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. 2022 Jul 23:12:11005.
doi: 10.7189/jogh.12.11005.

The association between self-rated health and all-cause mortality and explanatory factors in China's oldest-old population

Shangzhi Xiong  1   2 , Zhiyang Wang  1   3 , Beomhyeok Lee  1 , Qi Guo  1 , Nicholas Peoples  4 , Xurui Jin  5 , Enying Gong  1   6   7 , Yaxi Li  1 , Xinyue Chen  1 , Zhengting He  1   8 , Xian Zhang  1   5 , Lijing L Yan  1   9   10   11   12
Affiliations

The association between self-rated health and all-cause mortality and explanatory factors in China's oldest-old population

Shangzhi Xiong et al. J Glob Health. .

Abstract

Background: Self-rated health (SRH) is considered a condensed summary of information about bodily conditions that involves people's biological, cognitive, and cultural status, but has been under-studied in the oldest old population. This study aimed to investigate the association between SRH and all-cause mortality among the oldest-old population in China and to explore potential explanatory factors in this association.

Methods: The study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018 and included 30 222 participants aged 80 years or older (ie, the oldest old) in the analysis. We used Cox models to assess the association between SRH and mortality in this population and its subgroups, and used the Percentage Excess Risk Mediated approach to identify potential contributing factors.

Results: After adjustment of confounders, people with "good" "neutral", and "bad/very bad" SRH were significantly associated with 8% (95% confidence interval (CI) = 3%-13%), 23% (95% CI = 18%-29%), and 52% (95% CI = 44%-61%) higher hazard of mortality respectively, compared with those with "very good" SRH. The significant SRH-mortality associations were exclusive to men and those with at least primary education. The adjustment of "regular physical activity", "leisure activity", "activities of daily living (ADL)", and "cognitive function" all led to noticeable attenuation to the SRH-mortality association, with "leisure activity" causing the most attenuation (64.9%) in the "Good SRH" group.

Conclusions: Self-rated health is significantly associated with all-cause mortality among the oldest old population in China, particularly among men and the educated, and is considerably explained by regular physical activity, leisure activity, ADL, and cognitive function. We advocate the use of SRH as a simple and efficient tool in research and (potentially) health care practices.

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Conflict of interest statement

Competing interests: The authors completed the Unified Declaration of Interest Form (available upon request from the corresponding author) and declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of included participants in the study.
Figure 2
Figure 2
Kaplan-Meier curves by self-rated health levels.
Figure 3
Figure 3
Proportions of the self-rate health (SRH)-mortality association attributable to health-related factors. Notes: The reference group was “Very good” SRH. *Adjusted for gender, ethnicity, age, marital status, occupation, education, and residence. **Adjusted for gender, ethnicity, age, marital status, occupation, education, residence, lifestyle, ADL, and cognitive function. by gender and education
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References

    1. Jylhä M.What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009;69:307-16. 10.1016/j.socscimed.2009.05.013 - DOI - PubMed
    1. Assari S, Lankarani MM, Burgard S.Black-white difference in long-term predictive power of self-rated health on all-cause mortality in United States. Ann Epidemiol. 2016;26:106-14. 10.1016/j.annepidem.2015.11.006 - DOI - PMC - PubMed
    1. Szybalska A, Broczek K, Puzianowska-Kuznicka M, Slusarczyk P, Chudek J, Skalska A, et al. Self-rated health and its association with all-cause mortality of older adults in Poland: The PolSenior project. Arch Gerontol Geriatr. 2018;79:13-20. 10.1016/j.archger.2018.07.016 - DOI - PubMed
    1. Falk H, Skoog I, Johansson L, Guerchet M, Mayston R, Hörder H, et al. Self-rated health and its association with mortality in older adults in China, India and Latin America-a 10/66 Dementia Research Group study. Age Ageing. 2017;46:932-9. 10.1093/ageing/afx126 - DOI - PMC - PubMed
    1. Ganna A, Ingelsson E.5 year mortality predictors in 49803 UK Biobank participants: a prospective population-based study. Lancet. 2015;386:533-40. 10.1016/S0140-6736(15)60175-1 - DOI - PubMed