The impact of changes in self-rated general health on 28-year mortality among middle-aged Danes
The impact of changes in self-rated general health on 28-year mortality among middle-aged Danes
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DOI：
10.1080/02813430903020446
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发表时间：
2009-01-01
影响因子：
2.1
通讯作者：
Hollnagel, Hanne
中科院分区：
文献类型：
--
作者：
Nielsen, Anni Brit Sternhagen;Siersma, Volkert;Hollnagel, Hanne
Objective.自测一般健康（SRH）预测未来死亡率。SRH可能会发生变化，这些变化可能会改变死亡风险。在一组丹麦人中，研究了68岁以前的全因死亡率及其与40-45岁、45-51岁和51-60岁的SRH变化的关系。设计前瞻性人群研究始于1976年，随访时间为1981年、1987年和1996年。设置.哥本哈根郊区。科目1936年出生的1198人。主要结果测量。全因死亡率。结果在45年、51年和60年检查后，连续两次SRH评分的参与者中，每1000观察年的死亡率分别为7.6（95% CI 6.4; 8.9）、8.5（95% CI 7.1; 10.2）和8.9（95% CI 6.4; 10.3）。在双变量考克斯回归分析中，两个时间点之间的SRH下降与死亡风险增加相关，这种相关性随着参与者年龄的增长而增加。SRH变化对死亡率影响的多变量分析得出了类似的结果：SRH下降的风险比为（参考：未改变的goodo）1.55（95% CI 0.93-2.58）、1.96（95% CI 1.09-3.53）和2.22（95% CI 0.97-5.09）。然而，SRH（在40-45年的时间间隔内）不变的差和改善也与增加有关，额外的分析表明，在一个评级中将SRH评为差与风险增加有关。结论SRH的变化与较高的死亡风险相关，而不是保持良好的SRH。
Objective. Self-rated general health (SRH) predicts future mortality. SRH may change, and these changes may alter the mortality risk. All-cause mortality until the age of 68 and its association with changes in SRH from the age of 40-45, 45-51, and 51-60 years was examined in a cohort of Danes. Design. Prospective population study started in 1976 with follow-up in 1981, 1987, and 1996. Setting. Suburban area of Copenhagen. Subjects. A total of 1198 individuals born in 1936. Main outcome measure. All-cause mortality. Results. Among participants with two consecutive SRH ratings the mortality rate per 1000 observation years was 7.6 (95% CI 6.4; 8.9), 8.5 (95% CI 7.1; 10.2), and 8.9 (95% CI 6.4; 10.3) after the 45-, 51-, and 60-year examination. Decline in SRH between two time-points was in bivariate Cox regression analyses associated with an increased mortality risk, the association increasing as participants grew older. Multivariate analysis of the effect of changes of SRH on mortality gave similar results: hazard ratios for declined SRH were (reference: ounchanged goodo) 1.55 (95% CI 0.93-2.58), 1.96 (95% CI 1.09-3.53), and 2.22 (95% CI 0.97-5.09) at the 40-45, 45-51, and 51-60-year intervals. However, unchanged poor and improved SRH (at the 40-45-year interval) were also associated with an increase, and additional analyses showed that just rating SRH as poor at one rating was associated with increased risk. Conclusion. Changes in SRH are associated with higher mortality risks than unchanged good SRH.