SELF-EVALUATED HEALTH AND MORTALITY AMONG THE ELDERLY IN NEW-HAVEN, CONNECTICUT, AND IOWA AND WASHINGTON COUNTIES, IOWA, 1982-1986

SELF-EVALUATED HEALTH AND MORTALITY AMONG THE ELDERLY IN NEW-HAVEN, CONNECTICUT, AND IOWA AND WASHINGTON COUNTIES, IOWA, 1982-1986
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DOI:
10.1093/oxfordjournals.aje.a115489
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发表时间:
1990-01-01
影响因子:
5
通讯作者:
LEMKE, JH
LEMKE, JH
中科院分区:
医学2区
文献类型:
--
作者:
IDLER, EL;KASL, SV;LEMKE, JH

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在后续研究中,在两个非机构化老年人样本中测试了整体健康自我评估预测生存的能力。来自康涅狄格州纽黑文市的耶鲁健康与老龄化项目 (n = 2,812) 以及爱荷华州和华盛顿县 (美国) 65+ 农村健康研究 (n = 3,673) 的数据被用来调查 1982 年自我评估的全球健康状况(优秀、良好、一般、差)与 1982 年至 1986 年生存率之间的关联。尽管对身体健康状况进行了广泛的控制以残疾和慢性病、社会人口特征和随访期开始时的健康风险行为的衡量形式,以及考虑纽黑文数据分层样本设计的分析技术的使用,对健康的不良自我认知会显着增加死亡风险。纽黑文男性和女性极端类别(“差”与“优秀”相比)的调整后比值比分别为 5.33(95% 置信区间 (CI) 1.93-14.75)和 ​​2.99(95% CI 1.30-6.91);爱荷华州男性和女性的这一比例分别为 4.84 (95% Cl 2.22-10.57) 和 3.16 (95% Cl 1.49-6.71)。报告健康状况“一般”和“良好”的受访者还显示,剂量反应方式的死亡风险升高。对健康状况的自我认知似乎是死亡率研究中具有独特前瞻性的重要因素。
The ability of global self-evaluations of health to predict survival in follow-up studies is tested in two samples of elderly, noninstitutionalized adults. Data from the Yale Health and Aging Project, New Haven Connecticut (n = 2,812), and the 65+ Rural Health Study, Iowa and Washington counties, Iowa (USA) (n = 3,673), were used to investigate the association between 1982 self-evaluated global health status (excellent, good, fair, poor) and survivorship from 1982 to 1986. Despite extensive controls for physical health status in the form of measures of disabilities and chronic conditions, sociodemographic characteristics, and health risk behaviors at the beginning of the follow-up period, and the use of analytic techniques which take into account the stratified sample design of the New Haven data, poor self-perceptions of health significantly increase the risk of mortality. Adjusted odds ratios for the extreme categories ("poor" as compared with "excellent") for New Haven men and women were 5.33 (95% confidence interval (CI) 1.93-14.75) and 2.99 (95% Cl 1.30-6.91), respectively; for Iowa men and women they were 4.84 (95% Cl 2.22-10.57) and 3.16 (95% Cl 1.49-6.71). Respondents reporting "fair" and "good" health also show elevated risks of mortality in dose-response fashion. Self-perceptions of health status appear to be a factor of unique prospective significant in mortality studies.