title: Among nonagenarians, congruence between self-rated and proxy-rated health was low but both predicted mortality.
abstract: OBJECTIVE
  The congruence between self-rated global health (SRH) and proxy-rated global health (PRH), the factors associated with congruence between SRH and PRH, and their associations with mortality are examined using data from the Vitality 90+ study.
  
  
  METHODS
  The data consist of 213 pairs of subjects--aged 90 years and older--and proxies. The relationship between SRH and PRH was analyzed by chi-square test and Cohen's kappa. Logistic regression analysis was used to find out the factors that are associated with the congruence between health ratings. The association between SRH and PRH with mortality was studied using Cox proportional hazard models.
  
  
  RESULTS
  The subjects rated their health more negatively than the proxies. Kappa value indicated only slight congruence between SRH and PRH, and they also predicted mortality differently. Good self-reported functional ability was associated with congruence between SRH and PRH.
  
  
  CONCLUSIONS
  The results imply that the evaluation processes of SRH and PRH differ, and the measures are not directly interchangeable. Both measures are useful health indicators in very old age but SRH cannot be replaced by PRH in analyses.
authors.affiliation: Tampere School of Health Sciences, University of Tampere, Medisiinarinkatu 3, Tampere 33014, Finland. merja.vuorisalmi@uta.fi
authors.forename: Merja
authors.initials: M
authors.lastname: Vuorisalmi
authors.forename: Tytti
authors.initials: T
authors.lastname: Sarkeala
authors.forename: Antti
authors.initials: A
authors.lastname: Hervonen
authors.forename: Marja
authors.initials: M
authors.lastname: Jylhä
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D005387:Finland; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D019727:Proxy