Self-reported health and survival in the longitudinal study of aging, 1984–1986

doi:10.1016/0895-4356(94)00143-E

Journal of Clinical Epidemiology

Volume 48, Issue 3, March 1995, Pages 375-387

https://doi.org/10.1016/0895-4356(94)00143-E Get rights and content

Abstract

Changing and often declining health among elderly individuals makes interpreting the long-standing association between self-reported health (SRH) and mortality potentially problematic. This analysis of the Longitudinal Study of Aging from 1984 through 1986 explores changes over time in the association between a single self-report of health and survival among 4380 noninstitutionalized individuals aged 70 and older. Health was reported as excellent or very good (excellent/very good), good, fair or poor. The association between SRH and survival was modeled controlling for age, race, education, marital status, body mass index, difficulty performing activities of daily living, social contacts, self-reported stroke, heart disease, cancer, diabetes and recent hospitalization. Among women, SRH and survival were associated in a nonproportional model, with relative hazard declining over time. Women with poor vs excellent/very good SRH had adjusted relative hazards at 5, 14, 23 and 32 months of 3.8 [95% confidence interval (CI) 2.0–7.1], 2.7 (95% CI: 1.8–4.1), 2.0 (95% CI: 1.3–3.0), and 1.4 (95% CI: 0.7–2.7). The declining relative hazard was due to an increasing mortality rate over time among women initially reporting excellent/very good health. SRH was associated with survival among men in a proportional model (constant relative hazard over time). Men with poor vs excellent/very good SRH had an adjusted relative hazard of 1.7 (95% CI: 1.1–2.6) over the entire follow-up. The relative hazard of lesser magnitude among men reflects the weaker SRH-survival association, possibly too weak for any interaction with time to be detected. The constant relative hazard is also consistent with a rapid decline in health before death among men. The diminishing SRH-survival association among women is consistent with their longer period of declining health before death.

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^☆: Presented in part at the 24th Annual Meeting of the Society for Epidemiologic Research, June 1991.

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Original articleSelf-reported health and survival in the longitudinal study of aging, 1984–1986☆

Abstract

J Clin Epidemiol

Soc Sci Med

Soc Sci Med

J Chron Dis

J Clin Epidemiol

Controlled Clin Trials

Subjective State of health and survival in elderly adults

J Gerontol

Self-rated health: a predictor of mortality among the elderly

Am J Public Hlth

Health perceptions and survival: do global evaluations of health status really predict mortality?

J Gerontol

Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington Counties, Iowa, 1982–1986

Am J Epidemiol

Perceived health and mortality: a nine-year follow-up of the Human Population Laboratory Cohort

Am J Epidemiol

The association of self-rated health with two-year mortality in a sample of well elderly

J Hlth Aging

Self-reported health status as a predictor of mortality for the noninstitutionalized population 70 years of age and over

Gerontologist [Abstract]

Perceived health status and mortality among older men and women

J Gerontol

A longitudinal study of functional change and mortality in the United States

J Gerontol

A prospective study of functional status among community elders

Am J Public Hlth

Morbidity and disability in older persons in the years prior to death

Am J Public Hlth

Self-rated health and mortality in the NHANES—I Epidemiologic Follow-Up Study

Am J Public Hlth

The Supplement on Aging to the 1984 National Health Interview Survey. Vital and Health Statistics

Disability-free life among the elderly in the United States

J Hlth Aging

An analysis of the validity of health questionnaires

Soc Forces

Measurement of health status

Med Care

Aging and perceived health status

J Gerontol

Self-ratings of health among the old and old-old

J Hlth Soc Behav

Social context and self-assessments of health among the elderly

J Hlth Soc Behav

A comparison of self and physicians' health ratings in an older population

J Hlth Hum Behav

Self-rated health and associated factors among men of different ages

J Gerontol

Indices of health in an aging population

J Gerontol

Differences in the appraisal of health between aged and middle-aged adults

J Gerontol

Self-reported physical health among aged adults

J Gerontol

Predicting self-related health among the aged

Res Aging

Original article
Self-reported health and survival in the longitudinal study of aging, 1984–1986☆