The impact of changes in self-rated general health on 28-year mortality among middle-aged Danes.
OBJECTIVE
Self-rated general health (SRH) predicts future mortality. SRH may change, and these changes may alter the mortality risk. All-cause mortality until the age of 68 and its association with changes in SRH from the age of 40-45, 45-51, and 51-60 years was examined in a cohort of Danes.


METHODS
Prospective population study started in 1976 with follow-up in 1981, 1987, and 1996.


METHODS
Suburban area of Copenhagen.


METHODS
A total of 1198 individuals born in 1936.


METHODS
All-cause mortality.


RESULTS
Among participants with two consecutive SRH ratings the mortality rate per 1000 observation years was 7.6 (95% CI 6.4; 8.9), 8.5 (95% CI 7.1; 10.2), and 8.9 (95% CI 6.4; 10.3) after the 45-, 51-, and 60-year examination. Decline in SRH between two time-points was in bivariate Cox regression analyses associated with an increased mortality risk, the association increasing as participants grew older. Multivariate analysis of the effect of changes of SRH on mortality gave similar results: hazard ratios for declined SRH were (reference: "unchanged good") 1.55 (95% CI 0.93-2.58), 1.96 (95% CI 1.09-3.53), and 2.22 (95% CI 0.97-5.09) at the 40-45, 45-51, and 51-60-year intervals. However, unchanged poor and improved SRH (at the 40-45-year interval) were also associated with an increase, and additional analyses showed that just rating SRH as poor at one rating was associated with increased risk.


CONCLUSIONS
Changes in SRH are associated with higher mortality risks than unchanged good SRH.
Nielsen
Anni Brit Sternhagen
AB
The Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark. a.nielsen@gpract.ku.dk
Siersma
Volkert
V
Kreiner
Svend
S
Hiort
Line Conradsen
LC
Drivsholm
Thomas
T
Eplov
Lene Falgaard
LF
Hollnagel
Hanne
H
D000328:Adult; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011379:Prognosis; D012307:Risk Factors; D012649:Self Concept; D011795:Surveys and Questionnaires