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. 2020 Mar 30;20(1):120.
doi: 10.1186/s12877-020-01516-9.

Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up

Maarit Wuorela  1   2 , Sirkku Lavonius  3   4 , Marika Salminen  5   6 , Tero Vahlberg  7 , Matti Viitanen  3   8 , Laura Viikari  3   5
Affiliations

Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up

Maarit Wuorela et al. BMC Geriatr. .

Abstract

Background: Despite a non-specific nature of self-rated health (SRH), it seems to be a strong predictor of mortality. The aim of this study is to assess the association of SRH and objective health status (OH) with all-cause mortality in 70-year-old community-dwelling older people in Finland.

Methods: A prospective study with 5-, 10- and 27-year follow-ups. SRH (n = 1008) was assessed with a single question and OH (n = 962) by the Rockwood's Frailty Index (FI). To assess the association of SRH and OH with mortality, Cox regression model was used.

Results: Of the 1008 participants, 138 (13.7%), 319 (31.6%), and 932 deceased (86.3%) during the 5-, 10- and 27-year follow-ups, respectively. In unadjusted models, subjects with poor SRH had almost eightfold risk for mortality compared to those with good SRH during the 5-year follow-up; among those with poor OH, the risk was fourfold compared to those with good OH. In the 10-year-follow up, both poor SRH and poor OH predicted about fourfold risk for mortality compared to those with good health. During the 27-year follow-up, OH was a stronger predictor of mortality than SRH. Poor SRH, compared to good SRH, showed 95% sensitivity and 34% specificity for 5-year mortality; corresponding figures for OH were 54 and 80%, respectively.

Conclusions: Single-item SRH seems to be able to capture almost the same as OH in predicting a short-term (less than 10 years) mortality risk among older adults in clinical settings. The use of SHR may also enhance the focus on patient-centered care.

Keywords: Frailty; Mortality; Objective health; Older people; 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 survival curves by self-rated health (a) and objective health status (b). Number of participants alive at 0-, 5-, 10-, 15-, 20- and 25-year follow-ups by. a Self-rated health categories. Good: 451, 429, 381, 299, 175 and 76. Moderate: 363, 338, 262, 170, 81 and 30. Poor: 148, 119, 71, 40, 15 and 4. b Objective health status categories. Good: 103, 101, 94, 70, 41 and 17. Rather good: 644, 611, 515, 376, 203 and 81. Poor: 261, 213, 141, 86, 41 and 17
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