Changes over time from baseline poor self-rated health: For whom does poor self-rated health not predict mortality?

Abstract

The aim of this study was to understand for whom and why poor self-rated health (SRH) is a less valid predictor of longevity or future health by examining the predictors of decline in health among people with poor baseline SRH. The sample included 409 participants in the Cross-Sectional and Longitudinal Study of the old–old (75+) in Israel, who were self-respondents and rated their health as poor at baseline and their status was known at follow-up 3.5 years later: deceased/moved to proxy interview/remained in poor SRH/or improved SRH. Baseline measures included self-reported medical status, physical, cognitive, psychological and social functioning. Findings showed that less decline in health was predicted by less difficulty in physical and cognitive functioning at baseline and by a more active physical and social life, after controlling for socio-demographics. Most of the predictors retained a unique contribution in a multivariate model, suggesting that engagement in meaningful activities serves as an indicator of better health and longer survival even within a group of old–old people in poor health. It may reflect greater social support, contribute to fitness and/or provide a sense of mastery, which could explain similar findings regarding gender and race/ethnicity groups for whom SRH is a less potent predictor of mortality.

Keywords:

• self-assessed health
• old–old
• mastery
• perceived control
• perceived health

Acknowledgements

The Cross-Sectional and Longitudinal Aging Study was funded by US National Institute on Aging Grants R01-5885-03 and R01-5885-06, with Baruch Modan as Principal Investigator.