Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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
See this image and copyright information in PMC

References

    1. Jylhä Marja. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine. 2009;69(3):307–316. doi: 10.1016/j.socscimed.2009.05.013. - DOI - PubMed
    1. Mossey J M, Shapiro E. Self-rated health: a predictor of mortality among the elderly. American Journal of Public Health. 1982;72(8):800–808. doi: 10.2105/AJPH.72.8.800. - DOI - PMC - PubMed
    1. Idler Ellen L., Benyamini Yael. Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies. Journal of Health and Social Behavior. 1997;38(1):21. doi: 10.2307/2955359. - DOI - PubMed
    1. Assari Shervin. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults. SAGE Open Medicine. 2016;4:205031211666697. doi: 10.1177/2050312116666975. - DOI - PMC - PubMed
    1. Bruin, A, Picavet, H.S.J., Nossikov, A. Health interview surveys: towards international harmonization of methods and instruments. WHO regional publications. European series; No 58; - PubMed