Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium
•The association of self-rated health with mortality is confirmed by the large CHANCES study.•Self-rated health is a simple tool that may be used to identify elders at risk of early mortality.•Changing factors related to self-rated health is important for the elders to feel and be healthy. To evalua...
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| Vydané v: | Maturitas Ročník 103; s. 37 - 44 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Ireland
Elsevier B.V
01.09.2017
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| ISSN: | 0378-5122, 1873-4111, 1873-4111 |
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| Abstract | •The association of self-rated health with mortality is confirmed by the large CHANCES study.•Self-rated health is a simple tool that may be used to identify elders at risk of early mortality.•Changing factors related to self-rated health is important for the elders to feel and be healthy.
To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.
Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.
All-cause, cardiovascular and cancer mortality.
Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).
SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. |
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| AbstractList | •The association of self-rated health with mortality is confirmed by the large CHANCES study.•Self-rated health is a simple tool that may be used to identify elders at risk of early mortality.•Changing factors related to self-rated health is important for the elders to feel and be healthy.
To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.
Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.
All-cause, cardiovascular and cancer mortality.
Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).
SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. ObjectivesTo evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.Study DesignIndividual data on SRH and important covariates were obtained for 424,791 European and Unites States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.Main outcome measuresAll-cause, cardiovascular and cancer mortality.ResultsWithin the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).ConclusionSRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good". Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. All-cause, cardiovascular and cancer mortality. Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy". Highlights • The association of self-rated health with mortality is confirmed by the large CHANCES study. • Self-rated health is a simple tool that may be used to identify elders at risk of early mortality. • Changing factors related to self-rated health is important for the elders to feel and be healthy. To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good".OBJECTIVESTo evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good".Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.STUDY DESIGNIndividual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.All-cause, cardiovascular and cancer mortality.MAIN OUTCOME MEASURESAll-cause, cardiovascular and cancer mortality.Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).RESULTSWithin the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy".CONCLUSIONSRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy". Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”. Study design: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. Main outcome measures: All-cause, cardiovascular and cancer mortality. Results: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). Conclusion: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. |
| Author | Peasey, Anne Gardiner, Julian Bueno-de-mesquita, H.B(as). Pajak, Andrzej Malyutina, Sofia Orfanos, Philippos Lorbeer, Roberto Klinaki, Eleni Lagiou, Pagona Trichopoulos, Dimitrios Saum, Kai-Uwe Schöttker, Ben Katsoulis, Michael Trichopoulou, Antonia Wilsgaard, Tom de Groot, Lisette CPGM Tamosiunas, Abdonas Matthews, Charles E. Eriksson, Sture Juerges, Hendrik Brenner, Hermann Kubinova, Ruzena Boffetta, Paolo Mons, Ute Aadahl, Mette Bamia, Christina |
| Author_xml | – sequence: 1 givenname: Christina surname: Bamia fullname: Bamia, Christina email: cbamia@med.uoa.gr organization: National and Kapodistrian University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Nutrition and Health, 115 27 Athens, Greece – sequence: 2 givenname: Philippos surname: Orfanos fullname: Orfanos, Philippos organization: National and Kapodistrian University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Nutrition and Health, 115 27 Athens, Greece – sequence: 3 givenname: Hendrik surname: Juerges fullname: Juerges, Hendrik organization: University of Wuppertal, 42119, Wuppertal, Germany – sequence: 4 givenname: Ben surname: Schöttker fullname: Schöttker, Ben organization: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany – sequence: 5 givenname: Hermann surname: Brenner fullname: Brenner, Hermann organization: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany – sequence: 6 givenname: Roberto surname: Lorbeer fullname: Lorbeer, Roberto organization: Institute for Community Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, 17475 Greifswald, Germany – sequence: 7 givenname: Mette surname: Aadahl fullname: Aadahl, Mette organization: Research Centre for Prevention and Health, Center for Health, The Capital Region of Denmark, 2600 Glostrup, Denmark – sequence: 8 givenname: Charles E. surname: Matthews fullname: Matthews, Charles E. organization: National Cancer Institute, Division of Cancer Epidemiology and Genetics, Nutritional Epidemiology Branch, Bethesda, MD, 20892-9704, USA – sequence: 9 givenname: Eleni surname: Klinaki fullname: Klinaki, Eleni organization: Hellenic Health Foundation, 115 27, Athens, Greece – sequence: 10 givenname: Michael surname: Katsoulis fullname: Katsoulis, Michael organization: Hellenic Health Foundation, 115 27, Athens, Greece – sequence: 11 givenname: Pagona surname: Lagiou fullname: Lagiou, Pagona organization: National and Kapodistrian University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Nutrition and Health, 115 27 Athens, Greece – sequence: 12 givenname: H.B(as). surname: Bueno-de-mesquita fullname: Bueno-de-mesquita, H.B(as). organization: Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands – sequence: 13 givenname: Sture surname: Eriksson fullname: Eriksson, Sture organization: Umeå University, Department of Geriatrics, SE 90185 Umeå, Sweden – sequence: 14 givenname: Ute surname: Mons fullname: Mons, Ute organization: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany – sequence: 15 givenname: Kai-Uwe surname: Saum fullname: Saum, Kai-Uwe organization: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany – sequence: 16 givenname: Ruzena surname: Kubinova fullname: Kubinova, Ruzena organization: National Institute of Public Health, Šrobarova 48, 10042 Prague 10, Czech Republic – sequence: 17 givenname: Andrzej surname: Pajak fullname: Pajak, Andrzej organization: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Faculty of Health Sciences, 31-137 Krakow, Poland – sequence: 18 givenname: Abdonas surname: Tamosiunas fullname: Tamosiunas, Abdonas organization: Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių av. 17, Kaunas LT-50161, Lithuania – sequence: 19 givenname: Sofia surname: Malyutina fullname: Malyutina, Sofia organization: Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Russia – sequence: 20 givenname: Julian surname: Gardiner fullname: Gardiner, Julian organization: Department of Epidemiology and Public Health, University College London, WC1E 6BT, UK – sequence: 21 givenname: Anne surname: Peasey fullname: Peasey, Anne organization: Department of Epidemiology and Public Health, University College London, WC1E 6BT, UK – sequence: 22 givenname: Lisette CPGM surname: de Groot fullname: de Groot, Lisette CPGM organization: Division of Human Nutrition, Wageningen University, P.O. Box 8129, NL-6700 EV Wageningen, The Netherlands – sequence: 23 givenname: Tom surname: Wilsgaard fullname: Wilsgaard, Tom organization: Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway – sequence: 24 givenname: Paolo surname: Boffetta fullname: Boffetta, Paolo organization: Hellenic Health Foundation, 115 27, Athens, Greece – sequence: 25 givenname: Antonia surname: Trichopoulou fullname: Trichopoulou, Antonia organization: National and Kapodistrian University of Athens, Medical School, Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Nutrition and Health, 115 27 Athens, Greece – sequence: 26 givenname: Dimitrios surname: Trichopoulos fullname: Trichopoulos, Dimitrios organization: Hellenic Health Foundation, 115 27, Athens, Greece |
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| ContentType | Journal Article |
| Copyright | 2017 Elsevier B.V. Copyright © 2017 Elsevier B.V. All rights reserved. Wageningen University & Research |
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| Keywords | OR All-cause mortality Cohort CI Ageing SRH CHANCES HR Self-rated health Elderly ageing elderly cohort Hazard Ratio Confidence Interval all-cause mortality Self-Rated Health Odds Ratio Consortium on Health and Ageing Network of Cohorts in Europe and the United States |
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| Snippet | •The association of self-rated health with mortality is confirmed by the large CHANCES study.•Self-rated health is a simple tool that may be used to identify... Highlights • The association of self-rated health with mortality is confirmed by the large CHANCES study. • Self-rated health is a simple tool that may be used... To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as... Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as... ObjectivesTo evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as... |
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| Title | Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium |
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