The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults

Abstract

Objective - To examine the extent to which older people's self assessments of general health, physical health, and mental health predict functional decline and mortality. Design - The study uses population-based secondary data from the US Longitudinal Study of Aging (LSOA). Participants - A total of 7527 persons aged 70 years or above living in the community. Methods - Eight different measures on self reported general, physical, and mental health were used. Change in functional status was measured using a composite index of ADLs and IADLs over a period of six years. Duration of survival was calculated over a period of seven years. Adjusting for age and gender, multiple logistic regression was used in analysing functional decline, and Cox proportional hazard model, for mortality. Then all of the self assessed health measures were incorporated into the final model - controlling for baseline sociodemographic characteristics, functional status, disease/conditions, and use of health and social services - to assess the independent contribution of each measure in predicting future health outcomes. Main results - Overall, older people's self assessed general, physical, and mental health were predictive of functional decline and mortality. In multivariate analyses, older people who assessed their global health, self care ability, and physical activity less favourably were more likely to experience poor health outcomes. Gender disparity, however, was observed with poor global health affecting functional decline in men only. Self care ability was predictive of functioning in women only, whereas it was predictive of mortality in men only. Conclusions - Self assessed global health, as well as, specific dimensions of health act as significant, independent predictors of functioning and mortality in a community dwelling older people.