Self-rated Health Group Research Articles

Investigating Resilience Through Intrinsic Capacity Networks in Older Adults.

The network approach may provide a framework for understanding intrinsic capacity (IC) as a system's underlying functioning. The system's resilience to resist functional decline may arise from the interrelationships among system components, that is, body functions or capacities. We applied network analysis to investigate whether the interplay between different intrinsic capacities differs according to age and self-rated health (SRH) in older adults. The study sample consisted of a population-based cohort of community-dwelling older adults aged 75, 80, and 85 years (men n = 356 and women n = 469). We quantified 5 IC domains: vitality, locomotion, cognition, psychology, and sensory, using performance-based measurements and questionnaires, and estimated IC networks for 2 age (75 vs 80 and 85 years) and SRH (higher vs lower) groups separately for sexes. Differences in global network properties (eg, density, overall connectivity) and centrality indices were compared between the groups. Intrinsic capacity network density (ie, the number of edges) was higher in the 80- and 85-year-olds compared to the 75-year-olds, and in the worse compared to the better SRH group in both sexes. However, the differences in edge weights and global strength of the networks were statistically nonsignificant. Walking speed was the most central node in the estimated networks. With increasing age and health decline, the IC network seems to become denser, which may indicate a loss of system resilience. Walking is a more complex activity than the others requiring the functioning of many subsystems, which may explain why it connects multiple domains in the IC network.

Mediation of Grip Strength on the Association Between Self-Rated Health and Estimated Cardiovascular Disease Risk

Background: Grip strength and self-rated health (SRH) have been reciprocally related, and each has been associated with cardiovascular disease (CVD) risk. However, the pathway between SRH and grip strength in the association with CVD risk remains uncertain. This cross-sectional study evaluated whether grip strength mediates the association between SRH and estimated CVD risk. Methods: In 15,930 Koreans 40-79 years of age without CVD history from the 2014 to 2018 Korea National Health and Nutrition Examination Survey, the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using Pooled Cohort Equations. Relative grip strength (RGS) was defined as measured grip strength divided by body mass index. SRH was assessed using a single questionnaire. Results: After adjusting for the covariates, males in the non-highest RGS tertiles, the fair/poor/very poor SRH groups, or the other joined categories of RGS tertiles and SRH groups (except the highest RGS tertile and good SRH group) had higher odds for 10-year ASCVD risk ≥7.5% than the reference group. The ASCVD risk was higher in females in the lowest RGS tertile, the poor/very poor SRH group, or the combined category of lowest RGS tertile and poor SRH group than the reference group. RGS significantly mediated the relationship between better SRH and the lower ASCVD risk (indirect effect: β = -0.078, 95% CI [-0.097 to -0.060], P < 0.05) and reduced the total effect of SRH on the ASCVD risk (direct effect: β = -0.225, t = -3.203, P = 0.001). RGS mediated 26% of the association between SRH and ASCVD risk. Conclusion: Grip strength may have a mediating role in the relationship between SRH and the estimated 10-year risk of ASCVD.

Low Self-Rated Health as A Risk Factor for Depression in South Korea: A Survey of Young Males and Females.

This is a cross-sectional study aimed to examine whether low self-rated health (SRH) is a risk factor for depression among young males and females. Data from the SRH, quality of life (QoL) and depression questionnaires as well as general information, were collected from 512 males and females aged 20–29 years in South Korea. Chi-square test was used to analyze the distribution of depression between the high and low SRH groups. Logistic regression was used to analyze the relationship between SRH and depression after adjusting for covariates. There were 32.6% males and 30.1% females who were at risk for depression. A significant difference in the distribution of depression between the low and high SRH groups in both males and females was found. The low SRH group had a higher prevalence of depression than the high SRH group in both males and females in the crude analysis. However, when the BMI, economic status, and mental component score were adjusted, the OR of the low SRH group was still significant in males. Low SRH may be a risk factor for depression especially in males. Further studies to improve SRH by developing preventive measures against depression status while considering gender characteristics are needed.

Poor self-rated health predicts the incidence of functional disability in elderly community dwellers in Japan: a prospective cohort study

BackgroundAlthough previous large population studies showed elderly with poor self-rated health (SRH) to be at a high risk of functional disability in Western countries, there have been few studies in which the association between SRH and functional disability was investigated in Japanese community dwellers. The association between SRH and functional disability, defined as certification of the long-term care insurance (LTCI) system, in Japanese elderly community dwellers was examined in this study.MethodsA total of 10,690 individuals (39.5% men, mean age of 71.4 years) who were 65 years of age or more who did not have a history of cardiovascular disease or LTCI certification were followed in this prospective study for 10.5 years. SRH was classified into four categories: good, rather good, neither good nor poor, and poor. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) for the incidence of functional disability among the SRH groups for each sex.ResultsThe number of individuals with functional disability was 3377. Men who rated poor for SRH scored significantly higher for functional disability (HR [95% confidence interval]: poor = 1.74 [1.42, 2.14]) while women who rated rather good, neither good nor poor, and poor scored significantly higher for functional disability (rather good =1.12 [1.00, 1.25], neither good nor poor = 1.29 [1.13, 1.48], poor = 1.92 [1.65, 2.24]: p for trend < 0.001 in both sexes).ConclusionSelf-rated health, therefore, might be a useful predictor of functional disability in elderly people.

Gender differences in the effect of self-rated health (SRH) on all-cause mortality and specific causes of mortality among individuals aged 50 years and older.

Although different gender associations between self-rated health (SRH) and mortality have been reported, the results of the respective studies have been inconsistent and little is known about the cause-specific relation of mortality with SRH by gender. Therefore, to evaluate the gender differences in all-cause or specific causes of mortality by SRH, this retrospective cohort study was conducted using the data of 19,770 Korean adults aged 50 years and over who underwent health screening at Seoul National University Hospital between March 1995 and December 2008. SRH was surveyed using a simple questionnaire, and the all-cause mortality and cause-specific mortality were followed up from baseline screening until December 31, 2016. Results showed that the relationship between SRH and all-cause mortality differed by gender, and the differences also varied depending on the cause of death. In men, the adjusted hazard ratio (aHR) of all-cause mortality was higher in the poor SRH group than the very good SRH groups even after adjustment for socio-demographic, clinical, and behavioral risk factors (aHR:1.97, 95% CI 1.51-2.56), and these results were similar to those for cancer, cardiovascular, and respiratory disease mortalities (aHR:1.52, 95% CI 0.93-2.50; aHR: 2.11, 95% CI 1.19-3.74; aHR:10.30, 95% CI 2.39-44.44, respectively). However, in women, the association between SRH and all-cause mortality was insignificant, and inverse relationships were found for cardiovascular and respiratory disease mortalities in the poor and very good SRH groups. Cancer mortality had a positive relation with SRH (aHR: 1.14, 95% CI 0.75-1.72; aHR: 2.58, 95% CI 1.03-6.48; aHR: 0.49, 95% CI 0.24-0.98; aHR: 0.15, 95% CI 0.04-0.57: all-cause, cancer, cardiovascular, and respiratory disease mortalities, respectively). Clinicians need to take these gender differences by SRH into account when evaluating the health status of over-middle aged adults.

P47 Self-Rated Health and Lifestyle/Food Habits of Guardians of 7 to 16-Year-Old School Students

Background Self-rated health (SRH) status instruments are subjective by nature. They can help predict mortality risk. Therefore, this tool has been extensively employed in gerontology and public health. Among adolescents, SRH is influenced by shortage of food, family support and life satisfaction, suggesting that SRH is associated with lifestyle and food habits from young adolescents to the elderly. Objective The role of lifestyle, food habits and concerns about food in the SRH of guardians of 7 to 16-year-old school students in Japan was examined. Study Design, Settings, Participants In this cross-sectional study, we randomly selected 1,658 students and their guardians from eight schools in Hyogo, Japan, in 2017. Questionnaires were distributed to the students who were asked to give it to their parents. The completed questionnaires were returned via postage-free envelopes. Measurable Outcome/Analysis Only 496 (29.9%) participants returned both completed questionnaires. SRH was measured as a single item, i.e. ‘How would you rate your health?’, and responses were on a five-point likert-type scale as follows: 1 excellent; 2 very good; 3 good; 4 poor; 5 fair. The outcome variable was dichotomised as ‘high’ for scores 1 and 2 or ‘low’ for 3, 4 and 5. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for SRH. Results Of the respondents, 95.5% were mothers and 18.4% scored their SRH as fair or poor. Compared to the ‘low’ SRH group, ‘high’ SRH group guardians had lower body mass index (BMI) (OR, 0.89; 95% CI, 0.82–0.97), higher frequencies of eating breakfast (2.00; 1.30–3.09), talking with the family during meals (1.67; 1.25–2.28) and getting 7–8 hours of sleep (2.38; 1.45–3.92). There was no significant relationship between the SRH of the guardians and their children by χ2 test. Conclusion The SRH of guardians of students, aged 7–16 years in Japan, is influenced by frequency of eating breakfast, talking with family during meals, adequate sleep duration and lower BMI. Funding None.

Self-Rated Health and Lifestyle/Food Habits in Japanese Junior High School Students

Adolescence is a crucial period for health status formation. Adolescence is the period during which health-related behaviours, such as nutrition-related behaviours and physical activities, are developed. Self-rated health (SRH) assessment during adolescence is strongly associated with general well-being and psychosomatic symptoms. The current study investigated the relationship between SRH and lifestyle, eating habits and attitudes toward food among junior high school students. A total of 438 students aged 13&amp;ndash;15 years and their parents in the Hyogo prefecture of Japan participated in this study. Questionnaires were distributed to the students, who attempted them at home with their parents and returned them via Freepost envelopes. The questionnaires comprised the SRH assessment, lifestyle information, an unidentifiable description of the subject and their guardian&amp;rsquo;s SRH, and 39 parameters regarding food-related habits and attitudes. The &amp;chi;2 test or Fisher&amp;rsquo;s exact test were employed to assess any associations between the independent variables and SRH at a 5% level of significance. The differences between the healthy and unhealthy SRH groups were examined for all significant items using a logistic regression analysis after adjusting for sex and age. Of the participants, 188 (42.9%) returned both completed questionnaires. Among the respondents, 53.2% reported feeling very healthy. SRH assessment did not significantly differ with sex, age or school. Eleven parameters were significantly associated with SRH (P &amp;lt; 0.05 by &amp;chi;2 test). The guardians&amp;rsquo; SRH had no association with the students&amp;rsquo; SRH. The excellent SRH group had no headaches [odd&amp;rsquo;s ratio (OR): 1.68; confidence interval (CI): 1.29&amp;ndash;2.18], went to bed early [OR: 1.88; CI: 1.17&amp;ndash;3.02], liked home-cooked meals to a greater extent [OR: 2.55; CI: 1.54&amp;ndash;4.22], and had good exercise habits [OR: 2.98; CI: 1.27&amp;ndash;6.99] compared with the very good to poor SRH group. High SRH was strongly associated with going to bed early, not having headaches, liking home-cooked meals, and having good exercise habits among Japanese junior high school students.

Contribution of social relationships to self-rated health among Japanese community-dwelling elderly.

Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly.Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment.Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 (P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 (P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 (P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 (P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 (P = 0.227), respectively.Conclusion: This study indicated the importance of interaction with friends and relatives for maintaining higher SRH among community-dwelling elderly people.

Self-rated health is associated with subsequent functional decline among older adults in Japan.

Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan. A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later. One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61). SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

The relationship between self‐rated health and dietary choices of African Americans (806.6)

This cross sectional study investigated the relationship between dietary patterns measured with Healthy Eating Index 2005 (HEI‐05) and Self‐Rated Health (SRH) in African Americans (AA) with (n=129) and without (n=120) type 2 diabetes (T2D). Recruitment was by community outreach in South Florida. Socio‐demographic information and SRH were collected using questionnaires or self‐report. Dietary variables were collected using the Willett’s food frequency questionnaire, and then HEI‐05 scores were calculated. Reported SRH of individuals with T2D was lower (33.9%, p=.001) than SRH of those without T2D for excellent/very good category. HEI‐05 scores between T2D (41.10±11.62) and without T2D (44.01±13.54) groups were only marginally significant (p=.088). Linear regression model showed an association between SRH and HEI‐05 (p=.038, B=‐2.758) after controlling for covariates. ANCOVA analysis showed that after controlling for covariates the mean HEI‐05 scores of “excellent/very good” SRH group (46.53 ± 1.81) were significantly higher than HEI‐05 scores of “good” SRH group (41.77± 1.22, p=.029) and also than “fair/poor” SRH group (40.54±1.57, p=.016). African Americans had better dietary choices when they perceived their health as “excellent/very good”.Grant Funding Source: Supported by NIH/NIDDK sponsored grant. AV was supported by NIH/NIGMS R25 GM061347.

Factors Associated with Self-rated Health of Rural Population: A Report from the Prospective Observational Study

Factors Associated with Self-rated Health of Rural Population: A Report from the Prospective Observational Study

Effect of information seeking and avoidance behavior on self-rated health status among cancer survivors

ObjectiveSocial determinants, such as socioeconomic status (SES) and race/ethnicity are linked to striking health disparities across the cancer continuum. One important mechanism linking social determinants and health disparities may be communication inequalities that are caused by differences in accessing, processing and utilizing cancer information. In this context, we examined health information-seeking/avoidance as a potential mediator between social determinants and self-rated health (SRH) status among cancer survivors. MethodsData came from the 2008 well-informed, thriving and surviving (WITS) study of post-treatment cancer survivors (n=501). We examined the mediating effect of health communication-related behavior between SES and disparities in SRH. ResultsThe likelihood of belonging to the Low SRH group was higher among patients who had avoided health information and whose family members had not sought health information on behalf of the survivor, those in the lowest household income bracket, and those who had high school or less education after adjusting for potential confounders. ConclusionDifferences in SRH among cancer survivors are associated with SES as well as communication inequalities. Practice implicationsIt is necessary to provide a supportive environment in which health information is made available if disparities in health-related quality of life among cancer survivors are to be reduced.

Importance of Physical Performance and Quality of Life for Self-Rated Health in Older Japanese Women

ABSTRACTOur study aimed to investigate the physical performance and quality of life (QOL) as associated factors with self-rated health (SRH). Japanese community-dwelling women aged 65 years or more (n = 51; mean age = 75.3 ± 6.0) answered a questionnaire regarding socio-demographic information, SRH, QOL by the Short Form-8, and performed the physical tests, such as Timed Up and Go, Functional Reach (FR), One Leg Stand (OLS), Five Chair Stands (CS), and hand grip strength (HGS). Smoking (p = 0.04), more medical consultations (p = 0.03), and more number of medications (p = 0.001) were significantly associated with poor self-assessment of their health. Moreover, those who assessed their health condition as not so good to bad condition had lower performance in FR (p = 0.02), HGS (p = 0.04), OLS (p = 0.05), and CS (p = 0.02), and poorer QOL condition in general health (p < 0.01), bodily pain (p = 0.02), and vitality (p = 0.03) in comparison with the other SRH groups (good and/or normal). Therefore, we encouraged the use of the SRH assessment and the interpretation of its results based on the present findings such as associating the SRH of older women with their physical performance and QOL.

The association of neighbourhood and individual social capital with consistent self-rated health: a longitudinal study in Brazilian pregnant and postpartum women

BackgroundSocial conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum.MethodsA multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH – good SRH at baseline and follow-up, and, 2. Poor SRH – poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates.ResultsThe Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children, urinary infection and water plumbing outside the house.ConclusionsLow individual social capital during pregnancy, considered here as social support and social network, was independently associated with poor SRH in women whereas neighbourhood social capital did not affect women’s SRH during pregnancy and the months thereafter. From pregnancy and up to six months postpartum, the effect of individual social capital explained better the consistency of SRH over time than neighbourhood social capital.

Factors Associated with Self-rated Health in the Rural Population: Age- and Gender-specific Analysis.

Objective: Multiple studies worldwide have supported the predictive validity of self-rated health (SRH) with regard to disability and mortality among elderly people. Although SRH is an important study topic providing clues to enhance a person’s quality of life, there is currently insufficient data on age- and gender-specific differences among factors associated with SRH in Japan, particularly in rural areas. The present study examined the factors associated with SRH of a segment of Japan’s rural population by age- and gender-specific analysis.Methods: We used data from a cohort study of all users who underwent an annual health checkup at a public clinic in a rural area. The study subjects were 155 male and 169 female users from June 2009 to August 2010 who agreed to participate in this study. We divided the study subjects into 4 categories as follows: men aged less than 65, women aged less than 65, men aged 65 and over, and women aged 65 and over. The subjects who responded positively to the SRH-related questions were defined as the high SRH group, and those who responded negatively were defined as the low SRH group. We then compared the data between the high and the low groups in each category.Results: In all four categories, there were statistically significant differences in regular hospital or clinic attendance between the high and low SRH groups. In all four categories, there were no significant differences in eating or exercise habits between the two SRH groups.Conclusion: Because regular hospital or clinic attendance by a subject is indicative of the presence of chronic health problems, it is natural for the subject’s perception of their own health to be negative. However, rural physicians should provide patients with emotional and psychological support to deal with any health-related concerns positively.

Morbidity associated with "self-rated health" in epithelial ovarian cancer survivors

BackgroundEpithelial ovarian cancer survivors (EOCSs) frequently report multiple complaints after their treatment. The objective was to study somatic and mental morbidity in EOCSs associated with their Self- Rated Health (SRH) assessed by a single item.Findings were compared to age-matched controls from the general population.MethodsIn a cross -sectional follow-up design 189/287 (66%) EOCSs treated at The Norwegian Radiumhospital 1979–2003 responded to a mailed questionnaire on demographic data, and somatic and mental morbidity. SRH last week was rated on item #29 of the European Organization and Treatment of Cancer Quality of Life Questionnaire in 84/189 (97%) of responding EOCSs. For comparisons "good" and "poor" SRH groups were defined by the median score on the SRH item.ResultsEOCSs with "poor SRH" had higher level of somatic symptoms, anxiety, depression and fatigue than those with "good SRH" (p < .001). In multivariate analyses somatic symptoms, age and fatigue, were significantly associated with the SRH score in EOCSs, but not the cancer-related variables (FIGO stage, recurrence in < 6 months or chemotherapy ever). The model explained 70% of the variance in SRH in linear and 77% in logistic regression analyses. The distribution of the SRH scores in EOCSs did not differ significantly from that of normative controls; however a higher proportion of controls recorded a high SRH score.ConclusionSRH is strongly related to common somatic complaints, impairment and fatigue but not to cancer-related variables. A single question concerning SRH last week might be a quick screening method for collecting important information on symptoms in EOCSs, in addition to cancer – related questions.

Association Between a Self-Rated Health Question and Mortality in Young and Old Dialysis Patients: A Cohort Study

Self-rated health (SRH) has been shown to predict mortality in large community-based studies; however, large clinical-based studies of this topic are rare. We assessed whether an SRH item predicts mortality in a large sample of incident dialysis patients beyond sociodemographic, disease, and clinical measures and possible age interaction. Prospective cohort study. 1,443 predominantly white patients from 38 dialysis centers in The Netherlands participating in the Netherlands Cooperative Study on the Adequacy of Dialysis-2 between 1997 and 2004. SRH score completed at 3 months after the start of dialysis therapy (baseline). Cox proportional hazards model estimated the association between SRH and all-cause mortality. Interaction of SRH with age (<65 and >/=65 years) was examined in an additive model. Mean age of patients was 59.6 +/- 14.8 years, with 61% men and 69% married/living together. Mean follow-up was 2.7 +/- 1.8 years. Deaths per SRH group in the multivariate analyses sample: excellent/very good (9 of 63 patients; 14.3%), good (148 of 473 patients; 31.3%), fair (194 of 508 patients; 38.2%), and poor (45 of 71 patients; 63.4%). Patients with poor, fair, or good health ratings had a greater mortality risk than those with excellent/very good health ratings (adjusted hazard ratio [HR(adj)], 3.56; 95% confidence interval [CI], 1.71 to 7.42; HR(adj), 2.09; 95% CI, 1.06 to 4.12; HR(adj), 1.87; 95% CI, 0.95 to 3.70, respectively) independent of a range of risk factors. No age interaction with SRH was found. Although the SRH-mortality association remained strong despite extensive adjustments, unknown residual confounding could still exist. SRH is an independent predictor of mortality in incident dialysis patients. Patients with poor SRH in both age strata had a significantly increased risk of mortality even after controlling for demographic and clinical confounders. Patient self-assessment of health can be an invaluable and economical complement to clinical measures in risk assessment.

Changes in health, functional performance and activity predict changes in self-rated health: a 10-year follow-up study in older people

The purpose was to examine changes in self-rated health (SRH) in older people and associations between these changes and various self-reported and objectively measured indicators of health status, functional performance and activity at three time-points 5 years apart. Further, our aim was to examine whether SRH takes the form of a continuum. The study group comprised all the baseline 75-year-old inhabitants of the City of Jyväskylä, Finland ( N=382). Four groups were formed according to change/stability in SRH: ‘good–good’, ‘good–bad’, ‘bad–good’ and ‘bad–bad’. Cross-tabulation and one-way analysis of variance (ANOVA) was used to examine the cross-sectional differences, and GLM Repeated Measures to analyze the differences in changes in the determinants of SRH over time. Stability was more common than change in SRH, although in most participants there was a decline in most of the determinants of SRH. A systematic relation was found between the SRH groups and the indicators of health status, functional performance and physical and social activity, especially over the first 5-year period. A substantial decrease in these indicators was associated with a decline in SRH. Among older people change and stability in SRH over time systematically reflect health status, functional performance, and physical and social activity. The relatively high stability found in SRH indicates that with increasing age older people adapt to their worsening health conditions. SRH seems to form a continuum when a wide range of self-reported and objectively measured indicators on physical, psychological and social components of health are taken into account.