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. 2019 Jun 29;17(1):111.
doi: 10.1186/s12955-019-1184-z.

Features and impact of missing values in the association of self-rated health with mortality in care homes: a longitudinal study

María Del Pilar Rodríguez-García  1 , Alba Ayala  2 , Carmen Rodríguez-Blázquez  3 , Pablo Martínez-Martín  3 , Maria João Forjaz  4 , Javier Damián  3
Affiliations

Features and impact of missing values in the association of self-rated health with mortality in care homes: a longitudinal study

María Del Pilar Rodríguez-García et al. Health Qual Life Outcomes. .

Abstract

Background: Self-rated health (SRH) is a health measure used in studies of older adults. The objective of this study is to analyze SRH as a predictor of mortality in the institutionalized older population and the characteristics of those who do not provide information about their SRH on health questionnaires.

Methods: This is a 15-year follow-up study of older adult residents in nursing or care homes in of Madrid, Spain. SRH was measured on a 5-point Likert type scale. The association between answering the SRH question and socio-demographic and health characteristics was evaluated through prevalence ratio (PR), estimated by Poisson regression models. Survival rates associated with SRH were studied through a multivariate Cox regression.

Results: The sample has a mean age of 83.4 (standard deviation, SD = 7.3), with 75.7% women. Twelve percent did not answer the SRH item. Those who did not answer showed a higher probability of disability (Barthel index, PR = 0.76, 95% confidence interval = 0.67-0.86) and/or dementia (PR = 8.03, 3.38-19.03). A trend for higher mortality was observed in those persons who did not respond (adjusted hazard ratio HR = 1.26, 0.75-2.11). The mortality rate was 32% higher for those who declared poor SRH in comparison with those who reported good SRH (adjusted HR = 1.32, 1.08-1.6).

Conclusions: There is an elevated number of people who do not respond to the SRH item, mainly those with disabilities and cognitive deterioration. Lack of response to SRH is a good indicator of 15-year mortality for persons institutionalized in care or nursing homes.

Keywords: Care and nursing homes; Elderly people; Missing values; Mortality; Self-rated health.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curve for crude mortality relative to reply or not the item self-rated health questionnaire
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