Self-rated Physical Functioning Research Articles

Physical Activity Levels, Correlates, and All-Cause Mortality Risk in People Living With Different Health Conditions.

To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality. We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity Questionnaire, and mortality data were obtained from the Dutch death register. People with a reported health condition were less likely to meet physical activity guidelines than people without a reported health condition (odds ratios ranging from 0.55 to 0.89). Higher body mass index and sitting time, and lower self-rated health, physical functioning, and education levels were associated with lower odds of meeting physical activity guidelines across most health conditions. Finally, we found a protective association between physical activity and all-cause mortality in both people living with and without different health conditions. People living with different health conditions are generally less physically active compared with people living without a health condition. Both people living with and without self-reported health conditions share a number of key factors associated with physical activity levels. We also observed the expected protective association between physical activity and all-cause mortality.

Association of Weight at Different Ages and All-Cause Mortality Among Older Adults in the US.

Objective: Assess the association of BMI and BMI change with mortality. Methods: Using data from the Wisconsin Longitudinal Study (WLS) on participants born mainly in 1939 (n=4922), we investigated the associations between various measures of BMI across the life course (age 54 BMI; age 65 BMI; age 72 BMI; lifetime maximum BMI; BMI change between ages 54 and 65; BMI change between ages 65 and 72) and mortality. We also assessed whether these associations are mediated by late life health. Results: BMI at age 54 was more strongly associated with late life mortality than BMI at older ages. The association between BMI change and mortality varied based on the timing of weight change. Health at age 72, particularly self-rated health, diabetes, and physical functioning, mediated the observed associations. Conclusion: Knowing older people's weight at midlife and how their weight has changed may be more important in assessing late life mortality risk than their current weight.

Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998-2016 Health and Retirement Study.

Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. We used data from the Health and Retirement Study (1998-2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50-64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.

EFFECTIVENESS OF BEHAVIOURAL MEDICAL REHABILITATION UNDER REALLIFE CONDITIONS IN GERMANY: A PROPENSITY-SCORE MATCHED ANALYSIS

ObjectivesIn Germany, behavioural medical rehabilitation programmes have been implemented for patients with musculoskeletal disorders and additional mental health comorbidity. The aim of this cohort study is to assess the relative effectiveness of behavioural medical rehabilitation under real-life conditions.DesignParticipants received either a common or behavioural medical rehabilitation programme. Propensity score matching was used to provide balanced samples of both groups (German Clinical Trials Register: DRKS00016404).ParticipantsA total of 360 patients treated in behavioural medical rehabilitation were compared with 360 matched controls. The mean age of study participants was approximately 53.5 years (standard deviation (SD)=7.0 years) and 74.0% were women.ResultsNo significant and clinical meaningful differences were found in return to work, applications for disability pension, and the number of patients receiving social security benefits in the year after rehabilitation. However, participants in behavioural medical rehabilitation reported better self-rated work ability, physical functioning and self-management skills, and decreased pain disability and fear-avoidance beliefs 10 months after rehabilitation. Standardized effect sizes were between 0.13 and 0.22.ConclusionBehavioural medical rehabilitation had no clinical meaningful effect on maintaining and restoring work ability. However, behavioural medical rehabilitation affected pain and disease management skills 10 months after completing the rehabilitation programme.LAY ABSTRACTMental health comorbidity increases the risk for patients with musculoskeletal disorders to receive a disability pension despite participating in a multimodal rehabilitation programme. In Germany, behavioural medical rehabilitation programmes were therefore developed for people who are affected from both musculoskeletal and mental health disorders. These programmes integrate additional psychological treatment into the standard multimodal rehabilitation approach. To test whether these programmes are more effective in enabling a stable return to work and improving self-rated health, this study compared 360 patients treated in behavioural medical rehabilitation with 360 comparable controls treated in conventional medical rehabilitation. The results indicate that participants could benefit more from a behavioural medical rehabilitation programme. Patients did not return to work significantly more often. However, they reported better self-rated work ability, better pain and health-related outcomes, and fewer days with unemployment benefits. In conclusion, more consistent implementation of the programme offers the opportunity to further improve these outcomes.

Does working beyond the statutory retirement age have an impact on health and functional capacity? The Finnish Retirement and Aging cohort study

ObjectiveThis study aimed to compare the development of self-rated health, psychological distress and physical functioning between those retired on time and those who continued working beyond the individual retirement age.MethodsThe...

Worry and rumination in breast cancer patients: perseveration worsens self-rated health.

A number of studies have shown that self-rated health reliably predicts mortality. This study assessed the impact of perseveration on self-rated health, physical functioning, and physical symptoms (pain, fatigue, breast cancer symptoms) among breast cancer patients. We hypothesized that cancer-related distress would serve as an intervening variable between both worry and rumination and self-rated health, physical functioning, and physical symptoms. Women (N = 124) who were approximately 7 weeks post-surgery but pre adjuvant treatment completed the Impact of Events Scale, the Penn State Worry Questionnaire, and the Rumination Scale. They also rated their pain, fatigue, physical functioning, and self-rated health using the RAND-36 and breast cancer symptoms with the Breast Cancer Prevention Trial Symptom Checklist (BCPT). Covariates included body mass index, age, cancer stage, menopause status, and physical comorbidities. Worry was associated with higher cancer-related distress, which in turn predicted greater pain and breast cancer symptoms, poorer physical functioning, and lower self-rated health. Rumination also predicted greater cancer-related distress, which ultimately contributed to greater pain along with poorer physical functioning and self-rated health. Models with fatigue as an outcome were not significant. These findings suggest that perseveration can heighten cancer-related distress and subsequent perceptions of physical symptoms and health among breast cancer patients prior to adjuvant treatment. Perseveration early in the cancer trajectory can adversely increase the impact of a cancer diagnosis and treatment on functioning and quality of life.

Prevalence and determinants of depressive symptoms among adults in Indonesia: A cross-sectional population-based national survey.

To analyze the association between personal health conditions (self-rated health, physical function, and chronic conditions) and symptoms of depression in Indonesia. Data were collected from the Indonesian family life survey 5. This study used a cross-sectional study design with a sample size of 17,734 respondents. We included depressive symptoms, self-rated health, physical function, chronic conditions, demographics and socioeconomic variables. The center for epidemiologic studies depression scale was used to measure symptoms of depression. Multivariate logistic regression analysis was used to analyze the data. The results showed that 23.47% of respondents had depressive symptoms, 20.04% had poor self-rated health, 55.93% had a poor physical function, and 32.37% had at least one chronic disease. Respondents who had poor self-rated health, had poor physical function, or had a chronic condition were all had a significantly higher odds of experiencing symptoms of depression after controlling for demographic variables (age, sex, married, and education level), social-economic, and smoking status. Depressive symptoms were significantly associated with personal health conditions including self-rated health, physical functioning, and chronic conditions among community residents. Strategies that can improve personal health conditions needed to be studied at the community level to improve the level of mental health.

Study of Independent Living Residents of a Continuing Care Senior Housing Community: Sociodemographic and Clinical Associations of Cognitive, Physical, and Mental Health

To examine associations of sociodemographic and clinical factors with cognitive, physical, and mental health among independent living older adults in a continuing care senior housing community (CCSHC). This was a cross-sectional study at the independent living sector of a CCSHC in San Diego County, California. Participants included English-speaking adults aged 65-95 years, of which two-thirds were women. Of the 112 subjects recruited, 104 completed basic study assessments. The authors computed composite measures of cognitive, physical, and mental health. The authors also assessed relevant clinical correlates including psychosocial factors such as resilience, loneliness, wisdom, and social support. The CCSHC residents were similar to a randomly selected community-based sample of older adults on most standardized clinical measures. In the CCSHC, physical health correlated with both cognitive function and mental health, but there was no significant correlation between cognitive and mental health. Cognitive function was significantly associated with physical mobility, satisfaction with life, and wisdom, whereas physical health was associated with age, self-rated physical functioning, mental well-being, and resilience. Mental health was significantly associated with income, optimism, self-compassion, loneliness, and sleep disturbances. Different psychosocial factors are significantly associated with cognitive, physical, and mental health. Longitudinal studies of diverse samples of older adults are necessary to determine risk factors and protective factors for specific domains of health. With rapidly growing numbers of older adults who require healthcare as well as supportive housing, CCSHCs will become increasingly important sites for studying and promoting the health of older adults.

Subjective Age as a Moderator in the Reciprocal Effects Between Posttraumatic Stress Disorder Symptoms and Self-Rated Physical Functioning.

It is now widely acknowledged that physical decline may increase among middle-aged and older adults who suffer from posttraumatic stress disorder (PTSD). Much less is known about the temporal sequencing of PTSD and physical decline relationship over time. While PTSD can lead to physical decline, physical decline may preserve or augment existing PTSD symptoms. Both problems can also mutually affect each other forming a vicious cycle. Additionally, it is important to address variables that can mitigate these longitudinal effects. Following the recovery capital framework, we consider how the existence or lack of capital in the form of young age identity may affect the recovery process. Therefore, the current study aimed to examine the reciprocal effects of PTSD symptoms and self-rated physical functioning and further test whether one’s subjective age moderates these effects. Using in-region random digit dialing, we collected a stratified sample of community dwelling older adult residing in south Israel. Of that sample (N at T1 = 339), 132 older adults (age range = 51–88, mean age = 66.90, SD = 9.14) were interviewed 4 months after the 2014 Israel–Gaza conflict (T2) and 1 year later (T3). Participants responded to PTSD symptoms scale, and reported their physical functioning and subjective age. PTSD symptoms and self-rated physical functioning were tested as both predictors and outcomes in a cross-lagged model. The moderating effect of subjective age was assessed by examining whether T2 variables interacted with subjective age in predicting T3 outcomes. Results showed that higher PTSD symptoms at T2 were associated with subsequent lower self-rated physical functioning at T3, yet self-rated physical functioning at T2 did not predict PTSD symptoms at T3, thereby highlighting the PTSD self-rated physical function direction. Moreover, subjective age moderated this latter association, so that this relationship was significant only for those who felt relatively older. In addition to clarifying the temporal sequencing of the PTSD self-rated physical functioning association, the study further suggests that an older subjective age (i.e., lack of recovery capital) could render middle-aged and older adults more susceptible to physical decline following PTSD symptoms. We therefore propose to develop interventions aimed at coping with an older age identity and facilitating a younger age identity among traumatized older individuals.

The Relationship Between Prior Concussions and Depression Is Modified by Somatic Symptomatology in Retired NFL Athletes.

A positive relationship between sport-related concussion (SRC) history and depressive symptoms in retired National Football League (NFL) athletes has been observed, with self-rated physical functioning identified as a confounding factor. The authors examined the influence of somatic symptom endorsement on the relationship between SRC history and self-reported depressive symptom severity in retired NFL athletes. Forty-three former NFL athletes completed self-report inventories of depression (with the Beck Depression Inventory II) and somatic symptoms (with the adjusted Patient Health Questionnaire-15). A moderation analysis examined the influence of somatic symptoms on the relationship between SRC history and depressive symptom severity. SRC history and somatic symptoms accounted for a significant amount of depressive symptomology. SRC history was not significantly associated with depressive symptom severity at low levels of somatic symptoms but was significant at the mean and high levels. The effect of somatic symptoms on depressive symptoms was nearly twice that of SRC history. The relationship between SRC and depression is complex, and treatment of depression in retired athletes should address comorbid somatic symptoms.

Symptom Experience and Self-rated Physical Functioning in Patients With Ovarian Cancer Receiving Chemotherapy: A Longitudinal Study.

In this longitudinal study, we investigated occurrence of multiple symptoms during chemotherapy in patients with ovarian cancer. We also evaluated whether self-rated physical functioning, selected demographic, and clinical variables were associated with symptom burden over time. In total, 82 patients provided longitudinal data (4 time points) by completing questionnaires including the Memorial Symptom Assessment Scale, the Karnofsky Performance Status Scale, and the Self-Administered Comorbidity Questionnaire. Demographic and clinical data were collected from medical records. Karnofsky Performance Status Scale score of less than 80 was defined as low and Karnofsky Performance Status Scale score 80 or higher as high physical functioning. Possible associations between the most frequent symptoms and selected variables were modeled using binary logistic regression for repeated measures. Palliative treatment was the main reason for treatment for 85% of the patients. Sixty percent of the patients reported high prevalence of symptoms, particularly lack of energy, difficulty sleeping, and worrying. The total number of symptoms increased during the treatment and returned to enrollment values at 6 months. This trend was dominated with physical symptoms. When we compared women with low (n = 33) versus high physical functioning (n = 49) at enrollment, low physical functioning was significantly associated with more symptoms and distress for the study period. Patients with low physical functioning were more likely to experience lack of energy (odds ratio [OR] = 8.33), feeling drowsy (OR = 4.17), feeling bloated (OR = 2.44), feeling sad (OR = 3.33), having pain (OR = 4.72), and worrying (OR = 2.50), and this remained stable throughout the observation period of 6 months. A high symptom burden was reported in this cohort of patients with ovarian cancer mainly treated with palliative intent. Low self-rated physical functioning was strongly associated with high symptom burden for the 6-month period. When chemotherapy is discussed with patients with ovarian cancer with low physical functioning, possible palliation benefits must be weighed against the added risk of long-term distressful symptoms that chemotherapy implies.

The age pattern of social inequalities in health at older ages: are common measures of socio-economic status interchangeable?

ObjectivesSocial inequalities in health have been largely documented in social science research. Members of the most disadvantaged groups experience worse health and higher mortality from birth throughout adulthood. However, it is not clear whether this association persists at older ages. Some studies have found a narrowing of the social gradient in health, at least when ‘traditional’ measures of socio-economic status (SES)—income, education, and occupation—are used. The main goal of the article is to highlight similarities and discrepancies in the age trend of social inequalities in health that arise when multiple measures of SES are considered. Study designThe present study uses a longitudinal sample of over 7000 individuals age 50+ from the Survey of Health, Ageing, and Retirement in Europe to examine the age trend of social inequalities in health. MethodsBy using growth curve models, individual trajectories of self-rated health and physical functioning were analyzed. SES is measured through wealth, income, and education. ResultsThe findings show that for both health outcomes, the choice of the indicator of SES is very consequential, as the age trend of social inequalities in health is substantially different for different measures of SES. ConclusionUsing multiple measures of SES is recommended, as using only one measure would give only a partial account of the age trend of social inequalities in health. In particular, wealth seems to better capture individual's socio-economic position, as it is able to detect health gradients even where education and income fail to do so.

The use of neipilept in treatment of asthenic syndrome

To assess the efficacy of neipilept in treatment of asthenic syndrome. Two groups of patients, aged from 30 to 40 years, with functional asthenia were examined. Patients were divided into main (n=40) and control (n=15) groups. In 22% men and 56% women, the disease was precipitated by emotional stress, in 46 and 38% by physical and stressful work conditions. Both groups received standard treatment. Patients of the main group received additionally neipilept in solution (500 mg daily) during 30 days. General physical and neurological examinations and psychometric assessment were performed. A significant reduction of asthenic symptoms, an increase in self-rated physical and mental functioning, a decrease in symptoms of cognitive dysfunction, anxiety and depression were observed in the main group compared to the control one. The positive changes in neuropsychological status improved quality of life and psychological adaptation in patients with functional asthenia exposed to chronic stress, physical and psychoemotional overstrain.

Associations between subjective social status and physical and mental health functioning among patients with hypertension

We examine the cross-sectional association between subjective social status and self-rated physical and mental health functioning in 518 Black and White patients enrolled in a community-based hypertension control research study. We found that (1) subjective social status, measured using both a proximal and distal referent group, was positively associated with physical and mental health functioning scores independent of educational level, household income, or both; (2) the effect of subjective social status on physical and mental health functioning differed significantly by race when using the distal, not the proximal, referent group. When the associations differed, they were stronger for Whites than Blacks.

Are Neighborhood Health Associations Causal? A 10-Year Prospective Cohort Study With Repeated Measurements

People who live in disadvantaged neighborhoods tend to have poor physical and mental health, but this might be due to selective residential mobility rather than causal neighborhood effects. As a test of social causation, I examined whether persons were less healthy when they were living in disadvantaged neighborhoods than at other times when they were living in more advantaged neighborhoods. Data were taken from the 10-year Household, Income and Labour Dynamics in Australia (HILDA) prospective cohort study, which had annual follow-up waves between 2001 and 2010 (n = 112,503 person-observations from 20,012 persons). Neighborhood disadvantage was associated with poorer self-rated health, mental health, and physical functioning, higher probability of smoking, and less frequent physical activity. However, these associations were almost completely due to between-person differences; the associations were not replicated in within-person analyses that compared the same persons living in different neighborhoods over time. Results were similar when using neighborhood remoteness as the exposure and when focusing only on long-term residence. In contrast, poor health predicted selective residential mobility to less advantaged neighborhoods, which provided evidence of social selection. These findings provide little support for social causation in neighborhood health associations and suggest that correlations between neighborhoods and health may develop via selective residential mobility.

The influence of the current recession on mental health and quality of life in people with chronic medical conditions seeking urgent care in Greek Accident and Emergency Departments

Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health.Participants were 3940 adults (1970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor–partner interdependence model.After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (bs = .08–.25, ps < .01). More optimistic people also reported better physical functioning (b = −.11, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b = − .09, p < .01) and fewer chronic illnesses (b = − .01, p < .05) over time. The strength of the relationship between optimism and health did not diminish over time.Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions.

The relationship between mental health and use of urgent care in patients with long term medical conditions. The findings from a 5 year programme grant

Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health.Participants were 3940 adults (1970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor–partner interdependence model.After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (bs = .08–.25, ps < .01). More optimistic people also reported better physical functioning (b = −.11, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b = − .09, p < .01) and fewer chronic illnesses (b = − .01, p < .05) over time. The strength of the relationship between optimism and health did not diminish over time.Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions.

Influence of depression, expectation of therapy effectiveness, and self-efficacy on the treatment outcome in patients with multiple somatic symptoms (MSS)

Optimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health.Participants were 3940 adults (1970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor–partner interdependence model.After controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (bs = .08–.25, ps < .01). More optimistic people also reported better physical functioning (b = −.11, p < .01) and fewer chronic illnesses (b = −.01, p < .05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b = − .09, p < .01) and fewer chronic illnesses (b = − .01, p < .05) over time. The strength of the relationship between optimism and health did not diminish over time.Being optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions.

Are people healthier if their partners are more optimistic? The dyadic effect of optimism on health among older adults

ObjectiveOptimism has been linked with an array of positive health outcomes at the individual level. However, researchers have not examined how a spouse's optimism might impact an individual's health. We hypothesized that being optimistic (and having an optimistic spouse) would both be associated with better health. MethodsParticipants were 3940 adults (1970 couples) from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. Participants were tracked for four years and outcomes included: physical functioning, self-rated health, and number of chronic illnesses. We analyzed the dyadic data using the actor–partner interdependence model. ResultsAfter controlling for several psychological and demographic factors, a person's own optimism and their spouse's optimism predicted better self-rated health and physical functioning (bs=.08–.25, ps<.01). More optimistic people also reported better physical functioning (b=−.11, p<.01) and fewer chronic illnesses (b=−.01, p<.05) over time. Further, having an optimistic spouse uniquely predicted better physical functioning (b=−.09, p<.01) and fewer chronic illnesses (b=−.01, p<.05) over time. The strength of the relationship between optimism and health did not diminish over time. ConclusionsBeing optimistic and having an optimistic spouse were both associated with better health. Examining partner effects is important because such analyses reveal the unique role that spouses play in promoting health. These findings may have important implications for future health interventions.

Sex differences in health and mortality in Moscow and Denmark

In high income countries females outlive men, although they generally report worse health, the so-called male-female health-survival paradox. Russia has one of the world's largest sex difference in life expectancy with a male disadvantage of more than 10 years. We compare components of the paradox between Denmark and Moscow by examining sex differences in mortality and several health measures. The Human Mortality Database and the Russian Fertility and Mortality Database were used to examine sex differences in all-cause death rates in Denmark, Russia, and Moscow in 2007-2008. Self-reported health data were obtained from the Study of Middle-Aged Danish Twins (n = 4,314), the Longitudinal Study of Aging Danish Twins (n = 4,731), and the study of Stress, Aging, and Health in Russia (n = 1,800). In both Moscow and Denmark there was a consistent female advantage at ages 55-89 years in survival and a male advantage in self-rated health, physical functioning, and depression symptomatology. Only on cognitive tests males performed similarly to or worse than women. Nevertheless, Muscovite males had more than twice higher mortality at ages 55-69 years compared to Muscovite women, almost double the ratio in Denmark. The present study showed that despite similar directions of sex differences in health and mortality in Moscow and Denmark, the male-female health-survival paradox is very pronounced in Moscow suggesting a stronger sex-specific disconnect between health indicators and mortality among middle-aged and young-old Muscovites.