title: Change in self-rated health and mortality among community-dwelling disabled older women.
abstract: OBJECTIVE
  Our study assessed whether change in self-rated health is a stronger predictor of mortality than baseline self-rated health and the most recent self-rated health (prior to death or loss to follow-up) among disabled older women.
  
  
  METHODS
  The Women's Health and Aging Study examined disabled older women at baseline and every 6 months for 3 years. During the follow-up period, 253 out of the 905 examined participants died. Cox regression models with time-dependent covariates were used.
  
  
  RESULTS
  After baseline characteristics were adjusted for, baseline self-rated health was not related to mortality. After covariates at the most recent observation and covariates measured only at baseline were controlled for, the most recent self-rated health was not associated with mortality either. After time-dependent covariates and covariates measured only at baseline were adjusted for, decline in self-rated health was significantly associated with increased mortality.
  
  
  CONCLUSIONS
  Change in self-rated health is a stronger predictor of mortality than self-rated health at baseline and at the most recent observation. Older women with "fair" health are worse off if they are on a declining health trajectory than if their "fair" health is stable. Family caregivers and clinicians need to closely monitor change in self-rated health among disabled older women.
authors.affiliation: National Center for Health Statistics, Hyattsville, MD, USA. hih9@cdc.gov
authors.forename: Beth
authors.initials: B
authors.lastname: Han
authors.forename: Caroline
authors.initials: C
authors.lastname: Phillips
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: Marja
authors.initials: M
authors.lastname: Jylha
authors.forename: Judith
authors.initials: J
authors.lastname: Kasper
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
mesh_terms: D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D009026:Mortality; D012647:Self-Assessment; D014481:United States; D016387:Women's Health