The association between self-rated health and all-cause mortality and explanatory factors in China’s oldest-old population

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Self-rated health (SRH) is considered a condensed summary of information about bodily conditions that involves people’s biological, cognitive, and cultural status, but has been under-studied in the oldest old population. This study aimed to investigate the association between SRH and all-cause mortality among the oldest-old population in China and to explore potential explanatory factors in this association.

Methods

The study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018 and included 30 222 participants aged 80 years or older (ie, the oldest old) in the analysis. We used Cox models to assess the association between SRH and mortality in this population and its subgroups, and used the Percentage Excess Risk Mediated approach to identify potential contributing factors.

Results

After adjustment of confounders, people with “good” “neutral”, and “bad/very bad” SRH were significantly associated with 8% (95% confidence interval (CI) = 3%-13%), 23% (95% CI = 18%-29%), and 52% (95% CI = 44%-61%) higher hazard of mortality respectively, compared with those with “very good” SRH. The significant SRH-mortality associations were exclusive to men and those with at least primary education. The adjustment of “regular physical activity”, “leisure activity”, “activities of daily living (ADL)”, and “cognitive function” all led to noticeable attenuation to the SRH-mortality association, with “leisure activity” causing the most attenuation (64.9%) in the “Good SRH” group.

Conclusions

Self-rated health is significantly associated with all-cause mortality among the oldest old population in China, particularly among men and the educated, and is considerably explained by regular physical activity, leisure activity, ADL, and cognitive function. We advocate the use of SRH as a simple and efficient tool in research and (potentially) health care practices.

Related collections

Most cited references 25

Record: found
Abstract: found
Article: not found

What is self-rated health and why does it predict mortality? Towards a unified conceptual model.

Marja Jylhä (2009)

The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different disciplines can only improve our understanding of this key measure of health status.

0 comments Cited 375 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study

Marko Elovainio, Christian Hakulinen, Laura Pulkki-Råback … (2017)

Summary Background The associations of social isolation and loneliness with premature mortality are well known, but the risk factors linking them remain unclear. We sought to identify risk factors that might explain the increased mortality in socially isolated and lonely individuals. Methods We used prospective follow-up data from the UK Biobank cohort study to assess self-reported isolation (a three-item scale) and loneliness (two questions). The main outcomes were all-cause and cause-specific mortality. We calculated the percentage of excess risk mediated by risk factors to assess the extent to which the associations of social isolation and loneliness with mortality were attributable to differences between isolated and lonely individuals and others in biological (body-mass index, systolic and diastolic blood pressure, and handgrip strength), behavioural (smoking, alcohol consumption, and physical activity), socioeconomic (education, neighbourhood deprivation, and household income), and psychological (depressive symptoms and cognitive capacity) risk factors. Findings 466 901 men and women (mean age at baseline 56·5 years [SD 8·1]) were included in the analyses, with a mean follow-up of 6·5 years (SD 0·8). The hazard ratio for all-cause mortality for social isolation compared with no social isolation was 1·73 (95% CI 1·65–1·82) after adjustment for age, sex, ethnic origin, and chronic disease (ie, minimally adjusted), and was 1·26 (95% CI 1·20–1·33) after further adjustment for socioeconomic factors, health-related behaviours, depressive symptoms, biological factors, cognitive performance, and self-rated health (ie, fully adjusted). The minimally adjusted hazard ratio for mortality risk related to loneliness was 1·38 (95% CI 1·30–1·47), which reduced to 0·99 (95% CI 0·93–1·06) after full adjustment for baseline risks. Interpretation Isolated and lonely people are at increased risk of death. Health policies addressing risk factors such as adverse socioeconomic conditions, unhealthy lifestyle, and lower mental wellbeing might reduce excess mortality among the isolated and the lonely. Funding Academy of Finland, NordForsk, and the UK Medical Research Council.

0 comments Cited 129 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

5 year mortality predictors in 498,103 UK Biobank participants: a prospective population-based study.

Andrea Ganna, Erik Ingelsson (2015)

To our knowledge, a systematic comparison of predictors of mortality in middle-aged to elderly individuals has not yet been done. We investigated predictors of mortality in UK Biobank participants during a 5 year period. We aimed to investigate the associations between most of the available measurements and 5 year all-cause and cause-specific mortality, and to develop and validate a prediction score for 5 year mortality using only self-reported information.

0 comments Cited 93 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Glob Health

Journal ID (iso-abbrev): J Glob Health

Journal ID (publisher-id): JGH

Title: Journal of Global Health

Publisher: International Society of Global Health

ISSN (Print): 2047-2978

ISSN (Electronic): 2047-2986

Publication date (Electronic, pub): 23 July 2022

Publication date (Electronic, collection): 2022

Volume: 12

Electronic Location Identifier: 11005

Affiliations

[1 ]Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China

[2 ]The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia

[3 ]Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

[4 ]Baylor College of Medicine, Houston, Texas, USA

[5 ]MindRank AI ltd., Hangzhou, Zheijang, China

[6 ]Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia

[7 ]School of population medicine and public health, China Academy of Medical Science & Peking Union Medical College, Beijing, China

[8 ]Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

[9 ]Duke Global Health Institute, Duke University, Durham, North Carolina, USA

[10 ]Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA

[11 ]The George Institute for Global Health, Beijing, China

[12 ]School of Public Health, Wuhan University, Wuhan, China

Author notes

[*]

Equal contributions as first-authors.

Correspondence to: Lijing L Yan Kunshan Jiangsu P.R.China  lijing.yan@ 123456duke.edu  Shangzhi Xiong Kunshan Jiangsu P.R.China  shangzhi.xiong@ 123456duke.edu

Article

Publisher ID: jogh-12-11005

DOI: 10.7189/jogh.12.11005

PMC ID: 9305379

PubMed ID: 35866355

SO-VID: a0e4ec5f-629b-48b8-a885-7e386a8166f6

License:

This work is licensed under a Creative Commons Attribution 4.0 International License.

The association between self-rated health and all-cause mortality and explanatory factors in China’s oldest-old population

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Global Health Next Generation Network

Most cited references 25

What is self-rated health and why does it predict mortality? Towards a unified conceptual model.

Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study

5 year mortality predictors in 498,103 UK Biobank participants: a prospective population-based study.

Author and article information

Journal

Affiliations

Author notes

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 192

Cited by 2

Most referenced authors 226