Seven-year predictors of self-rated health and life satisfaction in the elderly: The proof study

摘要

Objectives: To investigate the relationship between cognitive performance, affective state, metabolic syndrome and 7-year follow-up self-rated health (SRH) and perceived life satisfaction (PLS).Design: Analysis of a prospective cohort study.Setting: The PROOF study, including 1011 elderly community residents.Participants: Six hundred and fifty seven subjects completed metabolic syndrome (Met S) variables, neuropsychological and affective measurements at baseline, and then returned a 7-year follow-up questionnaire which included SRH and PLS.Measurements: The prospective association between cognitive function, Met S and each of its components, and affective disorders and subsequent subjective health and quality of life was examined. Covariates included educational level and use of tobacco. The analyses were made in men and women separately.Results: In multivariate models, the presence of Met S was significantly associated to weaker SRH (OR = 2.78, p = 0.009 in men and OR = 2.0, p = 0.02 in women). Higher triglycerides rate were associated with weaker SRH in men (OR = 2.23, p = 0.002) and higher fasting glucose in women (OR = 2.54, p = 0.006). Global Met S and abdominal obesity was significantly associated to weaker PLS in women only (respectively OR = 2.70, p = 0.0002 and OR = 1.9, p = 0.02). Depressive symptoms were significantly associated to both weaker SRH and PLS in men (OR = 1.30, p = 0.002; OR = 1.44, p < 0.0001 for SRH and PLS respectively) and in woman (OR = 1.09, p = 0.04; OR = 1.26, p < 0.0001 for SRH and PLS respectively). Anxiety was linked to both weaker SRH and PLS in women (OR = 1.17, p = 0.002 and OR = 1.11, p = 0.03 for SRH and PLS respectively). Finally, lower executive function was associated with weaker PLS in men (OR = 0.43, p = 0.0005).Conclusion: metabolic syndrome and certain of its components, anxiety and depressive symptoms, are independent predictors of poorer subjective health and quality of life as assessed over a period of 7 years in a population of a non-demented aging community. Moreover, executive performance was linked to subsequent quality of life in men. Many of these factors being treatable, our findings point to the necessity of providing preventive care strategies by the management of cardiovascular risk factors and anxio-depressive symptoms.