title: Evolution of self-rated health status in the elderly: cross-sectional vs. longitudinal estimates.
abstract: We assessed the perceived health status evolution among elderly subjects and examined the age-related differences in perceived health when comparing estimates obtained from cross-sectional and longitudinal approaches. Data come from a cohort of non-institutionalized individuals aged 65 years or older, living in Barcelona, Spain. One thousand three hundred fifteen (1315) elderly were successfully interviewed at baseline in 1986 and 754 (84.6% of the eligible) at the re-assessment (1993-1994). Estimates of change in perceived health status were calculated based on cross-sectional and longitudinal approaches. Cross-sectionally, no significant differences in the proportion of individuals with poor self-rated health were found (40.5 vs. 42.5%, P = 0.90). Among survivors, the proportion of individuals with poor health increased from 37.8% to 55.1% (P < 0.01), an 8.7-fold decline of perceived health when compared with the cross-sectional estimates. Comorbidity (aOR 2.1; 95%CI: 1.4-3.3) and no education (aOR 1.9; 95%CI: 1.1-3.2) were associated with a decline in health status after adjusting by baseline health status. We recommend the use of longitudinal studies to understand the evolution of perceived health in the elderly.
authors.affiliation: Health Services Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Orfila
authors.forename: M
authors.initials: M
authors.lastname: Ferrer
authors.forename: R
authors.initials: R
authors.lastname: Lamarca
authors.forename: J
authors.initials: J
authors.lastname: Alonso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012649:Self Concept; D012907:Smoking; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires