title: Does self-rated health predict dementia?
abstract: OBJECTIVE
  1. To determine if Self-Rated Health (SRH) predicts dementia over a five period in cognitively intact older adults, and in older adults with Cognitive Impairment, No Dementia (CIND); and 2. To determine if different methods of eliciting SRH (age-referenced (AR) versus unreferenced) yield similar results.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  1468 cognitively intact adults and 94 older adults with CIND aged 65+ living in the community, followed over five years.
  
  
  METHODS
  Age, gender, education, subjective memory loss, depressive symptoms, functional status, cognition, SRH and AR-SRH were all measured; dementia was diagnosed on clinical examination. Those with abnormal cognition not meeting criteria for dementia were diagnosed with CIND.
  
  
  RESULTS
  In those who were cognitively intact at time 1, and had good SRH: 69.4% were intact; 6.0% had CIND; 6.9% had dementia, and 17.7% had died at time 2, while in those with poor SRH: 44.9% were intact, 11.1% had CIND, 9.1% had dementia, and 34.8% had died (p<0.001, chi-square test). In multinomial regression models SRH predicted dementia and death. In those with CIND at time 1 and good SRH: 2.3% were intact: 18.6% had CIND; 34.9% had dementia and 44.2% had died at time 2, while in those with poor SRH: 4.8% were intact, 31.0% had CIND, 19.0% had dementia, and 43.6% had died (p=0.30, chi-square test). In multinomial regression models, this was not significant. AR-SRH analyses were similar.
  
  
  CONCLUSIONS
  In cognitively intact older adults SRH predicts dementia. In older adults with CIND, SRH does not predict dementia.
authors: Section of Geriatrics, University of Manitoba, Winnipeg, Manitoba, Canada. pstjohn@hsc.mb.ca
authors: Philip
authors: P
authors: St John
authors: Patrick
authors: P
authors: Montgomery
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000401:mortality / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008569:Memory Disorders / Q000523:psychology; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome