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Brückner RM, Schönenberg A, Wientzek R, Schreiber M, Prell T. Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe. J Diabetes 2024. [PMID: 38168898 DOI: 10.1111/1753-0407.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. METHODS We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. RESULTS We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). CONCLUSIONS As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.
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Affiliation(s)
| | | | - Rebecca Wientzek
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Mandy Schreiber
- Department of Internal Medicine II, Halle University Hospital, Halle, Germany
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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Vargese SS, Jylhä M, Raitanen J, Enroth L, Halonen P, Aaltonen M. Dementia-related disability in the population aged 90 years and over: differences over time and the role of comorbidity in the vitality 90 + study. BMC Geriatr 2023; 23:276. [PMID: 37149593 PMCID: PMC10163713 DOI: 10.1186/s12877-023-03980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND The burden of dementia, multimorbidity, and disability is high in the oldest old. However, the contribution of dementia and comorbidities to functional ability in this age group remains unclear. We examined the combined effects of dementia and comorbidities on ADL and mobility disability and differences between dementia-related disability between 2001, 2010, and 2018. METHODS Our data came from three repeated cross-sectional surveys in the population aged 90 + in the Finnish Vitality 90 + Study. The associations of dementia with disability and the combined effects of dementia and comorbidity on disability adjusted for age, gender, occupational class, number of chronic conditions, and study year were determined by generalized estimating equations. An interaction term was calculated to assess differences in the effects of dementia on disability over time. RESULTS In people with dementia, the odds of ADL disability were almost five-fold compared to people with three other diseases but no dementia. Among those with dementia, comorbidities did not increase ADL disability but did increase mobility disability. Differences in disability between people with and without dementia were greater in 2010 and 2018 than in 2001. CONCLUSION We found a widening gap in disability between people with and without dementia over time as functional ability improved mainly in people without dementia. Dementia was the main driver of disability and among those with dementia, comorbidities were associated with mobility disability but not with ADL disability. These results imply the need for strategies to maintain functioning and for clinical updates, rehabilitative services, care planning, and capacity building among care providers.
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Affiliation(s)
- Saritha Susan Vargese
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland.
- Believers Church Medical College Hospital, Thiruvalla, India.
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Mari Aaltonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
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3
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Aguiñaga S, Guzman J, Soto Y, Marquez DX. Self-rated health as a predictor of cognition among middle-aged and older Latinos. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:388-401. [PMID: 35174775 PMCID: PMC9381643 DOI: 10.1080/13825585.2022.2038070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
Self-rated health (SRH) has been used to predict cognitive decline in various populations; however, this relationship has not been examined in Latinos. This study examines the relationship between SRH and cognition among middle-aged and older Latinos. A cross-sectional analysis was conducted among Latinos (n = 425, Mage = 64.13 ± 7.65, 82% female). Participants rated their health as poor/fair, good, and excellent and completed cognitive performance tests. Analyses of covariance (ANCOVA) examined differences in cognition between SRH categories. ANCOVAs showed significant differences in SRH categories for working memory (F [2, 357] = 3.63, p = .028) and global cognition (F [2, 348] = 3.074, p = .047), such that those who self-rated their health as good had better scores compared to participants in the poor/fair category. Findings show that SRH is associated with cognition among middle-aged and older Latinos. SRH may serve as an indicator of early signs of cognitive decline.
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Affiliation(s)
- Susan Aguiñaga
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - Jacqueline Guzman
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - Yuliana Soto
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - David X. Marquez
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Chicago, IL 60612, United States
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4
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Dramé M, Cantegrit E, Godaert L. Self-Rated Health as a Predictor of Mortality in Older Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3813. [PMID: 36900823 PMCID: PMC10001164 DOI: 10.3390/ijerph20053813] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to investigate the link between self-reported health (SRH) and mortality in older adults. In total, 505 studies were found in PubMed and Scopus, of which 26 were included in this review. In total, 6 of the 26 studies included did not find any evidence of an association between SRH and mortality. Of the 21 studies that included community dwellers, 16 found a significant relationship between SRH and mortality. In total, 17 studies involved patients with no specific medical conditions; among these, 12 found a significant link between SRH and mortality. Among the studies in adults with specific medical conditions, eight showed a significant association between SRH and mortality. Among the 20 studies that definitely included people younger than 80 years, 14 found a significant association between SRH and mortality. Of the twenty-six studies, four examined short-term mortality; seven, medium-term mortality; and eighteen, long-term mortality. Among these, a significant association between SRH and mortality was found in 3, 7, and 12 studies, respectively. This study supports the existence of a significant relation between SRH and mortality. A better understanding of the components of SRH might help guide preventive health policies aimed at delaying mortality in the long term.
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Affiliation(s)
- Moustapha Dramé
- EpiCliV Research Unit, Medical School, University of the French West Indies, 97261 Fort-de-France, France
- Department of Clinical Research and Innovation, University Hospitals of Martinique, 97261 Fort-de-France, France
| | - Eléonore Cantegrit
- Department of Geriatrics, General Hospital of Valenciennes, 59300 Valenciennes, France
| | - Lidvine Godaert
- EpiCliV Research Unit, Medical School, University of the French West Indies, 97261 Fort-de-France, France
- Department of Geriatrics, General Hospital of Valenciennes, 59300 Valenciennes, France
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5
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Halonen P, Enroth L, Jämsen E, Vargese S, Jylhä M. Dementia and Related Comorbidities in the Population Aged 90 and Over in the Vitality 90+ Study, Finland: Patterns and Trends From 2001 to 2018. J Aging Health 2022; 35:370-382. [PMID: 36256914 PMCID: PMC10150268 DOI: 10.1177/08982643221123451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine trends in the prevalence of dementia and related comorbidities among the oldest old. METHODS Six repeated cross-sectional surveys were conducted between 2001 and 2018, each including all inhabitants aged over 90 in Tampere, Finland (n = 5386). Co-occurring conditions and their time trends among participants with dementia were examined using logistic regression and generalized estimating equations. RESULTS The prevalence of dementia decreased from 47% in 2007 to 41% in 2018. Throughout the study period, depression was more common among people with dementia compared to those without. The prevalence of hypertension, diabetes, and osteoarthritis increased and the prevalence of depression decreased among people with dementia. The mean number of comorbidities increased from 2.0 in 2001 to 2.3 in 2018. DISCUSSION Dementia remains highly prevalent among the oldest old and it is accompanied by an increasing burden of comorbidities, posing a challenge to people with dementia, their caregivers, and care systems.
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Affiliation(s)
- Pauliina Halonen
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Linda Enroth
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Esa Jämsen
- Gerontology Research Center, Tampere, Finland.,Faculty of Medicine and Health Technology, 7840Tampere University, Tampere, Finland.,Department of Geriatrics, 7840Tampere University HospitalHospital, Tampere, Finland
| | - Saritha Vargese
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences), 7840Tampere University, Tampere, Finland.,Gerontology Research Center, Tampere, Finland
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6
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Zang E, Wang X, Shi Y, Wu B, Fried TR. Prediction of physical functioning and general health status trajectories on mortality among persons with cognitive impairment. BMC Geriatr 2022; 22:766. [PMID: 36131230 PMCID: PMC9494770 DOI: 10.1186/s12877-022-03446-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The concern posed by the confluence of aging and cognitive impairment is growing in importance as the U.S. population rapidly ages. As such, we sought to examine the predictive power of physical functioning (PF) and general health status (GHS) trajectories on mortality outcomes among persons with cognitive impairment (PCIs). METHODS We used group-based trajectory models to identify latent group memberships for PF trajectories in 1,641 PCIs and GHS trajectories in 2,021 PCIs from the National Health and Aging Trends Survey (2011-2018) and applied logistic regressions to predict mortality using these memberships controlling for individual characteristics. RESULTS We identified six trajectory groups for PF and four groups for GHS. Trajectory group memberships for both outcomes significantly predicted mortality. For PF, group memberships largely captured the average levels over time, and worse trajectories (i.e., lower baselines and faster declines) were associated with higher odds of death. The highest mortality risk was associated with the group experiencing a sharp decline early in its PF trajectory, although its average level across time was not the lowest. For GHS, we observed two groups with comparable average levels across time, but the one with a convex-shape trajectory had much higher mortality risks compared to the one with a concave-shape trajectory. CONCLUSIONS Our findings highlighted that health trajectories predicted mortality among PCIs, not only because of general levels but also because of the shapes of declines. Close monitoring health deterioration of PCIs is crucial to understand the health burden of this population and to make subsequent actions.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, New Haven, CT, 06520, USA.
- Department of Biostatistics, Yale University, New Haven, CT, 06520, USA.
| | - Xueqing Wang
- Office of Population Research, Princeton University, Princeton, NJ, 08540, USA
- School of Public and International Affairs, Princeton University, Princeton, NJ, 08540, USA
| | - Yu Shi
- Department of Biostatistics, Yale University, New Haven, CT, 06520, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, 10010, USA
| | - Terri R Fried
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Medicine, Yale School of Medicine, New Haven, CT, 06520, USA
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7
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Does confidence in the future matter in life satisfaction among older people in widowhood in China? CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02931-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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8
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Ando T, Nishimoto Y, Hirata T, Abe Y, Takayama M, Maeno T, Fujishima S, Takebayashi T, Arai Y. Association between multimorbidity, self-rated health and life satisfaction among independent, community-dwelling very old persons in Japan: longitudinal cohort analysis from the Kawasaki Ageing and Well-being Project. BMJ Open 2022; 12:e049262. [PMID: 35210335 PMCID: PMC8883229 DOI: 10.1136/bmjopen-2021-049262] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This study aimed to identify associations between multimorbidity and subjective health outcomes among the very old persons, after adjusting for coexisting conditions such as frailty and depression. STUDY SETTING AND PARTICIPANTS This was an observational cross-sectional study involving 1012 independent, community-dwelling very old persons (507 men, 505 women; aged 85-89 years) in Kawasaki city, Japan. OUTCOME MEASURES The primary outcome was the cross-sectional associations between multimorbidity and poor self-rated health (SRH) and life satisfaction using binary logistic regression. The secondary outcome was the association of subjective health with each chronic condition. RESULTS The prevalence of multimorbidity (≥2 conditions) was 94.7%, and the average number of chronic conditions was 4.47±1.9. Multimorbidity was significantly associated with poor SRH in the adjusted model only when six or more chronic conditions were present (OR 4.80; 95% CI 1.34 to 17.11; p=0.016). Cerebrovascular disease, heart disease, respiratory disease, connective tissue disease and arthritis showed significant associations with poor SRH after multivariate adjustment. Sex-specific analysis replicated associations between multimorbidity with six or more conditions and SRH in both men and women, while the diseases with the greatest impact on SRH differed between men and women. Most conditions were not associated with low satisfaction with life scale, with the exception of arthritis (OR 1.92, 95% CI 1.32 to 2.78, p=0.001). CONCLUSIONS Multimorbidity is prevalent in the independent, community-dwelling very old persons and is associated with poor SRH when six or more conditions are present; conditions causing mobility limitations, such as cerebrovascular disease, connective tissue disease and arthritis, have a negative impact on SRH. TRIAL REGISTRATION NUMBER UMIN000026053.
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Affiliation(s)
- Takayuki Ando
- Center for General Medicine Education, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshinori Nishimoto
- Department of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takumi Hirata
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Midori Takayama
- Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan
| | - Takashi Maeno
- Graduate School of System Design and Management, Keio University, Yokohama, Kanagawa, Japan
| | - Seitaro Fujishima
- Center for General Medicine Education, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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9
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Chang LC, Dattilo J, Huang FH. Gratitude Strengthens the Relationship Between Leisure Social Support and Self-Rated Health Among Nursing Home Residents. J Gerontol Nurs 2022; 48:23-30. [PMID: 35103524 DOI: 10.3928/00989134-20220110-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A central outcome indicator of person-oriented services in primary health care is self-rated health (SRH). Therefore, promoting SRH among nursing home residents is valuable. We examined whether demographic variables, gratitude, and leisure social support (LSS) related to SRH, and whether gratitude moderated the relationship between LSS and SRH. To collect demographic information and measure gratitude, LSS, and SRH, we conducted face-to-face interviews with 237 participants from four nursing homes in Taiwan. We used hierarchical regression analysis to examine data. Results demonstrated that duration of residence, gratitude, and LSS predicted SRH, and that gratitude interacted with LSS. We discuss implications of these results in terms of facilitating gratitude to promote SRH among nursing home residents and guiding them to seek sources of LSS. In particular, we further discuss how gratitude strengthens the relationship between LSS and SRH. [Journal of Gerontological Nursing, 48(2), 23-30.].
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10
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Giri S, Mir N, Al-Obaidi M, Clark D, Kenzik KM, McDonald A, Young-Smith C, Paluri R, Nandagopal L, Gbolahan O, Nyrop KA, Muss HB, Pergolotti M, Bhatia S, Williams GR. Use of Single-Item Self-Rated Health Measure to Identify Frailty and Geriatric Assessment-Identified Impairments Among Older Adults with Cancer. Oncologist 2022; 27:e45-e52. [PMID: 35305105 PMCID: PMC8842332 DOI: 10.1093/oncolo/oyab020] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 09/16/2021] [Indexed: 12/23/2022] Open
Abstract
Background Poor self-rated health (SRH) is a known predictor of frailty and mortality in the general population; however, its role among older adults with cancer is unknown. We evaluated the role of SRH as a potential screening tool to identify frailty and geriatric assessment (GA)-identified impairments. Materials and Methods Adults ≥60 years diagnosed with cancer in the UAB Cancer & Aging Resilience Evaluation (CARE) registry underwent a GA at the time of initial consultation. We measured SRH using a single-item from the Patient-Reported Outcomes Measurement Information System global health scale and dichotomized responses as poor (poor, fair) and good (good, very good, and excellent). We evaluated the diagnostic performance of SRH in measuring frailty, and GA impairment (≥2 deficits among a set of seven GA domains). We examined the impact of SRH with survival using a Cox model adjusting for confounders, exploring the mediating role of frailty. Results Six hundred and three older adults with cancer were included, with a median age of 69 years. Overall, 45% (n = 274) reported poor SRH. Poor SRH demonstrated high sensitivity and specificity for identifying frailty (85% and 78%, respectively) and GA impairment (75% and 78%, respectively). In a Cox regression model, poor SRH was associated with inferior survival (HR = 2.26; 95% CI 1.60-3.18) after adjusting for confounders; frailty mediated 69% of this observed relationship. Conclusion Self-rated health may be used as a screening tool to identify older adults with cancer with frailty and GA impairments. Poor SRH is associated with inferior survival, which is mediated by frailty.
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Affiliation(s)
- Smith Giri
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nabiel Mir
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mustafa Al-Obaidi
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
| | - Deanna Clark
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
| | - Kelly M Kenzik
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew McDonald
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
| | - Crystal Young-Smith
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ravi Paluri
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lakshmin Nandagopal
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Olumide Gbolahan
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kirsten A Nyrop
- Division of Oncology, The University of North Carolina at Chapel Hill, NC, USA
| | - Hyman B Muss
- Division of Oncology, The University of North Carolina at Chapel Hill, NC, USA
| | - Mackenzi Pergolotti
- Revital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, AL, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Du L, Koscik RL, Chin NA, Bratzke LC, Cody K, Erickson CM, Jonaitis E, Mueller KD, Hermann BP, Johnson SC. Prescription Medications and Co-Morbidities in Late Middle-Age are Associated with Greater Cognitive Declines: Results from WRAP. FRONTIERS IN AGING 2022; 2:759695. [PMID: 35822000 PMCID: PMC9261362 DOI: 10.3389/fragi.2021.759695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022]
Abstract
The present study investigated: 1) sex differences in polypharmacy, comorbidities, self-rated current health (SRH), and cognitive performance, 2) associations between comorbidities, polypharmacy, SRH, and objective measures of health, and 3) associations of these factors with longitudinal cognitive performance. Analyses included 1039 eligible Wisconsin Registry for Alzheimer’s Prevention (WRAP) participants who were cognitively unimpaired at baseline and had ≥2 visits with cognitive composites, self-reported health history, and concurrent medication records. Repeated measures correlation (rmcorr) examined the associations between medications, co-morbidities, SRH, and objective measures of health (including LIfestyle for BRAin Health Index (LIBRA), and depression). Linear mixed-effect models examined associations between medications, co-morbidities, and cognitive change over time using a preclinical Alzheimer’s cognitive composite (PACC3) and cognitive domain z-scores (executive function, working memory, immediate learning, and delayed recall). In secondary analyses, we also examined whether the number of medications interacted with co-morbidities and whether they modified age-related cognitive trajectories. The number of prescribed medications was associated with worse SRH and a higher number of self-reported co-morbidities. More prescribed medications were associated with a faster decline in executive function, and more comorbidities were associated with faster PACC3 decline. Those with a non-elevated number of co-morbidities and medications performed an average of 0.26 SD higher (better) in executive function and an average of 0.18 SD higher on PACC3 than those elevated on both. Associations between medications, co-morbidities, and executive function, and PACC3 suggest that persons with more co-morbidities and medications may be at increased risk of reaching clinical levels of impairment earlier than healthier, less medicated peers.
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Affiliation(s)
- Lianlian Du
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- *Correspondence: Rebecca Langhough Koscik,
| | - Nathaniel A. Chin
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Lisa C. Bratzke
- School of Nursing, University of Wisconsin—Madison, Madison, WI, United States
| | - Karly Cody
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Claire M. Erickson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Communication Sciences & Disorders, University of Wisconsin—Madison, Madison, WI, United States
| | - Bruce P. Hermann
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, Madison, WI, United States
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, United States
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12
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Park G, Chung W. Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016). Epidemiol Health 2021; 43:e2021021. [PMID: 33831294 PMCID: PMC8289473 DOI: 10.4178/epih.e2021021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/11/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. METHODS This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status. RESULTS For cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2). CONCLUSIONS Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.
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Affiliation(s)
- Goun Park
- Department of Public health Science, Graduate School of Public Heath, Seoul National University, Seoul, Korea
| | - Wankyo Chung
- Department of Public health Science, Graduate School of Public Heath, Seoul National University, Seoul, Korea
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13
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Rani R, Arokiasamy P, Meitei WB, Sikarwar A. Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01521-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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14
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Lisko I, Törmäkangas T, Jylhä M. Structure of self-rated health among the oldest old: Analyses in the total population and those living with dementia. SSM Popul Health 2020; 11:100567. [PMID: 32258355 PMCID: PMC7110410 DOI: 10.1016/j.ssmph.2020.100567] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/08/2020] [Accepted: 03/12/2020] [Indexed: 01/04/2023] Open
Abstract
No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH. First study to explore structure of self-rated health in oldest old and persons with dementia. Fatigue, depression, mobility, dizziness, vision and heart disease directly affect health-rating in oldest old. Dementia, depression and arthritis affect health rating indirectly through various routes in oldest old. Dementia weakens many of the associations between objective indicators of health with self-rated health.
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Affiliation(s)
- Inna Lisko
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland.,Karolinska Institutet, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Stockholm, Karolinska Vägen 37 A, QA32, SE-171 64, Solna, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland
| | - Marja Jylhä
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,Science Center, Tampere University Hospital, Finland
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15
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Hanson CR, St John PD, Tate RB. Self-Rated Health Predicts Mortality in Very Old Men-the Manitoba Follow-Up Study. Can Geriatr J 2019; 22:199-204. [PMID: 31885760 PMCID: PMC6887141 DOI: 10.5770/cgj.22.391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Self-rated health (SRH) predicts death, but there are few studies over long-time horizons that are able to explore the effect age may have on the relationship between SRH and mortality. Objectives 1. To determine how SRH evolves over 20 years; and 2. To determine if SRH predicts death in very old men. Methods We analyzed a prospective cohort study of men who were fit for air crew training in the Second World War. In 1996, a regular questionnaire was administered to the 1,779 surviving participants. SRH was elicited with a 5-point Likert Scale with the categories: excellent, very good, good, fair and poor/bad. We examined the age-specific distribution of SRH in these categories from the age of 75 to 95 years, to the end of the follow-up period in 2018. We constructed age-specific Cox proportional hazard models with an outcome of time to death. Results SRH declined with age. The gradient in risk of death persisted across all ages; those with poor/fair/bad SRH had consistently higher mortality rates. However, the discrimination between good and excellent was less in those aged 85+. Conclusions SRH declines with advancing age, but continues to predict death in older men.
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Affiliation(s)
- Christian R Hanson
- Section of Geriatric Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
| | - Philip D St John
- Section of Geriatric Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.,Centre on Aging, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
| | - Robert B Tate
- Centre on Aging, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.,Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
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16
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Xu D, Arling G, Wang K. A cross-sectional study of self-rated health among older adults: a comparison of China and the United States. BMJ Open 2019; 9:e027895. [PMID: 31371288 PMCID: PMC6677996 DOI: 10.1136/bmjopen-2018-027895] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES We used nationally representative samples of China and the US older population to investigate (1) whether factors influencing self-rated health among older Chinese were similar to those among older Americans; and (2) whether there was a significant cross-national difference in self-rated health between China and the USA after controlling those available influencing factors. DESIGN A cross-sectional study. Data came from the 2014 Health and Retirement Study and China Health and Retirement Longitudinal Study conducted from 2014 to 2015. PARTICIPANTS Our final sample size totaled 8905 older adults in the USA and 4442 older adults in China. OUTCOME The response variable was self-rated health. Ordered logistic regression models were conducted to investigate factors influencing self-rated health among older adults. RESULTS More than three-fourths (78%) of older adults in China reported fair or poor health status, while almost 74% of older adults in the USA reported excellent, very good or good health status. In the overall ordered logistic regression model, when controlling statistically for sociodemographics, family structure, functional limitations, cognition, chronic conditions, mental health and health-related behaviours, the Chinese survey respondents were much more likely to rate their health as being poorer than the US respondents. The odds of having better versus poorer health was almost five times greater in American older adults than those in China (OR=4.88, 95% CI 4.06 to 5.86). Older adults in China living alone rated their health better than those living with spouse/partner; however, no significant difference was found between these two living arrangements in older Americans. In contrast, older adults in the USA living with others rated their health worse compared with those living with spouse/partner. In addition, older adults who had more activities of daily living limitations, poorer self-reported memory, worse mental health and chronic health conditions had lower self-rated health in both countries. CONCLUSIONS We found a striking difference in self-rated health between China and the USA even after controlling for measures of disease, functional status and other influencing factors. Relative to their American counterparts, Chinese elders were much more likely to report worse health.
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Affiliation(s)
- Dongjuan Xu
- School of Nursing, Purdue University, West Lafayette, Indiana, USA
| | - Greg Arling
- Schoolf of Nursing, Purdue University, West Lafayette, Indiana, USA
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, China
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17
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The association of health care access and utilization with self-perceived health in South Korea: the significance of age. J Biosoc Sci 2019; 52:1-13. [PMID: 31109384 DOI: 10.1017/s0021932019000191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Even though South Korea's universal health care system was established in 1989, many South Koreans continue to encounter obstacles in their attempts to access health care. Previous studies have not investigated the relationship between health care access and utilization and perceived health in the context of a universal health care system that implements a mandatory social health insurance policy. The objective of this study was to evaluate the influence of health care access and use of preventive health care services on self-rated health among young and middle-aged adults in Korea. The sample consisted of 1242 young adults aged 20-39 years and 2389 middle-aged adults aged 40-64 years who had participated in the cross-sectional 2015 Korea National Health and Nutrition Examination Survey. Using multiple logistic regression analysis, the association between health care access and use of preventive health care services and perceived poor health among young adults and middle-aged adults was assessed. The main finding was that a history of unmet health care requirements during the past 12 months was strongly associated with fair and poor self-rated health, especially among young adults. Additionally, middle-aged adults who had attended medical check-ups during the preceding 2 years reported poorer self-rated health. This study's findings suggest that, despite South Korea's universal public insurance system, there remains the need to improve access to health care services, especially among young adults. As a health improvement strategy, it is imperative that measures be taken to promote the availability of health care services when they are required and to solve any of the various individual accessibility problems, such as cost, particularly with young adults in mind.
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18
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Effects of Subjective Memory Complaints (SMCs) and Social Capital on Self-Rated Health (SRH) in a Semirural Malaysian Population. J Aging Res 2019; 2019:9151802. [PMID: 31093373 PMCID: PMC6481032 DOI: 10.1155/2019/9151802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 02/27/2019] [Accepted: 03/17/2019] [Indexed: 12/18/2022] Open
Abstract
Subjective memory complaints (SMCs) and social capital were known to be related to self-rated health (SRH). Despite this, no studies have examined the potential interaction of SMC and social capital on SRH. Using data from a cross-sectional health survey of men and women aged 56 years and above (n = 6,421), we examined how SMCs and social capital explained SRH in a population of community-dwelling older adults in a semirural area in Malaysia. We also evaluated whether SRH's relationship with SMCs is moderated by social capital. The association of SMC and social capital with poor SRH was investigated using multivariable logistic regression. Social capital (OR = 0.86, 95% CI = 0.82–0.89), mild SMC (OR = 1.70, 95% CI = 1.50–1.94), and moderate SMC (OR = 1.90, 95% CI = 1.63–2.20) were found to be associated with poor SRH after adjustment for sociodemographic factors and depression in the initial regression model. SMC was found to have partial interaction effects with social capital which was included in the subsequent regression model. Unlike individuals with no SMC and mild SMC, those who reported moderate SMC did not show decreasing probabilities of poor SRH despite increasing levels of social capital. Nevertheless, this analysis suggests that social capital and SMC are independent predictors of poor SRH. Further research needs to be targeted at improving the understanding on how social capital and SMC moderate and interact with the perception of health in older adults.
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Phung TKT, Siersma V, Vogel A, Waldorff FB, Waldemar G. Self-rated versus Caregiver-rated Health for Patients with Mild Dementia as Predictors of Patient Mortality. Am J Geriatr Psychiatry 2018; 26:375-385. [PMID: 28760512 DOI: 10.1016/j.jagp.2017.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/03/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Self-assessment of health is a strong and independent predictor of mortality for cognitively intact people. Because the ability of patients with dementia to rate their own health is questionable, caregiver-rated health for patients may serve as a proxy. The authors aimed to validate and compare self- and caregiver-rated health for patients with dementia as independent predictors of patient mortality. METHODS This was a post-hoc analysis of data from The Danish Alzheimer's Disease Intervention Study, a randomized controlled trial of psychosocial intervention for 330 patients with mild dementia and their caregivers with a 36-month follow-up. Patients and caregivers rated patients' health on the Euro Quality of Life Visual Analog Scale (EQ-VAS) from 0 (worst) to 100 (best). The ability of self- and caregiver-rated health for the patient to predict patient mortality was analyzed as hazard ratios (HRs) from Cox proportional hazard regression models, controlling for age, depression, comorbidities, functional level, quality of life, and randomization group. RESULTS Compared with the highest scores of 80-100, caregiver-rated EQ-VAS scores < 50 had an HR of 9.8 (95% CI: 2.9-33.1), scores between 50 and 64 had an HR of 3.8 (95% CI: 1.2-12.3), and scores between 65 and 79 had an HR of 4.6 (95% CI: 1.4-14.7). Self-rated EQ-VAS did not statistically significantly predict mortality. CONCLUSION Caregiver-rated health for patients with mild dementia using the EQ-VAS was shown to be an independent predictor of patient mortality with a dose-response pattern but patient-rated EQ-VAS was not.
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Affiliation(s)
- Thien Kieu Thi Phung
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Volkert Siersma
- Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Frans Boch Waldorff
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark; The Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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20
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McHugh JE, Lawlor BA. Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults. Aging Ment Health 2016; 20:415-22. [PMID: 25774986 DOI: 10.1080/13607863.2015.1018866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. METHODS 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. RESULTS Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. CONCLUSION Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.
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Affiliation(s)
- Joanna Edel McHugh
- a TRIL Centre, Trinity College Institute of Neuroscience , Trinity College Dublin , Dublin , Ireland
| | - Brian A Lawlor
- a TRIL Centre, Trinity College Institute of Neuroscience , Trinity College Dublin , Dublin , Ireland
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21
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Bendayan R, Piccinin AM, Hofer SM, Muniz G. Are Changes in Self-Rated Health Associated With Memory Decline in Older Adults? J Aging Health 2016; 29:1410-1423. [DOI: 10.1177/0898264316661830] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The association between patterns of change in self-rated health (SRH) and memory trajectories in older adults was examined using a systematic approach. Method: Data from the Health and Retirement Study ( n = 6,016) and the English Longitudinal Study of Ageing ( n = 734) were analyzed. Individuals were grouped into five categories according to their pattern of change in SRH over 8 years: stable excellent/very good/good, stable fair/poor, improvement, decline, and fluctuating pattern without a trend. Memory was measured using immediate and delayed recall tests. Kruskal–Wallis, chi-squares tests, and linear mixed models were used to examine the association. Results: Different rates of decline in memory can be identified in the different patterns of change in SRH. Those who had a stable excellent/very good/good pattern had the slowest rate of decline. Discussion: Our findings suggest that SRH status and patterns of change could be used as a marker of cognitive decline in prevention screening programs.
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Affiliation(s)
- Rebecca Bendayan
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | | | | | - Graciela Muniz
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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22
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Nielsen ABS, Siersma V, Waldemar G, Waldorff FB. Poor self-rated health did not increase risk of permanent nursing placement or mortality in people with mild Alzheimer's disease. BMC Geriatr 2016; 16:87. [PMID: 27094158 PMCID: PMC4837635 DOI: 10.1186/s12877-016-0262-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 04/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) has in many population-based studies predicted adverse health outcomes, e.g. morbidity, permanent nursing home (NH) placement, and mortality. However, the predictive value of SRH to NH placement and mortality among elderly people is not consistent. This may be due to cognitive impairment. Since the SRH item is widely used, it is important to know whether SRH has different predictive value among people with cognitive impairments. We aimed to examine SRH and the risk of permanent NH placement and mortality among people with mild Alzheimer's disease (AD). METHODS Data are from The Danish Alzheimer Intervention StudY (DAISY), a large randomized controlled trial of psychosocial intervention for patients with mild dementia and their caregivers with 3-years' follow-up. Five out of 14 Danish counties participated and 321 home-living elderly (mean age: 76.2 years) with mild AD (46.4 % male) were included during 2004 and 2005. Self-rated SRH, cognitive function (MMSE), quality of life (proxy-rated QOL-AD), activities of daily living (ADCS-ADL), insight, and socio-demographics were assessed at baseline. Comorbidities and information about NH placement and mortality was obtained over 3-years' follow-up from registries. With Cox proportional hazard regression we analysed the association between SRH (dichotomised into good vs. poor) and NH placement and mortality adjusted for potential confounders. RESULTS At baseline 66 % reported excellent or good, and 34 % fair, poor or very poor SRH. Mean MMSE was 24.0 (range: 20-30). NH placement and mortality totalled 28.1 % and 16.5 % at 3-years' follow-up, respectively. Poor SRH at baseline was not related to increased risk of NH placement or to increased mortality neither in the univariable nor in multivariable analysis: In the fully adjusted models HR was 0.63 (95 % CI 0.38-1.05) and 1.28 (95 % CI 0.67-2.45), respectively. CONCLUSIONS When poor SRH was present we found no increased risk for NH placement or death among elderly people with mild AD. SRH is a widely used parameter in clinical and epidemiological research but may not be a valid indicator of health in patients with AD due to loss of insight.
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Affiliation(s)
- Anni Brit Sternhagen Nielsen
- />The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- />The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Waldemar
- />Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Frans Boch Waldorff
- />The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
- />Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- />The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Nriagu J, Udofia EA, Ekong I, Ebuk G. Health Risks Associated with Oil Pollution in the Niger Delta, Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030346. [PMID: 27007391 PMCID: PMC4809009 DOI: 10.3390/ijerph13030346] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 02/28/2016] [Accepted: 03/14/2016] [Indexed: 02/02/2023]
Abstract
Background: Although there is considerable public concern about the environmental impacts of oil pollution in the Niger Delta of Nigeria, actual evidence on the pathological and psychological effects in the health of local communities is minimally known. We sought to associate the perspective measures of exposure to oil pollution with health outcomes (inventory of health symptoms and functional capacity limitations) and determine how emotional reactions to environmental risks moderate these health outcomes. Method: The study was conducted with 600 participants selected from five local government areas in Akwa Ibom State where oil pollution is rampant. A structured questionnaire was used to collect the data on the respondents’ exposure to oil pollution, self-rated health and disease symptoms, perception of risk of exposure and emotional reactions to local oil pollution. Results: Most of the participants lived in areas with visible oil pollution and/or near gas flaring facilities and regularly suffered direct exposure to oil in their environment. High level of emotional distress was a part of everyone's life for the study population. Risk perception in the study area was mediated, to a large extent, by dreaded hazards (catastrophic fears of pipeline explosions and oil spill fire), visual cues (gas flares and smoke stacks) and chemosensory cues (off-flavor in drinking water). The exposure metrics were found to be significant predictors of the health effects and influencing factors (emotional reactions). Multi-levels models suggest that at the individual level, the demographic variables and direct contact with oil pollution were important mediators of functional capacity limitation. At the community level, emotional distress from fear of the sources of exposure was an important mediator of the health symptoms. Conclusions: This study documents high levels of disease symptoms and environmental distress (worry, annoyance and intolerance) associated with oil pollution in the Niger Delta areas of Nigeria. It highlights the need for some intervention to ameliorate the psychological distress associated with living under such environmental adversity.
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Affiliation(s)
- Jerome Nriagu
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Emilia A Udofia
- Department of Community Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Ghana.
| | - Ibanga Ekong
- Department of Community Health, Faculty of Clinical Sciences, University of Uyo, P.M.B. 1017, Uyo, Akwa Ibom, Nigeria.
| | - Godwin Ebuk
- Department of Public Health Services, Akwa Ibom Ministry of Health Headquarters, P.M.B. 1030, Uyo, Akwa Ibom, Nigeria.
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Aichele S, Rabbitt P, Ghisletta P. Think Fast, Feel Fine, Live Long: A 29-Year Study of Cognition, Health, and Survival in Middle-Aged and Older Adults. Psychol Sci 2016; 27:518-29. [PMID: 26917212 DOI: 10.1177/0956797615626906] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 12/21/2015] [Indexed: 11/15/2022] Open
Abstract
In a 29-year study of 6,203 individuals ranging in age from 41 to 96 years at initial assessment, we evaluated the relative and combined influence of 65 mortality risk factors, which included sociodemographic variables, lifestyle attributes, medical indices, and multiple cognitive abilities. Reductions in mortality risk were most associated with higher self-rated health, female gender, fewer years as a smoker, and smaller decrements in processing speed with age. Thus, two psychological variables-subjective health status and processing speed-were among the top predictors of survival. We suggest that these psychological attributes, unlike risk factors that are more narrowly defined, reflect (and are influenced by) a broad range of health-related behaviors and characteristics. Information about these attributes can be obtained with relatively little effort or cost and-given the tractability of these measures in different cultural contexts-may prove expedient for prevention, diagnosis, and treatment of conditions related to increased mortality risk in diverse human populations.
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Affiliation(s)
- Stephen Aichele
- Faculty of Psychology and Educational Sciences, University of Geneva
| | | | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva Distance Learning University, Switzerland
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25
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Enroth L, Raitanen J, Hervonen A, Nosraty L, Jylhä M. Is socioeconomic status a predictor of mortality in nonagenarians? The vitality 90+ study. Age Ageing 2015; 44:123-9. [PMID: 25002455 DOI: 10.1093/ageing/afu092] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND socioeconomic inequalities in mortality are well-known in middle-aged and younger old adults, but the situation of the oldest old is less clear. The aim of this study was to investigate socioeconomic inequalities for all-cause, cardiovascular and dementia mortality among the people aged 90 or older. METHODS the data source was a mailed survey in the Vitality 90+ study (n = 1,276) in 2010. The whole cohort of people 90 years or over irrespective of health status or dwelling place in a geographical area was invited to participate. The participation rate was 79%. Socioeconomic status was measured by occupation and education, and health status by functioning and comorbidity. All-cause and cause-specific mortality was followed for 3 years. The Cox regression, with hazard ratios (HR) and 95% confidence intervals (CI), was applied. RESULTS the all-cause and dementia mortality differed by occupational class. Upper non-manuals had lower all-cause mortality than lower non-manuals (HR: 1.61; 95% CI: 1.11-2.32), skilled manual workers (HR: 1.56 95% CI: 1.09-2.25), unskilled manual workers (HR: 1.88; 95% CI: 1.20-2.94), housewives (HR: 1.77 95% CI: 1.15-2.71) and those with unknown occupation (HR: 2.33; 95% CI: 1.41-3.85). Inequalities in all-cause mortality were largely explained by the differences in functioning. The situation was similar according to education, but inequalities were not statistically significant. Socioeconomic differences in cardiovascular mortality were not significant. CONCLUSIONS socioeconomic inequalities persist in mortality for 90+-year-olds, but their magnitude varies depending on the cause of death and the indicator of socioeconomic status. Mainly, mortality differences are explained by differences in functional status.
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Affiliation(s)
- Linda Enroth
- School of Health Sciences and Gerontology Research Center, University of Tampere, Tampere 33014, Finland
| | - Jani Raitanen
- School of Health Sciences and Gerontology Research Center, University of Tampere, Tampere 33014, Finland UKK Institute for Health Promotion Research, Tampere, Finland
| | - Antti Hervonen
- School of Health Sciences and Gerontology Research Center, University of Tampere, Tampere 33014, Finland
| | - Lily Nosraty
- School of Health Sciences and Gerontology Research Center, University of Tampere, Tampere 33014, Finland
| | - Marja Jylhä
- School of Health Sciences and Gerontology Research Center, University of Tampere, Tampere 33014, Finland
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Orgeta V, Orrell M, Hounsome B, Woods B. Self and carer perspectives of quality of life in dementia using the QoL-AD. Int J Geriatr Psychiatry 2015; 30:97-104. [PMID: 24789766 DOI: 10.1002/gps.4130] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 03/26/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Quality of life (QoL) is one of the most important outcomes in improving well-being in people with dementia (PwD). The primary aim of the present study was to compare self and carer ratings of QoL in PwD and to identify the most important factors influencing self and carer ratings. METHODS We conducted a cross-sectional analytic study of 488 dyads using the Quality of Life in Alzheimer's Disease scale, demographics, data on self-rated health, and clinical characteristics. RESULTS Higher levels of self-rated health in PwD were associated with higher self-rated QoL after controlling for depression and activities of daily living. When the carer experienced less stress related to caregiving, the PwD reported better QoL. Higher carer-rated QoL was associated with less carer stress, better health for the family carer, and the PwD being of younger age. When carers lived with the PwD, and reported lower levels of depression and better functional ability for their relative, carer-rated QoL was higher. CONCLUSIONS The self-rated health of PwD and carers influences the ratings they make of the QoL of the PwD indicating that it is an important influence on QoL in this population.
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Affiliation(s)
- Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
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Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health a stable and predictive factor for allostatic load in early adulthood? Findings from the Nord Trøndelag Health Study (HUNT). Soc Sci Med 2014; 117:1-9. [PMID: 25016460 DOI: 10.1016/j.socscimed.2014.07.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 07/04/2014] [Accepted: 07/07/2014] [Indexed: 12/13/2022]
Abstract
Self-rated health (SRH) is a widely used health indicator predicting morbidity and mortality in a wide range of populations. However, little is known about the stability and biological basis of SRH. The aim of this study was to map the stability of SRH from adolescence to early adulthood, and to examine the relationships between SRH and biological dysregulation, in terms of allostatic load (AL). The AL score comprises the eleven biomarkers systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, waist-hip ratio (WHR), diabetes risk profile, glucose, C-reactive protein (CRP) and body mass index (BMI). Eleven years prospective data from the Nord-Trøndelag Health Study (HUNT), Norway, were utilised. Baseline data were gathered from 9141 adolescents (mean age 15.9 years) in the Young-HUNT I survey (1995-1997) and follow-up data were gathered from the adult HUNT3 survey (2006-2008). Altogether, 1906 respondents completed both questionnaires and clinical measurements in both studies. Cross-tables for SRH at baseline and follow-up showed that SRH remained unchanged in 57% of the respondents. Only 3% of the respondents changed their ratings by two steps or more on a four-level scale. Further, linear regression analyses adjusted for age and gender revealed that SRH in adolescence predicted AL in young adulthood. Similar patterns were found for most of the individual biomarkers. The consistency found in SRH from adolescence to young adulthood, and its association with AL across time, indicate that routines for dealing with SRH early in life may be a central strategy to prevent morbidity in the adult population.
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Affiliation(s)
- Tina Løkke Vie
- Helse Førde HF/Førde Health Trust, Postboks 1000, 6807 Førde, Norway.
| | | | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway.
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway.
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Nosraty L, Enroth L, Raitanen J, Hervonen A, Jylhä M. Do successful agers live longer? The Vitality 90+ study. J Aging Health 2014; 27:35-53. [PMID: 24907039 DOI: 10.1177/0898264314535804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To discover whether successful aging, understood as a multidimensional concept, predicts further survival in very old people. METHOD The population sample consisted of 1,370 persons aged 90 or over in the Vitality 90+ study. Four alternative models of successful aging were constructed, each of them consisting of physical, psychological, and social dimensions. Mortality was followed up after 4 and 7 years. RESULTS Three out of four models significantly predicted survival at both follow-ups for the whole group. Separately, "success" in the physical, psychological, and social components was also associated with higher survival. The associations were stronger in women than in men. DISCUSSION Successful aging, measured using physical, psychological, and social dimensions, predicts the length of future life in nonagenarians.
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Affiliation(s)
- Lily Nosraty
- Gerontology Research Center and School of Health Sciences, University of Tampere, Finland
| | - Linda Enroth
- Gerontology Research Center and School of Health Sciences, University of Tampere, Finland
| | - Jani Raitanen
- Gerontology Research Center and School of Health Sciences, University of Tampere, Finland UKK Institute for Health Promotion Research, Tampere, Finland
| | - Antti Hervonen
- Gerontology Research Center and School of Health Sciences, University of Tampere, Finland
| | - Marja Jylhä
- Gerontology Research Center and School of Health Sciences, University of Tampere, Finland
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Nielsen ABS, Siersma V, Waldemar G, Waldorff FB. The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up. Age Ageing 2014; 43:50-7. [PMID: 23985335 DOI: 10.1093/ageing/aft131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND self-rated health (SRH) predicts nursing home (NH) placement; subjective memory complaints (SMC) too. However, the predictive value of SRH in the presence of SMC is unclear. METHODS seven-hundred fifty-seven non-nursing home residents ≥65 years from general practices in Central Copenhagen were followed for 4 years (2002-2006). Patients gave information on SRH, cognition (SMC and MMSE), quality of life (EQ-5D) and socio-demographics. Information on comorbidities and permanent NH placement came from registries. The association between SRH (dichotomised into good versus poor) and SMC, and permanent NH placement was assessed using Cox proportional hazard regression adjusted for potential confounders. RESULTS NH placement totaled 6.5% at 4-year follow-up. Poor SRH increased NH placement [hazard ratio (HR) = 2.07, 95% CI: 1.11-3.87] adjusted for age, SMC, MMSE, sex and comorbidities. SRH was not associated with NH placement if accounting for additional health information; however, SMC was (HR = 2.47, 95% CI: 1.26-4.86). Increased placement was seen for patients with good SRH and SMC (HR = 6.64, 95% CI: 2.31-19.12), but not among patients with poor SRH and SMC (HR = 1.37, 95% CI: 0.59-3.20) when compared with the reference group (good SRH and without SMC). CONCLUSIONS both poor SRH and SMC were associated with permanent NH placement risk among elderly primary care patients. However, when SMC was present a reverse association was found for SRH: good SRH increased NH placement. Since SRH is integrated in widely used psychometric instruments, further research is needed to establish the mechanism and implications of this finding.
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Affiliation(s)
- Anni B S Nielsen
- The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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Galenkamp H, Deeg DJH, Huisman M, Hervonen A, Braam AW, Jylhä M. Is self-rated health still sensitive for changes in disease and functioning among nonagenarians? J Gerontol B Psychol Sci Soc Sci 2013; 68:848-58. [PMID: 23921719 DOI: 10.1093/geronb/gbt066] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES With age, there is an increasing gap between relatively stable levels of self-rated health (SRH) and actual health status. This study investigates longitudinal changes in SRH and examines its sensitivity to changes in chronic conditions and functioning among people aged 90 and older. METHODS In the Vitality 90+ Study, questionnaires were sent to all people aged 90 years and older living in Tampere, Finland. Included were respondents who provided data on the 2001 measurement and at least one follow-up measurement in 2003, 2007, or 2010 (N = 334). Generalized Estimating Equations analyses examined longitudinal change in SRH and the predictive value of number of chronic conditions and a functioning score based on 5 activities. RESULTS Within 2 years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH after 6 and 9 years were associated with increased chronic conditions (odds ratio [OR] = 1.23) and decreased functioning (OR = 1.28). The impact of chronic conditions and functioning was smaller among institutionalized people (chronic conditions OR = 0.90; functioning OR = 1.18) than among people living independently (chronic conditions OR = 1.30; functioning OR = 1.44). DISCUSSION SRH among nonagenarians was sensitive to changes in the number of chronic conditions and functioning although more pronounced on the longer than on the shorter term.
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Affiliation(s)
- Henrike Galenkamp
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Enroth L, Raitanen J, Hervonen A, Jylha M. Do Socioeconomic Health Differences Persist in Nonagenarians? J Gerontol B Psychol Sci Soc Sci 2013; 68:837-47. [DOI: 10.1093/geronb/gbt067] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Almomani FM, McDowd JM, Bani-Issa W, Almomani M. Health-related quality of life and physical, mental, and cognitive disabilities among nursing home residents in Jordan. Qual Life Res 2013; 23:155-65. [DOI: 10.1007/s11136-013-0461-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
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Wennberg P, Rolandsson O, van der A DL, Spijkerman AMW, Kaaks R, Boeing H, Feller S, Bergmann MM, Langenberg C, Sharp SJ, Forouhi N, Riboli E, Wareham N. Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: a case-cohort study. BMJ Open 2013; 3:bmjopen-2012-002436. [PMID: 23471609 PMCID: PMC3612773 DOI: 10.1136/bmjopen-2012-002436] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To investigate the association between self-rated health and risk of type 2 diabetes and whether the strength of this association is consistent across five European centres. DESIGN Population-based prospective case-cohort study. SETTING Enrolment took place between 1992 and 2000 in five European centres (Bilthoven, Cambridge, Heidelberg, Potsdam and Umeå). PARTICIPANTS Self-rated health was assessed by a baseline questionnaire in 3399 incident type 2 diabetic case participants and a centre-stratified subcohort of 4619 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study which was drawn from a total cohort of 340 234 participants in the EPIC. PRIMARY OUTCOME MEASURE Prentice-weighted Cox regression was used to estimate centre-specific HRs and 95% CIs for incident type 2 diabetes controlling for age, sex, centre, education, body mass index (BMI), smoking, alcohol consumption, energy intake, physical activity and hypertension. The centre-specific HRs were pooled across centres by random effects meta-analysis. RESULTS Low self-rated health was associated with a higher hazard of type 2 diabetes after adjusting for age and sex (pooled HR 1.67, 95% CI 1.48 to 1.88). After additional adjustment for health-related variables including BMI, the association was attenuated but remained statistically significant (pooled HR 1.29, 95% CI 1.09 to 1.53). I(2) index for heterogeneity across centres was 13.3% (p=0.33). CONCLUSIONS Low self-rated health was associated with a higher risk of type 2 diabetes. The association could be only partly explained by other health-related variables, of which obesity was the strongest. We found no indication of heterogeneity in the association between self-rated health and type 2 diabetes mellitus across the European centres.
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Affiliation(s)
- Patrik Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Daphne L van der A
- Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Annemieke M W Spijkerman
- Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Silke Feller
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Manuela M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Nita Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Elio Riboli
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Nicholas Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
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Zheng H, Thomas PA. Marital status, self-rated health, and mortality: overestimation of health or diminishing protection of marriage? JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2013; 54:128-43. [PMID: 23321283 PMCID: PMC9052865 DOI: 10.1177/0022146512470564] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study challenges two well-established associations in medical sociology: the beneficial effect of marriage on health and the predictive power of self-rated health on mortality. Using The National Health Interview Survey 1986-2004 with 1986-2006 mortality follow-up (789,096 respondents with 24,095 deaths) and Cox Proportional Hazards Models, we find the protective effect of marriage against mortality decreases with deteriorating health so that the married and unmarried in poor health are at similar risk for death. We also find the power of self-rated health to predict mortality is higher for the married than for any unmarried group. By using ordered logistic regression models, we find thresholds shift such that, compared to the unmarried, the married may not report poorer health until developing more severe health problems. These findings suggest the married tend to overestimate their health status. These two phenomena (diminishing protection and overestimation) contribute to but do not completely explain each other.
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Affiliation(s)
- Hui Zheng
- The Ohio State University, Columbus, OH 43210, USA.
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Abstract
OBJECTIVES 1. To determine if Self-Rated Health (SRH) predicts dementia over a five period in cognitively intact older adults, and in older adults with Cognitive Impairment, No Dementia (CIND); and 2. To determine if different methods of eliciting SRH (age-referenced (AR) versus unreferenced) yield similar results. DESIGN Prospective cohort. POPULATION 1468 cognitively intact adults and 94 older adults with CIND aged 65+ living in the community, followed over five years. MEASURES Age, gender, education, subjective memory loss, depressive symptoms, functional status, cognition, SRH and AR-SRH were all measured; dementia was diagnosed on clinical examination. Those with abnormal cognition not meeting criteria for dementia were diagnosed with CIND. RESULTS In those who were cognitively intact at time 1, and had good SRH: 69.4% were intact; 6.0% had CIND; 6.9% had dementia, and 17.7% had died at time 2, while in those with poor SRH: 44.9% were intact, 11.1% had CIND, 9.1% had dementia, and 34.8% had died (p<0.001, chi-square test). In multinomial regression models SRH predicted dementia and death. In those with CIND at time 1 and good SRH: 2.3% were intact: 18.6% had CIND; 34.9% had dementia and 44.2% had died at time 2, while in those with poor SRH: 4.8% were intact, 31.0% had CIND, 19.0% had dementia, and 43.6% had died (p=0.30, chi-square test). In multinomial regression models, this was not significant. AR-SRH analyses were similar. CONCLUSIONS In cognitively intact older adults SRH predicts dementia. In older adults with CIND, SRH does not predict dementia.
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Affiliation(s)
- Philip St John
- Section of Geriatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
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Helvik AS, Engedal K, Selbæk G. Three-year mortality in previously hospitalized older patients from rural areas--the importance of co-morbidity and self-reported poor health. BMC Geriatr 2013; 13:17. [PMID: 23419167 PMCID: PMC3600034 DOI: 10.1186/1471-2318-13-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/14/2013] [Indexed: 11/13/2022] Open
Abstract
Background The risk factors for mortality after hospitalization in older persons are not fully understood. The aim of the present study was to examine the three-year (1,096 days) mortality in previously hospitalized older patients from rural areas, and to explore how objectively and self-reported health indicators at baseline were associated with mortality. Methods The study included 484 (241 men) medical inpatients with age range 65–101 (mean 80.7, SD 7.4) years. Baseline information included the following health measures: the Charlson Index, the Mini-Mental-State Examination, Lawton and Brody’s scales for physical self-maintenance and the instrumental activities of daily living, the Hospital Anxiety and Depression scale, self-reported health (one item), and perceived social functioning (one item) and assistance in living at discharge. Results In all, 172 (35.5%) of those patients included had died within the three years of the follow-up period. Three-year mortality was associated with a high score at baseline on the Charlson Index (HR 1.73, 95%CI 1.09-2.74) and poor self-reported health (HR 1.52, 95%CI 1.03-2.25) in a Cox regression analysis adjusted for age, gender, other objectively measured health indicators, and perceived impaired social functioning. Conclusion In a study of older adults admitted to a general hospital for a wide variety of disorders, we found co-morbidity (as measured with the Charlson Index) and poor self-reported health associated with three-year mortality in analysis adjusting for age, gender, and other health-related indicators. The results suggest that self-reported health is a measure that should be included in future studies.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim NO-7491, Norway.
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Latham K, Peek CW. Self-rated health and morbidity onset among late midlife U.S. adults. J Gerontol B Psychol Sci Soc Sci 2013; 68:107-16. [PMID: 23197340 PMCID: PMC3605944 DOI: 10.1093/geronb/gbs104] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 10/18/2012] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although self-rated health (SRH) is recognized as a strong and consistent predictor of mortality and functional health decline, there are relatively few studies examining SRH as a predictor of morbidity. This study examines the capacity of SRH to predict the onset of chronic disease among the late midlife population (ages 51-61 years). METHOD Utilizing the first 9 waves (1992-2008) of the Health and Retirement Study, event history analysis was used to estimate the effect of SRH on incidence of 6 major chronic diseases (coronary heart disease, diabetes, stroke, lung disease, arthritis, and cancer) among those who reported none of these conditions at baseline (N = 4,770). RESULTS SRH was a significant predictor of onset of any chronic condition and all specific chronic conditions excluding cancer. The effect was particularly pronounced for stroke. DISCUSSION This research provides the strongest and most comprehensive evidence to date of the relationship between SRH and incident morbidity.
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Affiliation(s)
- Kenzie Latham
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Room 2048 ISR, Ann Arbor, MI 48106-1248, USA.
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French DJ, Sargent-Cox K, Luszcz MA. Correlates of subjective health across the aging lifespan: understanding self-rated health in the oldest old. J Aging Health 2012; 24:1449-69. [PMID: 23103451 DOI: 10.1177/0898264312461151] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the determinants of self-rated health (SRH) in different age groups of older adults, including the oldest old. METHODS Variables assessing physical health, difficulty with self-care, depressive symptoms, and cognitive impairment were pooled and harmonized from three Australian longitudinal studies of ageing (N = 5,222). The association of these with SRH was examined in older adults aged 60 to 64 years, 65 to 74 years, 75 to 84 years, and 85 years and older. RESULTS SRH was not associated with cognitive impairment or difficulty with self-care in the oldest old, and its association with physical health was diminished compared with younger groups. Depression showed a significant relationship in all age groups, conferring an approximately fourfold increase in the likelihood of poorer SRH. DISCUSSION As old age progresses, self-reports of poor health become most closely related to psychological symptoms. This explains some of the paradoxes of past literature and offers important insights for health professionals working with the oldest old.
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Whitson HE, Malhotra R, Chan A, Matchar DB, Østbye T. Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans. Asia Pac J Public Health 2012; 26:310-9. [PMID: 22535554 DOI: 10.1177/1010539512443698] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] = 6.79, 95% confidence interval [CI] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity.
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Affiliation(s)
- Heather E Whitson
- Duke University Medical Center, Durham, NC, USA Durham VA Geriatrics Research Education and Clinical (GRECC), Durham, NC, USA
| | - Rahul Malhotra
- Duke-National University of Singapore Graduate Medical School, Singapore
| | - Angelique Chan
- Duke-National University of Singapore Graduate Medical School, Singapore National University of Singapore, Singapore
| | - David B Matchar
- Duke University Medical Center, Durham, NC, USA Duke-National University of Singapore Graduate Medical School, Singapore
| | - Truls Østbye
- Duke University Medical Center, Durham, NC, USA Duke-National University of Singapore Graduate Medical School, Singapore
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Abstract
RÉSUMÉNous avons analysé une étude de cohorte prospective afin de déterminer (1) si l’auto-évaluation de son propre état de santé (AES) prédit la mortalité chez les personnes plus âgées, avec et sans symptômes dépressifs, et (2) de déterminer s’il y a une interaction entre l’AES et les symptômes dépressifs sur la mortalité. Nous avons suivi pendant cinq ans 1 751 adultes âgés de 65 ans qui habitaient dans les communautés. Les mesures comprenaient l’âge, le sexe, le niveau d’éducation, Center for Epidemiological Studies-Depression (CES-D), the Modified Mini-Mental State Examination (MMS), et le questionnaire Older Americans’ Research Survey (OARS). Notre indicateur de résultats était la duree de vie avant le décès. Les analyses ont été faites sur des sujets avant ou non des symptômes dépressifs. Nous avons construit des modèles de régression de Cox avec un terme d’interaction pour la CES-D et l’AES. L’indice de risque pour la mortalite était de 1,63 pour les sujets atteints de symptômes dépressifs ; il était de 1,68 pour les sujets sans symptômes. Aucune interaction significative n’a été trouvée entre les symptômes dépressifs et l’A-ES pour la mortalité.
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Wennberg P, Rolandsson O, Jerdén L, Boeing H, Sluik D, Kaaks R, Teucher B, Spijkerman A, Bueno de Mesquita B, Dethlefsen C, Nilsson P, Nöthlings U. Self-rated health and mortality in individuals with diabetes mellitus: prospective cohort study. BMJ Open 2012; 2:e000760. [PMID: 22337818 PMCID: PMC3282291 DOI: 10.1136/bmjopen-2011-000760] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate whether low self-rated health (SRH) is associated with increased mortality in individuals with diabetes. DESIGN Population-based prospective cohort study. SETTING Enrolment took place between 1992 and 2000 in four centres (Bilthoven, Heidelberg, Potsdam, Umeå) in a subcohort nested in the European Prospective Investigation into Cancer and Nutrition. PARTICIPANTS 3257 individuals (mean ± SD age was 55.8±7.6 years and 42% women) with confirmed diagnosis of diabetes mellitus. PRIMARY OUTCOME MEASURE The authors used Cox proportional hazards modelling to estimate HRs for total mortality controlling for age, centre, sex, educational level, body mass index, physical inactivity, smoking, insulin treatment, hypertension, hyperlipidaemia and history of myocardial infarction, stroke or cancer. RESULTS During follow-up (mean follow-up ± SD was 8.6±2.3 years), 344 deaths (241 men/103 women) occurred. In a multivariate model, individuals with low SRH were at higher risk of mortality (HR 1.38, 95% CI 1.10 to 1.73) than those with high SRH. The association was mainly driven by increased 5-year mortality and was stronger among individuals with body mass index of <25 kg/m(2) than among obese individuals. In sex-specific analyses, the association was statistically significant in men only. There was no indication of heterogeneity across centres. CONCLUSIONS Low SRH was associated with increased mortality in individuals with diabetes after controlling for established risk factors. In patients with diabetes with low SRH, the physician should consider a more detailed consultation and intensified support.
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Affiliation(s)
- Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
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Chang LC. An Interaction Effect of Leisure Self-determination and Leisure Competence on Older Adults’ Self-rated Health. J Health Psychol 2011; 17:324-32. [DOI: 10.1177/1359105311415727] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined whether there was an interaction effect of leisure self-determination and leisure competence on older adults’ self-rated health (SRH), controlling for self-efficacy. Three hundred eighty-nine older adults living in Keelung City, Taiwan were systematically selected as participants. Data were collected by a face-to-face questionnaire survey which included measures of self-efficacy, leisure self-determination, leisure competence, and SRH scales. The data were analyzed using multiple regression analysis. The results showed a significant reinforcement interaction effect of leisure self-determination and leisure competence on SRH among the participants after controlling for self-efficacy. Implications of the results are further discussed.
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Jylhä M. Self-Rated Health and Subjective Survival Probabilities as Predictors of Mortality. INTERNATIONAL HANDBOOK OF ADULT MORTALITY 2011. [DOI: 10.1007/978-90-481-9996-9_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Shega JW, Ersek M, Herr K, Paice JA, Rockwood K, Weiner DK, Dale W. The Multidimensional Experience of Noncancer Pain: Does Cognitive Status Matter? PAIN MEDICINE 2010; 11:1680-7. [DOI: 10.1111/j.1526-4637.2010.00987.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim HC, Lee KS, Cheong HK, Lee YH, Lim KY, Chung YK, Oh BH, Hong CH. Application of health concern and activity model on cognition in the elderly. Arch Gerontol Geriatr 2010; 53:e187-91. [PMID: 20934758 DOI: 10.1016/j.archger.2010.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 08/26/2010] [Accepted: 08/31/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to examine the effects of physical, mental, social activity, and health concern on cognition in the elderly by means of the health concern and activity (HCA) model. Data were obtained from 3157 subjects aged 60 years and above. The subjects were divided into four groups according to the HCA model. Cognitive function was assessed by the Korean version of the mini-mental state examination (K-MMSE). A cross-sectional, factorial design was used in which the K-MMSE score was the dependent variable, with physical, mental, and social activity as one factor and health concern as the other. Analysis of covariance revealed significant differences in the K-MMSE score between all four groups after adjusting for age, sex, education, current smoking, and alcohol consumption for all subjects. The results suggest that having health concerns as well as physical, mental, or social activity is associated with cognitive function in the elderly.
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Affiliation(s)
- Hyun-Chung Kim
- Department of Psychiatry, National Medical Center, Euljiro 6-ga 18-79, Jung-gu, Seoul 100-799, Republic of Korea
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Yarmo-Roberts D, Freak-Poli RL, Cooper B, Noonan T, Stolewinder J, Reid CM. The heart of the matter: health status of aged care clients receiving home- and community-based care. J Aging Res 2010; 2010:275303. [PMID: 21152197 PMCID: PMC2989748 DOI: 10.4061/2010/275303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 05/26/2010] [Accepted: 06/03/2010] [Indexed: 11/20/2022] Open
Abstract
Objective. To determine the current health status of home based elderly clients receiving government funded aged care packages. Design. Prospective Observational study. Setting. Community based, home care program in Australia. Participants. Community-dwelling older adults receiving aged care packages. Measurements. A comprehensive test battery of physical, mental and social scales were completed including a Caregiver Strain Index where appropriate. Results. 37% of the 334 subjects were male and the mean age was 81 ± 8 years. Physical functioning was low compared to the Australian population. Depression was highly prevalent with 15.9% severely depressed and 38.7% mildly depressed. 26% of clients screened positive for dementia. Relatively good levels of social support were reported, however social networking activity levels were low. Sixty one percent of clients had caregivers, of whom 63.3% had high levels of strain. Strain was higher in caregivers of clients on higher levels of care (78.5% versus 50.6% highly strained). Conclusion. The data suggests that as a group there is a high degree of comorbidity, and depression, dementia and caregiver strain are highly prevalent. The findings may aid administrators and health policy planners in directing resources to key areas impacting on health outcomes in this group.
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Affiliation(s)
- Deborah Yarmo-Roberts
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria 3004, Australia
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Bowles KH, Holland DE, Horowitz DA. A comparison of in-person home care, home care with telephone contact and home care with telemonitoring for disease management. J Telemed Telecare 2010; 15:344-50. [PMID: 19815903 DOI: 10.1258/jtt.2009.090118] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We compared the effects of evidence-based disease management guidelines delivered to patients with heart failure and diabetes using three different modalities: in-person visits alone (Control), in-person visits and a telephone intervention (Telephone), and in-person visits and telemonitoring (Telemonitoring). Patients were randomized to the three groups. There were 112 patients in the Control group, 93 in the Telephone group and 98 in the Telemonitoring group. During the first 60 days, 10% of the Control group were rehospitalized, 17% of the Telephone group and 16% of the Telemonitoring group. Having heart failure and receiving more in-person visits were significantly related to readmission and time to readmission. However, after adjusting for diagnosis and visits, the differences between the three groups were non-significant. There was a trend for increased risk of readmission for the Telephone group compared to Control alone (P = 0.07, risk ratio 2.2, 95% CI: 0.9 to 5.2) and for readmission sooner (P = 0.02, risk ratio 2.3, 95% CI: 1.2 to 4.6). Patient rehospitalization and emergency department visit rates were lower than the national average, making it difficult to detect a difference between groups. Previous rehospitalization was a consistent predictor of those who were rehospitalized, suggesting that it may be a useful indicator for identifying patients likely to need additional attention.
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Affiliation(s)
- Kathryn H Bowles
- New Courtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
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Wells Y, De Vaus D, Kendig H, Quine S. Health and Wellbeing through Work and Retirement Transitions in Mature Age: Understanding Pre—Post and Retrospective Measures of Change. Int J Aging Hum Dev 2010; 69:287-310. [PMID: 20235469 DOI: 10.2190/ag.69.4.c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The capacity to measure change is essential in examining successful adaptation to ageing. Few studies measuring change have compared findings using pre—post approaches (employing difference scores) with those from retrospective approaches (employing self-ratings). Where this has occurred, differences have been attributed either to ceiling and floor effects or to the operation of social comparison (Choi, 2002, 2003). Our study compared pre—post and retrospective measures of change in health, health behaviors, and wellbeing over periods of 1 and 3 years among retirees. Retrospective measures were found to be more positive than pre—post measures. This discrepancy was associated with floor and ceiling effects and with a robust self-image, but not with recency, social comparison, or social desirability response sets. Pre—post difference scores have limitations as indicators of change, particularly where ceiling effects operate. A retrospective perception of improvement, combined with deterioration in scores, may result from successful psychological adaptation as people grow older.
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Waldorff FB, Nielsen AB, Waldemar G. Self-rated health in patients with mild Alzheimer's disease: Baseline data from the Danish Alzheimer Intervention Study. Arch Gerontol Geriatr 2010; 50:1-5. [DOI: 10.1016/j.archger.2008.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 12/12/2008] [Accepted: 12/15/2008] [Indexed: 10/21/2022]
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What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 2009; 69:307-16. [PMID: 19520474 DOI: 10.1016/j.socscimed.2009.05.013] [Citation(s) in RCA: 1399] [Impact Index Per Article: 93.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Indexed: 11/21/2022]
Abstract
The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different disciplines can only improve our understanding of this key measure of health status.
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