0,75 a 0,87) less caries experience when compared to reference groups. In the self-perception of oral health, the results for income of R $ 1001 to 5000.00 and R $ 5001 or more dissipated, respectively, a 23% (PR= 0,77; 95%IC 0,64 a 0,91) and 43% (PR= 0,57; 95%IC 0,45 a 0,72) lower prevalence of having negative self-perception of oral health and qualified originating from complete higher education reported a 23% lower prevalence of negative self-perceived oral health when compared to the reference (PR= 0,79; 95%IC 0,66 a 0,97). Conclusions: The findings of the present study confirm that socioeconomic indicators influence the experience of caries and self-perceived oral health among university students.

"Working old-old": Psychological well-being, cognitive abilities and physical health of employed and self-employed Europeans aged 75.

Recent research deals with the effects of employment/self-employment of elderly on mental and physical health. However, the rising group of "old-old", aged 75 and above, is almost missing in this research. This study aimed to analyze psychological well-being, cognitive abilities and physical health of employed/self-employed and retired Europeans aged 75 and above ("old-old"). We used data recently collected by Survey of Health, Ageing and Retirement in Europe (SHARE). Our final sample consisted of N = 9,884, 57.69%were female. Employed or self-employed (vs. retired) rate was 30.20%for male and 28.88%for female. Mean age of the sample was 81.07 (SD = 4.90). Employed/self-employed "old-old" showed significant better psychological well-being, cognitive abilities and physical health than their retired counterparts. Age of the groups did not differ. Further analysis indicated the close connection between physical health (i.e. chronic diseases, negative self-perceived health, physical inactivity and ADL number of limitations) and employment/self-employment status. Against the background of continuity theory of ageing future research has to focus on the growing group of "old-old" still working.