title: Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People.
abstract: Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self-rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms) were included as geriatric giants. Participants provided a score for life satisfaction and were followed up for vital status. Concordance of self-rated health with physician-rated (k = .3 [.0]) and nurse-rated health (k = .2 [.0]) was low. All three ratings were associated with the geriatric giants except for hearing loss (all p < 0.001). Associations were equal in strength, except for depressive symptoms, which showed a stronger association with self-rated health (.8 [.1] versus .4 [.1]). Self-rated health predicted mortality less well than the other ratings. Self-rated health related stronger to life satisfaction than physician's and nurse's ratings. We conclude that professionals' health ratings are more reflective of physical health whereas self-rated health reflects more the older person's mental health, but all three health ratings are useful in research.
authors.affiliation: Leyden Academy on Vitality and Ageing, Leiden, the Netherlands.|Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Thomas
authors.identifier: http://orcid.org/0000-0001-8346-078X
authors.initials: T
authors.lastname: Puvill
authors.affiliation: Leyden Academy on Vitality and Ageing, Leiden, the Netherlands.|Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Lindenberg
authors.affiliation: Primary Care and Public Health, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.affiliation: Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.affiliation: Leyden Academy on Vitality and Ageing, Leiden, the Netherlands.|Faculty of medical sciences, University of Groningen, Groningen, The Netherlands.
authors.forename: Joris P J
authors.initials: JP
authors.lastname: Slaets
authors.affiliation: Department of Public Health and Center for Healthy Aging, Copenhagen University, Copenhagen, Denmark.
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp