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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Published in:Maturitas Vol. 103; pp. 37 - 44
Main Authors: Bamia, Christina, Orfanos, Philippos, Juerges, Hendrik, Schöttker, Ben, Brenner, Hermann, Lorbeer, Roberto, Aadahl, Mette, Matthews, Charles E., Klinaki, Eleni, Katsoulis, Michael, Lagiou, Pagona, Bueno-de-mesquita, H.B(as)., Eriksson, Sture, Mons, Ute, Saum, Kai-Uwe, Kubinova, Ruzena, Pajak, Andrzej, Tamosiunas, Abdonas, Malyutina, Sofia, Gardiner, Julian, Peasey, Anne, de Groot, Lisette CPGM, Wilsgaard, Tom, Boffetta, Paolo, Trichopoulou, Antonia, Trichopoulos, Dimitrios
Format: Journal Article
Language:English
Published: 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”.
AbstractList 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".
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”.
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".
•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”.
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.
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
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  surname: Trichopoulou
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  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
Copyright_xml – notice: 2017 Elsevier B.V.
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DOI 10.1016/j.maturitas.2017.06.023
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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
Language English
License Copyright © 2017 Elsevier B.V. All rights reserved.
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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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SubjectTerms Ageing
All-cause mortality
Cardiovascular Diseases - mortality
Chair Nutrition and Health over the Lifecourse
CHANCES
Cohort
Elderly
Europe - epidemiology
Global Nutrition
Health Status
HNE Nutrition and Health over the Lifecourse
HNE Voeding en Gezondheid in de Levenscyclus
Humans
Internal Medicine
Neoplasms - mortality
Obstetrics and Gynecology
Proportional Hazards Models
Prospective Studies
Self Report
Self-rated health
United States - epidemiology
VLAG
Wereldvoeding
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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