title: Determinants of self-rated health: could health status explain the association between self-rated health and mortality?
abstract: The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.
authors.affiliation: Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192, Japan. cmurata@hama-med.ac.jp
authors.forename: Chiyoe
authors.initials: C
authors.lastname: Murata
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kondo
authors.forename: Koji
authors.initials: K
authors.lastname: Tamakoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuya
authors.forename: Hideaki
authors.initials: H
authors.lastname: Toyoshima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D016016:Proportional Hazards Models; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014505:Urban Population