Self-rated current and future health independently predict subsequent mortality in an aging population.

摘要

BACKGROUND: Self-rated current health is an independent, robust predictor of subsequent mortality in older adults. Investigators hypothesize that individuals likely take into account their future health when reporting their current health. However, few have measured and examined self-rated future health in relation to mortality. METHODS: We investigate the effect of three self-rated health measures on 10-year mortality in 2091 men and women in an aging cohort: (i) self-rated current health, (ii) self-rated future health (1 year in the future), and (iii) a combined measure of current and future health. Vital status at follow-up year 10 was the outcome. We used data from SPPARCS (Study of Physical Performance and Age-Related Changes in Sonomans), a population-based, census-sampled, study of the epidemiology of aging, health, and functioning. RESULTS: Compared to those reporting their future health as better/same, participants reporting their future health as worse or unknown (don't know) experienced elevated 10-year mortality (adjusted rate ratio [RR]=1.6, 95% confidence interval [CI], 1.2-2.1, p=.01), after adjustment for self-rated current health and other relevant covariates. The combined measure of current and future health also contributed important information. Compared to the referent (the best combination, current health excellent/good and future health better/same), participants reporting the worst combination, fair/poor current health and worse/unknown future health, experienced the highest 10-year mortality in the cohort (adjusted RR=3.2, 95% CI, 2.2-4.7, p=.00). CONCLUSIONS: Self-rated future health is an independent, robust predictor of mortality. It is as predictive of subsequent mortality in older adults as the standard measure of self-rated current health. Furthermore, a measure that combines self-reports of current health with future health was most useful in the identification of older adults with the highest mortality rates. Thus, the combined measure of current and future health may be most useful in practice, in distinguishing the differential mortality rates among persons reporting fair or poor self-rated current overall health.