title: The contribution of self-rated health and depressive symptoms to disability severity as a predictor of 10-year mortality in European elderly men.
abstract: OBJECTIVE
  To investigate the effect of disability severity and the contribution of self-rated health and depressive symptoms to 10-year mortality.
  
  
  METHODS
  Longitudinal data were collected from 1141 men aged 70 to 89 years from the Finland, Italy, and the Netherlands Elderly Study from 1990 to 2000. Disability severity was classified into 4 categories: no disability, instrumental activities, mobility, and basic activities of daily living. Self-rated health and depressive symptoms were classified into 2 and 3 categories, respectively. Multivariate Cox proportional hazard models were used to calculate mortality risks.
  
  
  RESULTS
  Men with severe disability had a risk of mortality that was more than 2-fold higher (hazard ratio [HR]=2.41; 95% confidence interval [CI]=1.84, 3.16) than that of men without disability. Men who had severe disability and did not feel healthy had the highest mortality risk (HR = 3.30; 95% CI = 2.52, 4.33). This risk was lower at lower levels of disability and higher levels of self-rated health. The same trend was observed for depressive symptoms.
  
  
  CONCLUSIONS
  For adequate prognoses on mortality or for developing intervention strategies, not only physical aspects of health but also other health outcomes should be taken into account.
authors.affiliation: National Institute for Public Health and the Environment, Center for Prevention and Health Services Research, PO Box 1, 3720 BA Bilthoven, The Netherlands. carolien.van.den.brink@rivm.nl
authors.forename: Carolien L
authors.initials: CL
authors.lastname: van den Brink
authors.forename: Marja
authors.initials: M
authors.lastname: Tijhuis
authors.forename: Geertrudis A M
authors.initials: GA
authors.lastname: van den Bos
authors.forename: Simona
authors.initials: S
authors.lastname: Giampaoli
authors.forename: Aulikki
authors.initials: A
authors.lastname: Nissinen
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003863:Depression / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology; D004185:Disability Evaluation; D005060:Europe / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D011379:Prognosis; D012306:Risk