title: Correlates and predictors of self-rated health and ambulatory status among elderly women - Cross-sectional and 10 years population-based cohort study.
abstract: OBJECTIVE
  To investigate the correlates and predictors of self-rated health (SRH) and self-reported ambulatory status (AMB) among elderly women.
  
  
  METHODS
  A random sample of 1620 postmenopausal women aged 53-66 years in 1994 was selected from Osteoporosis Risk Factor and Prevention (OSTPRE) - study cohort in Finland. SRH and AMB were assessed in baseline (1994) and after 10-year follow-up (2004). A prognostic model was developed to predict the probability of good 10-year SRH and AMB.
  
  
  RESULTS
  Full AMB was correlated with and predicted by good SRH (OR=4.3, p<0.001). Good quality of life (QoL) was both correlate and predictor of good 10-year SRH (OR=2.0, p<0.001) and full AMB (OR=2.6, p<0.001). Low BMI was associated with good SRH (OR=0.97, p<0.049) and full AMB (OR=0.92, p<0.001), good grip strength with good SRH (OR=2.7, p<0.001) and ability to squat down with full AMB (OR=1.7, p=0.002). Cardiovascular diseases, arthritis and back pain were common significant negative correlates (p<0.001) of baseline AMB and SRH out of variety of chronic diseases with significant association with either one. The significant (p<0.05) baseline predictors in final prognostic model for good 10-year SRH included baseline AMB and SRH, QoL, age, BMI, grip strength and psychiatric diseases (C-index=0.81) and for full 10-year AMB ability to squat, baseline AMB and SRH, QoL, BMI, hypertension and arthritis (C-index=0.81). These risk scores had better predictive power in comparison to that of baseline SRH and AMB alone (p<0.001 in univariate Z-score test).
  
  
  CONCLUSIONS
  Among elderly women AMB is strongly linked to SRH. SRH and AMB are affected mostly by musculoskeletal, cardiovascular and psychiatric diseases as well as body anthropometry, muscle strength and subjective QoL. The present study provides a novel algorithm for predicting probability of full AMB and good SRH in postmenopausal women.
authors.affiliation: University of Kuopio, Bone and Cartilage Research Unit (BCRU), OSTPRE Study Group, P.O. Box 1627, 70211 Kuopio, Finland. joonas.sirola@kuh.fi
authors.forename: Joonas
authors.initials: J
authors.lastname: Sirola
authors.forename: Marjo
authors.initials: M
authors.lastname: Tuppurainen
authors.forename: Toni
authors.initials: T
authors.lastname: Rikkonen
authors.forename: Risto
authors.initials: R
authors.lastname: Honkanen
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: Heikki
authors.initials: H
authors.lastname: Kröger
mesh_terms: D000203:Activities of Daily Living; D000465:Algorithms; D001168:Arthritis / Q000453:epidemiology; D001416:Back Pain / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D001523:Mental Disorders; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D010809:Physical Fitness; D017698:Postmenopause; D011446:Prospective Studies; D011788:Quality of Life