Somatic multimorbidity and self-rated health in the older population.
ABSTRACT Chronic diseases are important predictors of self-rated health (SRH). This study investigated whether multimorbidity has a synergistic or cumulative impact on SRH. Moderation by gender and age was examined.
Data originated from the Longitudinal Aging Study Amsterdam (N=2046, aged 57-98 years). We assessed the presence of lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes mellitus, arthritis, and cancer. SRH was measured with the question "How is your health in general?" including 5 response categories. Generalized ordered probit models were applied; possible synergism was examined by testing for nonlinearity of the association.
The association between multimorbidity and SRH was nonlinear in that the effect of having a single disease was larger than the added effects of co-occurring diseases. However, from the second disease onward, each additional co-occurring disease caused cumulative declines in SRH. Only in the oldest old (85+), the impact of a single disease was similar to that of co-occurring diseases. Results were similar for men and women.
Our findings help to improve understanding of the impact multimorbidity has on SRH: Having a single disease increases the chance of poor health more than each co-occurring disease, indicating some overlap between diseases or adaptation to declining health.
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ABSTRACT: To establish self-rated health, health-related behaviours and health conditions of Maori and non-Maori in advanced age.The New Zealand medical journal 01/2014; 127(1397):13-29.
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ABSTRACT: Objectives.With age, there is an increasing gap between relatively stable levels of self-rated health (SRH) and actual health status. This study investigates longitudinal changes in SRH and examines its sensitivity to changes in chronic conditions and functioning among people aged 90 and older. In the Vitality 90+ Study, questionnaires were sent to all people aged 90 years and older living in Tampere, Finland. Included were respondents who provided data on the 2001 measurement and at least one follow-up measurement in 2003, 2007, or 2010 (N = 334). Generalized Estimating Equations analyses examined longitudinal change in SRH and the predictive value of number of chronic conditions and a functioning score based on 5 activities. Within 2 years, most people (56.3%) had unchanged SRH, but declined SRH (22.3%) was associated with worse baseline functioning and declined functioning. Clear declines in SRH after 6 and 9 years were associated with increased chronic conditions (odds ratio [OR] = 1.23) and decreased functioning (OR = 1.28). The impact of chronic conditions and functioning was smaller among institutionalized people (chronic conditions OR = 0.90; functioning OR = 1.18) than among people living independently (chronic conditions OR = 1.30; functioning OR = 1.44).Discussion.SRH among nonagenarians was sensitive to changes in the number of chronic conditions and functioning although more pronounced on the longer than on the shorter term.The Journals of Gerontology Series B Psychological Sciences and Social Sciences 08/2013; · 3.01 Impact Factor
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ABSTRACT: As the Global Activity Limitation Index (GALI) has only recently been created and it is not yet known whether it adds any additional information to self-rated health (SRH), two hypotheses were tested: (1) GALI is primarily correlated with functional disability and secondarily with morbidity and (2) SRH is primarily correlated with morbidity and secondarily with functional disability. The data source used was a subsample of the 2006 Spanish National Health Survey comprising people aged more than 64 years (N = 7,835). Age, sex, social class, physical and mental morbidities, and functional disability were selected as predictors in multinomial logistic regression models, in which GALI and SRH were the outcome variables. Fractional polynomials were used to handle the continuous predictors. The results supported, generally, both hypotheses: functional disability was the main correlate of GALI and physical morbidity, rather than mental morbidity, was the main correlate of SRH. Furthermore, mental morbidity was as strong a correlate of GALI as SRH, but physical morbidity was notably less strong a correlate for GALI than for SRH. In older people, GALI mainly measured functional disability, whereas SRH mainly measured physical morbidity.Journal of clinical epidemiology 01/2014; · 5.48 Impact Factor