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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
BMC Geriatrics ( IF 3.4 ) Pub Date : 2020-03-30 , DOI: 10.1186/s12877-020-01516-9
Maarit Wuorela , Sirkku Lavonius , Marika Salminen , Tero Vahlberg , Matti Viitanen , Laura Viikari

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. 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. 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. 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.

中文翻译:

自我评估的健康状况和客观健康状况可预测老年人全因死亡率:一项为期5年,10年和27年的随访的前瞻性研究

尽管自评健康(SRH)具有非特异性,但它似乎是死亡率的有力预测指标。这项研究的目的是评估SRH和客观健康状况(OH)与芬兰70岁社区居住老年人的全因死亡率之间的关系。一项为期5年,10年和27年的随访的前瞻性研究。SRH(n = 1008)由一个问题进行评估,OH(n = 962)由Rockwood脆弱指数(FI)评估。为了评估SRH和OH与死亡率的关系,使用了Cox回归模型。在5年,10年和27年的随访中,分别有100例参与者中的138例(13.7%),319例(31.6%)和932例死亡(86.3%)。在未经校正的模型中,SRH不良的受试者在5年的随访中死亡风险几乎是SRH良好的受试者的八倍。在OH差的人中 与具有良好OH的人相比,该风险是四倍。在10年的随访中,与健康状况良好的人相比,SRH和OH均较差的人预测死亡风险约为四倍。在27年的随访中,OH比SRH更能预测死亡。与良好的SRH相比,较差的SRH对5年死亡率显示出95%的敏感性和34%的特异性;OH的相应数字分别为54%和80%。在预测临床环境中老年人的短期(少于10年)死亡风险时,单项SRH似乎能够捕获与OH几乎相同的物质。SHR的使用还可以增强对以患者为中心的护理的关注。OH是比SRH更强的死亡率预测指标。与良好的SRH相比,较差的SRH对5年死亡率显示出95%的敏感性和34%的特异性;OH的相应数字分别为54%和80%。在预测临床环境中老年人的短期(少于10年)死亡风险时,单项SRH似乎能够捕获与OH几乎相同的结果。SHR的使用还可以增强对以患者为中心的护理的关注。OH是比SRH更强的死亡率预测指标。与良好的SRH相比,较差的SRH对5年死亡率显示出95%的敏感性和34%的特异性;OH的相应数字分别为54%和80%。在预测临床环境中老年人的短期(少于10年)死亡风险时,单项SRH似乎能够捕获与OH几乎相同的物质。SHR的使用还可以增强对以患者为中心的护理的关注。
更新日期:2020-04-22
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