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Lintuaho R, Saltychev M, Pentti J, Vahtera J, Stenholm S. Physical activity and self-rated health during retirement transition: a multitrajectory analysis of concurrent changes among public sector employees. BMJ Open 2023; 13:e073876. [PMID: 37775283 PMCID: PMC10546116 DOI: 10.1136/bmjopen-2023-073876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVES The aim of the study was to evaluate concurrent changes in physical activity and self-rated health during retirement transition over 4 years by multivariate trajectory analysis and to examine whether sociodemographic and lifestyle factors predict the probability of being classified to a certain subgroup of observed changes. DESIGN Prospective cohort study. SETTING Public sector employees. PARTICIPANTS 3550 participants of the Finnish Retirement and Aging study. PRIMARY AND SECONDARY OUTCOME MEASURES Participants estimated on a yearly questionnaire their weekly hours of different types of activities converted to metabolic equivalent of task-hour/week. Self-rated health was assessed on a 5-point Likert-like scale from poor to excellent and dichotomised as suboptimal and optimal. Multivariate trajectory analysis was used to distinguish different subgroups of trajectories. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain trajectory group. RESULTS Three trajectory groups were identified, all displaying increasing activity during retirement with a simultaneous decrease in perceived suboptimal health. Physical activity peaked at 18 months after retirement and then slightly decreased, except for initially highly physically active participants (9%) with good self-rated health, who demonstrated a constant high level of physical activity. Male gender, professional occupation, being married or cohabiting, body mass index <30 kg/m2, not smoking and using alcohol below risk levels were associated with higher physical activity and better self-rated health. CONCLUSION Changes in physical activity and perceived health during retirement transition were interconnected. Both were improved during retirement transition, but the change was temporary. Longer follow-up studies are required to assess the changes over a longer period after retirement.
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Affiliation(s)
- Roosa Lintuaho
- Department of Emergency Medicine, TYKS Turku University Hospital, Turku, Finland
- Department of Physical and Rehabilitation Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
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Collinge AN, Bath PA. Socioeconomic Background and Self-Reported Sleep Quality in Older Adults during the COVID-19 Pandemic: An Analysis of the English Longitudinal Study of Ageing (ELSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4534. [PMID: 36901540 PMCID: PMC10001974 DOI: 10.3390/ijerph20054534] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic negatively impacted sleep quality. However, research regarding older adults' sleep quality during the pandemic has been limited. This study examined the association between socioeconomic background (SEB) and older adults' sleep quality during the COVID-19 pandemic. Data on 7040 adults aged ≥50 were acquired from a COVID-19 sub-study of the English Longitudinal Study of Ageing (ELSA). SEB was operationalized using educational attainment, previous financial situation, and concern about the future financial situation. Sociodemographic, mental health, physical health, and health behavior variables were included as covariates. Chi-squared tests and binary logistic regression were used to examine associations between SEB and sleep quality. Lower educational attainment and greater financial hardship and concerns were associated with poor sleep quality. The relationship between educational attainment and sleep quality was explained by the financial variables, while the relationship between previous financial difficulties and sleep quality was explained by physical health and health behavior variables. Greater financial concerns about the future, poor mental health, and poor physical health were independent risk factors for poor sleep quality in older adults during the pandemic. Healthcare professionals and service providers should consider these issues when supporting older patients with sleep problems and in promoting health and wellness.
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Affiliation(s)
- Adam N. Collinge
- Information School, University of Sheffield, Sheffield S1 4DP, UK
| | - Peter A. Bath
- Information School, University of Sheffield, Sheffield S1 4DP, UK
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
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Self-Rated Health: When and How to Use It in Studies Among Older People? INTERNATIONAL HANDBOOK OF HEALTH EXPECTANCIES 2020. [DOI: 10.1007/978-3-030-37668-0_12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Maron J, Gomes de Matos E, Piontek D, Kraus L, Pogarell O. Exploring socio-economic inequalities in the use of medicines: is the relation mediated by health status? Public Health 2019; 169:1-9. [PMID: 30771720 DOI: 10.1016/j.puhe.2018.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 12/03/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study evaluated mediating effects of the health status on the association between socio-economic status (SES) and medicine use. It was hypothesized that more privileged people show a reduced use of medicines, as compared with the underprivileged, because of their superior health status. It was further hypothesized that people may apply medication based on their type of health complaint (ill physical versus mental status). STUDY DESIGN Data were taken from the 2012 German Epidemiological Survey of Substance Abuse, a nationally representative cross-sectional study of n = 9084 individuals of the German general population aged 18-64 years. METHODS Direct and indirect effects of SES on weekly use of analgesics and sedatives/hypnotics were examined by applying generalized structural equation modeling. Self-rated physical and mental health statuses were considered as potential mediators. SES was measured by using educational level as a proxy. All analyses were gender-stratified. RESULTS Among men, both physical and mental health mediated the path from SES to the use of analgesics and sedatives/hypnotics, respectively, with a stronger effect of physical health on analgesic use and mental health on sedative/hypnotic use. These effects were only partially found among women. CONCLUSIONS Social inequalities in health seem to have substantial impact on the prevalence of medicine use. Identification and elimination of the reasons for poor health among people of low SES may, therefore, not only help to reduce health inequalities directly. A decline in the use of medicines would also result in less side-effects and a reduced number of people with medicine-related misuse and addiction.
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Affiliation(s)
- J Maron
- IFT Institut für Therapieforschung, Department of Epidemiology and Diagnostics, Leopoldstr. 175, 80804 Munich, Germany; LMU Munich, University Hospital, Department of Psychiatry and Psychotherapy, Nußbaumstr. 7, 80336 Munich, Germany.
| | - E Gomes de Matos
- IFT Institut für Therapieforschung, Department of Epidemiology and Diagnostics, Leopoldstr. 175, 80804 Munich, Germany.
| | - D Piontek
- IFT Institut für Therapieforschung, Department of Epidemiology and Diagnostics, Leopoldstr. 175, 80804 Munich, Germany.
| | - L Kraus
- IFT Institut für Therapieforschung, Department of Epidemiology and Diagnostics, Leopoldstr. 175, 80804 Munich, Germany; Stockholm University, Department for Public Health Sciences, Sveavägen 160, 10691 Stockholm, Sweden; Institute of Psychology, ELTE Eötvös Loránd University, 1075 Budapest, Kazinczy utca 23-27, Hungary.
| | - O Pogarell
- LMU Munich, University Hospital, Department of Psychiatry and Psychotherapy, Nußbaumstr. 7, 80336 Munich, Germany.
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Kim JH, Park EC, Lee Y, Lee SG. Influence of Offspring on Self-Rated Health among Older Adults: Evidence from the Korean Longitudinal Study of Aging (2006-2012). Korean J Fam Med 2018; 39:191-199. [PMID: 29788709 PMCID: PMC5975991 DOI: 10.4082/kjfm.2018.39.3.191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/30/2016] [Accepted: 01/09/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND We investigated whether offspring protect or jeopardize in parents. METHODS We used data from the Korean Longitudinal Study of Aging and performed a longitudinal analysis of 10,236 individuals at baseline (2006) to estimate the association between offspring-related factors and self-rated health among individuals ≥45 years of age. RESULTS The estimate for self-rated health was 0.612 times lower (95% confidence interval [CI], 0.503-0.746; P<0.0001) for those with zero offspring. The estimate for self-rated health was 0.736 (95% CI, 0.635-0.853; P<0.0001) for those with five offspring or more. The estimate for self-rated health was 0.707 (95% CI, 0.528-0.947; P=0.020) for males with zero offspring. The estimate for self-rated health was 0.563 (95% CI, 0.422-0.751; P<0.001) for females with no offspring and for females with five or more offspring. The estimate for self-rated health was 0.686 times lower (95% CI, 0.573-0.822; P<0.0001) for those with five or more offspring compared to females with two offspring. CONCLUSION Those with more offspring (≥5) and those with no offspring tended to have an increased probability of low self-rated health. Overall, our results suggest that offspring have a significant positive effect on self-rated health, which was evident graphically as an inverted U-shape.
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Affiliation(s)
- Jae-Hyun Kim
- Department of Health Administration, Dankook University College of Medicine, Cheonan, Korea
- Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Yunhwan Lee
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
- Institute on Aging, Ajou University Medical Center, Suwon, Korea
| | - Sang Gyu Lee
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Hospital Management, Yonsei University Graduate School of Public Health, Seoul, Korea
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Lanari D, Bussini O, Minelli L. The Effects of Immigrant Status and Age at Migration on Changes in Older Europeans’ Health. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1177/0197918318766359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the differences between natives and immigrants in regard to transition probabilities among health states in self-rated health (SRH), depression, and activities of daily living for middle-aged and older adults in Europe. The Survey of Health, Aging, and Retirement allows us to investigate how successfully the immigrants have aged from 2004 to 2011 compared to natives, according to country of origin and age at migration. We showed that some groups, such as Eastern European immigrants, have higher probabilities of health deterioration in terms of SRH. Moreover, those immigrants who arrived in the host country during adulthood experienced relatively fast health decline.
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Kimura M. Social determinants of self-rated health among Japanese mothers of children with disabilities. Prev Med Rep 2018; 10:129-135. [PMID: 29755931 PMCID: PMC5945918 DOI: 10.1016/j.pmedr.2018.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 12/03/2022] Open
Abstract
Caregivers of children with disability are more likely to be affected by social determinants that lead to poor health. Additionally, a previous study revealed that although mothers of a single child with disability wanted to have another child, various obstacles including social, cultural, economic, and biological factors existed and some had to give up on having another child. Since the mental health and well-being of these mothers were poorer than those of mothers with multiple children with and without disabilities, such family composition may also affect maternal health. This study aimed to investigate and compare the social determinants of self-rated health of mothers only having children with disabilities and those having multiple children with and without disabilities. Through parents' associations of children with disabilities throughout Japan, 2311 self-administrated questionnaires were distributed to mothers of such children from January to March 2016. Out of the 1133 responses (return rate 49%), 1012 (43.8%) mothers of children with disabilities under 20 years of age were used for this study. Logistic regression showed that poor financial situation was most strongly related to poor self-rated health among all mothers. Other factors related to poor self-rated health were a lack of existence of child without disability, social isolation, low health consciousness, child's sex (girl), and severity of disability (mild/moderate). However, these relationships differ based on the existence of a child without disability. Investigating how socioeconomic and cultural conditions relate to family composition including child birth, and how they determine health is needed in the future. Social determinants of health of mothers of children with disabilities were found. Poor financial status was strongly associated with mothers' self-rated health. Social isolation and health consciousness had significant associations with health. Having multiple children with and without disability influenced mothers' health. Social capital was not related to mothers' self-rated health.
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Affiliation(s)
- Miyako Kimura
- St. Marianna University, 2-16-1, Sugao, Miyamae-ku, Kawasaki-shi, Kanagawa, Japan
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Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health in adolescence a predictor of prescribed medication in adulthood? Findings from the Nord Trøndelag Health Study and the Norwegian Prescription Database. SSM Popul Health 2017; 4:144-152. [PMID: 29349283 PMCID: PMC5769112 DOI: 10.1016/j.ssmph.2017.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 01/10/2023] Open
Abstract
Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years' prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16.0 years) in the Young-HUNT I survey (1995-1997), were linked to individual data from NorPD, including information on all medications prescribed in 2013-2014. Gender-stratified negative binomial regression models were used to investigate the association between SRH and medication, also adjusted for age, baseline self-reported medicine use, physical and mental disability, smoking, and physical activity. Based on the Anatomical Therapeutic Chemical (ATC) Classification System, total consumption and consumption related to various ATC groups were examined. The adjusted analyses showed a dose-response relationship for females, with poorer SRH predicting higher average medication for both total consumption and for the ATC groups "Musculoskeletal system" (M), "Nervous system" (N; Analgesics (N02), Opioids (N02A)) and "Respiratiory system" (R). The predictive power of SRH, as well as the role of the adjustment factors, varies by gender and drug groups. This knowledge is important in order to identify risks for later disease and to capture pathological changes before and beyond the disease diagnosis, potentially preventing morbidity in the adult population.
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Affiliation(s)
- Tina Lokke Vie
- Helse Førde HF/Førde Health Trust, postboks 1000, 6807 Førde, Norway
| | | | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
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van Schoor NM, Zambon S, Castell MV, Cooper C, Denkinger M, Dennison EM, Edwards MH, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen NL, Peter R, Schaap LA, Rijnhart JJM, van der Pas S, Deeg DJH. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Qual Life Res 2016; 25:1423-32. [PMID: 26547441 PMCID: PMC4870285 DOI: 10.1007/s11136-015-1171-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. METHODS Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. RESULTS The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. CONCLUSIONS Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
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Affiliation(s)
- N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - S Zambon
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M V Castell
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M Denkinger
- Bethesda Geriatric Clinic, University of Ulm, Ulm, Germany
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - F Herbolsheimer
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - S Maggi
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M Sánchez-Martinez
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R Peter
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - L A Schaap
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - J J M Rijnhart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - S van der Pas
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - D J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Sharma B, Nam EW, Kim D, Yoon YM, Kim Y, Kim HY. Role of gender, family, lifestyle and psychological factors in self-rated health among urban adolescents in Peru: a school-based cross-sectional survey. BMJ Open 2016; 6:e010149. [PMID: 26842274 PMCID: PMC4746445 DOI: 10.1136/bmjopen-2015-010149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE We examined the role of gender, family, lifestyle and psychological factors in self-rated health. DESIGN Cross-sectional study. SETTING A total of 970 randomly selected students from 11 secondary schools in Lima and Callao, Peru, participated in 2014. MAIN OUTCOME MEASURE Self-rated health was measured with a single item: 'In general, how would you rate your health?' Responses were arranged along a five-point Likert-type scale: 'excellent', 'very good', 'good', 'fair' and 'poor'. The outcome variable was dichotomised as 'good' (excellent, very good or good) or 'poor/fair' (poor or fair). METHODS We calculated adjusted ORs (AORs) and 95% CIs for poor/fair self-rated health using multivariate logistic regression analyses at 3-graded levels. RESULTS 32.5% of the respondents had fair/poor self-rated health, 23.7% of the total males and 40.0% of the total female samples. Males were less likely to have poor/fair self-rated health (AOR 0.61; CI 0.41 to 0.91). Poor family support strongly increased the likelihood of having poor/fair self-rated health (no support, (AOR 3.15; CI 1.63 to 6.09); low support, (AOR 2.50; CI 1.29 to 4.85)). The other associated variables were missed meals due to a shortage of food (AOR 1.97; CI 1.15 to 3.36), television watching during leisure time (AOR 1.70; CI 1.09 to 2.67), low physical activity (AOR 1.49; CI 1.03 to 2.15), school absenteeism (AOR 1.54; CI 1.03 to 2.31) and perceived life satisfaction (AOR 0.28; CI 0.15 to 0.25). CONCLUSIONS Gender, missing meals due to a shortage of food, family support, physical activity and life satisfaction influenced self-rated health among adolescents in Peru. Interventions that focus on promoting physical activity for at least 1 h each day for 3 or more days per week, food security and strengthening supportive family roles may improve self-rated health during adolescence.
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Affiliation(s)
- Bimala Sharma
- Yonsei Global Health Center, Yonsei University, Wonju City, Gangwon-do, the Republic ofKorea
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
| | - Eun Woo Nam
- Yonsei Global Health Center, Yonsei University, Wonju City, Gangwon-do, the Republic ofKorea
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
| | - Dohyeong Kim
- Yonsei Global Health Center, Yonsei University, Wonju City, Gangwon-do, the Republic ofKorea
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
| | - Young Min Yoon
- Yonsei Global Health Center, Yonsei University, Wonju City, Gangwon-do, the Republic ofKorea
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
| | - Yeunju Kim
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
| | - Ha Yun Kim
- Yonsei Global Health Center, Yonsei University, Wonju City, Gangwon-do, the Republic ofKorea
- Department of Health Administration, Graduate School, Yonsei University, Wonju City, Gangwon-do, the Republic of Korea
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The components of self-perceived health in the Kailali district of Nepal: a cross-sectional survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3215-31. [PMID: 25789457 PMCID: PMC4377960 DOI: 10.3390/ijerph120303215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 01/14/2023]
Abstract
Self-perceived health is a health measure with well-established links with mortality, healthcare services utilization, and future health. Various components of self-perceived health have been identified in different populations. In this study, we aimed to investigate the components of self-perceived health in a Nepali population. This was a cross-sectional survey conducted in the Kailali district of Nepal in 2014. The sample was initially consisted of 309 households, representative of the population of one municipality and one village; however, 304 participants were included in the analyses. Information on socio-demographic characteristics, health condition, satisfaction with healthcare services, psychological factors, and health behaviors was extracted. Logistic regression analyses were carried out to identify putative components of self-perceived health. Among the 304 respondents, 244 (80.3%) and 60 (19.7%) perceived their health as good and poor, respectively. Middle age and lower satisfaction with healthcare services were associated with worse self-perceived health, accounting for 10.3% of variance. No regular exercise, drinking, smoking, and being unhappy were also related with worse self-perceived health, after adjustment for age and satisfaction level. In the final model, however, drinking status did not significantly contribute. Our findings support previous findings that individuals with positive health behaviors and psychological wellbeing are more likely to perceive their health better. This study may direct public health policies toward more targeted interventions.
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Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN PSYCHIATRY 2012; 2012:278730. [PMID: 23762764 PMCID: PMC3671693 DOI: 10.5402/2012/278730] [Citation(s) in RCA: 619] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 10/15/2012] [Indexed: 12/31/2022]
Abstract
This paper provides a concise but comprehensive review of research on religion/spirituality (R/S) and both mental health and physical health. It is based on a systematic review of original data-based quantitative research published in peer-reviewed journals between 1872 and 2010, including a few seminal articles published since 2010. First, I provide a brief historical background to set the stage. Then I review research on R/S and mental health, examining relationships with both positive and negative mental health outcomes, where positive outcomes include well-being, happiness, hope, optimism, and gratefulness, and negative outcomes involve depression, suicide, anxiety, psychosis, substance abuse, delinquency/crime, marital instability, and personality traits (positive and negative). I then explain how and why R/S might influence mental health. Next, I review research on R/S and health behaviors such as physical activity, cigarette smoking, diet, and sexual practices, followed by a review of relationships between R/S and heart disease, hypertension, cerebrovascular disease, Alzheimer's disease and dementia, immune functions, endocrine functions, cancer, overall mortality, physical disability, pain, and somatic symptoms. I then present a theoretical model explaining how R/S might influence physical health. Finally, I discuss what health professionals should do in light of these research findings and make recommendations in this regard.
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Affiliation(s)
- Harold G. Koenig
- Departments of Medicine and Psychiatry, Duke University Medical Center, P.O. Box 3400, Durham, NC 27705, USA
- Department of Medicine, King Abdulaziz University, Jeddah 21413, Saudi Arabia
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Hirosaki M, Ohira T, Kajiura M, Kiyama M, Kitamura A, Sato S, Iso H. Effects of a laughter and exercise program on physiological and psychological health among community-dwelling elderly in Japan: randomized controlled trial. Geriatr Gerontol Int 2012; 13:152-60. [PMID: 22672359 DOI: 10.1111/j.1447-0594.2012.00877.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To examine the effects of a once-weekly laughter and exercise program on physical and psychological health among elderly people living in the community. As a regular exercise program can be difficult to maintain, we provided a more enjoyable program to enhance adherence to exercise. METHODS A total of 27 individuals aged 60 years or older, without disabilities, were randomly assigned to either an immediate treatment group (n=14) or a delayed treatment group (n=13). The intervention was a 120-min session consisting of laughter and exercise, carried out once a week for 10 consecutive weeks. Measurements taken at baseline, 3 and 6 months included bodyweight, height, body fat, lean mass, bone mineral density, hemoglobin A1c (HbA(1c)), glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides, as well as self-rated health and psychological factors. RESULTS All participants completed the 3-month program. Bone mineral density increased significantly in the immediate treatment group compared with the delayed treatment group during the first 3 months (P<0.001). In addition, HbA(1c) decreased significantly (P=0.001), and self-rated health increased significantly (P=0.012). CONCLUSIONS The combination of a laughter and exercise program might have physiological and psychological health benefits for the elderly. Laughter might be an effective strategy to motivate the elderly to participate in physical activity.
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Affiliation(s)
- Mayumi Hirosaki
- Department of Field Medicine, Graduate School of Public Health, Kyoto University, Kyoto, Japan.
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Darviri C, Fouka G, Gnardellis C, Artemiadis AK, Tigani X, Alexopoulos EC. Determinants of self-rated health in a representative sample of a rural population: a cross-sectional study in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:943-54. [PMID: 22690175 PMCID: PMC3367289 DOI: 10.3390/ijerph9030943] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 03/12/2012] [Accepted: 03/12/2012] [Indexed: 11/17/2022]
Abstract
Self-rated health (SRH) is a health measure related to future health, mortality, healthcare services utilization and quality of life. Various sociodemographic, health and lifestyle determinants of SRH have been identified in different populations. The aim of this study is to extend SRH literature in the Greek population. This is a cross-sectional study conducted in rural communities between 2001 and 2003. Interviews eliciting basic demographic, health-related and lifestyle information (smoking, physical activity, diet, quality of sleep and religiosity) were conducted. The sample consisted of 1,519 participants, representative of the rural population of Tripoli. Multinomial regression analysis was conducted to identify putative SRH determinants. Among the 1,519 participants, 489 (32.2%), 790 (52%) and 237 (15.6%) rated their health as "very good", "good" and "poor" respectively. Female gender, older age, lower level of education and impaired health were all associated with worse SRH, accounting for 16.6% of SRH variance. Regular exercise, healthier diet, better sleep quality and better adherence to religious habits were related with better health ratings, after adjusting for sociodemographic and health-related factors. BMI and smoking did not reach significance while exercise and physical activity exhibited significant correlations but not consistently across SRH categories. Our results support previous findings indicating that people following a more proactive lifestyle pattern tend to rate their health better. The role of stress-related neuroendocrinologic mechanisms on SRH and health in general is also discussed.
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Affiliation(s)
- Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Street, 4, 11527 Athens, Greece; (C.D.); (A.K.A.); (E.C.A.)
| | - Georgia Fouka
- Technological Education Institute of Athens, Ag Spyridonos Street, Egaleo, 12210 Athens, Greece;
| | | | - Artemios K. Artemiadis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Street, 4, 11527 Athens, Greece; (C.D.); (A.K.A.); (E.C.A.)
| | - Xanthi Tigani
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Street, 4, 11527 Athens, Greece; (C.D.); (A.K.A.); (E.C.A.)
| | - Evangelos C. Alexopoulos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Street, 4, 11527 Athens, Greece; (C.D.); (A.K.A.); (E.C.A.)
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Fifteen Dimensions of Health among Community-Dwelling Older Singaporeans. Curr Gerontol Geriatr Res 2011; 2011:128581. [PMID: 22110500 PMCID: PMC3205690 DOI: 10.1155/2011/128581] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 08/24/2011] [Accepted: 08/26/2011] [Indexed: 11/17/2022] Open
Abstract
This paper aims to present a broad perspective of health of older Singaporeans spanning 15 health dimensions and study the association between self-rated health (SRH) and other health dimensions. Using data from a survey of 5000 Singaporeans (≥60 years), SRH and health in 14 other dimensions were assessed. Generalized logit model was used to assess contribution of these 14 dimensions to positive and negative SRH, compared to average SRH. About 86% reported their health to be average or higher. Prevalence of positive SRH and "health" in most other dimensions was lower in older age groups. Positive and negative SRH were associated with mobility, hearing, vision, major physical illness, pain, personal mastery, depressive symptoms, and perceived financial adequacy. The findings show that a majority of older Singaporeans report themselves as healthy overall and in a wide range of health dimensions.
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Self-rated health (SRH) and socioeconomic position (SEP) among urban home-dwelling older adults. Arch Gerontol Geriatr 2011; 54:117-20. [PMID: 21388692 DOI: 10.1016/j.archger.2011.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 01/23/2011] [Accepted: 01/24/2011] [Indexed: 11/21/2022]
Abstract
The main purpose of this study was to examine the association of education and adequacy of income with self-rated health (SRH) among home-dwelling older people aged 75 and over living in the urban area. A cross-sectional survey from 2008 was used to study 1395 older adults aged 75 and over living in one of the central areas of the city center of Helsinki, the capital of Finland. Associations of SRH with, education and adequacy of income were tested using ordinal regression model. Those with a lower level of education had higher level of poor health. Self-assessed adequacy of income had also a strong association with SRH. For the oldest respondents this association was even stronger than the association between education and SRH. Subjective evaluation of financial situation should be used as a key indicator of socioeconomic position (SEP) in studies examining inequalities in health especially among older adults.
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Bell IR, Lewis DA, Lewis SE, Schwartz GE, Brooks AJ, Scott A, Baldwin CM. EEG ALPHA SENSITIZATION IN INDIVIDUALIZED HOMEOPATHIC TREATMENT OF FIBROMYALGIA. Int J Neurosci 2009; 114:1195-220. [PMID: 15370183 DOI: 10.1080/00207450490475724] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Fibromyalgia (FM) patients show evidence of sensitizability in pain pathways and electroencephalographic (EEG) alterations. One proposed mechanism for the claimed effects of homeopathy, a form of complementary medicine used for FM, is time-dependent sensitization (TDS, progressive amplification) of host responses. This study examined possible sensitization-related changes in EEG relative alpha magnitude during a clinical trial of homeopathy in FM. A 4-month randomized, placebo-controlled double-blind trial of daily orally administered individualized homeopathy in physician-confirmed FM, with an additional 2-month optional crossover phase, included three laboratory sessions, at baseline, 3 and 6 months (N = 48, age 49.2 +/- 9.8 years, 94% women). Nineteen leads of EEG relative alpha magnitude at rest and during olfactory administration of treatment and control solutions were evaluated in each session. After 3 months, the active treatment group significantly increased, while the placebo group decreased, in global alpha-1 and alpha-2 during bottle sniffs over sessions. At 6 months, the subset of active patients who stayed on active continued to increase, while the active-switch subgroup reversed direction in alpha magnitude. Groups did not differ in resting alpha. Consistent with the TDS hypothesis, sniff alpha-1 and alpha-2 increases at 6 months versus baseline correlated with total amount of time on active remedy over all subjects (r = 0.45, p = .003), not with dose changes or clinical outcomes in the active group. The findings suggest initiation of TDS in relative EEG alpha magnitude by daily oral administration of active homeopathic medicines versus placebo, with laboratory elicitation by temporolimbic olfactory stimulation or sniffing.
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Affiliation(s)
- Iris R Bell
- Program in Integrative Medicine, Department of Psychiatry, The Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, Arizona, USA.
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Ostbye T, Malhotra R, Chan A. Thirteen dimensions of health in elderly Sri Lankans: results from a National Sri Lanka Aging Survey. J Am Geriatr Soc 2009; 57:1376-87. [PMID: 19549023 DOI: 10.1111/j.1532-5415.2009.02350.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore age and sex differences in distribution of 13 health dimensions with a focus on self-rated health (SRH) and the association between SRH and other health dimensions in elderly Sri Lankans. DESIGN Sri Lanka Aging Survey, a nationally representative cross-sectional survey. SETTING Community based. PARTICIPANTS Inhabitants of 13 districts in Sri Lanka aged 60 and older (N=2,413). MEASUREMENTS Self-reported SRH, hearing, activities of daily living (ADLs), instrumental activities of daily living (IADLs), mobility, physical disability, chronic diseases, stress and worry, mood, cognition, social participation, social support, and financial health. RESULTS The prevalence of being "healthy" in most health dimensions, including SRH, declined with age. Men were more likely to report better SRH; independence in ADLs, IADLs, and mobility; absence of physical disability and chronic diseases; and good mental health. Absence of chronic diseases, independence in ADLs and IADLs, freedom from stress and worry, and absence of depression were associated with positive (excellent/very good/good) SRH. The male SRH advantage was not significant in adjusted analyses, and sex did not modify the association between SRH and other health dimensions. CONCLUSION Several of the dimensions associated with positive SRH are to a certain extent modifiable and therefore provide a potential for improvement in SRH of elderly Sri Lankans. Differences between this study and studies from elsewhere in the associations between different health dimensions and SRH, and in how sex modifies these associations, suggest that some of the associations may depend on cultural context.
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Affiliation(s)
- Truls Ostbye
- Health Services Research, Duke-National University of Singapore Graduate Medical School, Singapore
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19
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Modernising social care services for older people: scoping the United Kingdom evidence base. AGEING & SOCIETY 2009. [DOI: 10.1017/s0144686x08008301] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTIn common with other developed countries at the end of the 20th century, modernising public services was a priority of the United Kingdom (UK) Labour administration after its election in 1997. The modernisation reforms in health and social care exemplified their approach to public policy. The authors were commissioned to examine the evidence base for the modernisation of social care services for older people, and for this purpose conducted a systematic review of the relevant peer-reviewed UK research literature published from 1990 to 2001. Publications that reported descriptive, analytical, evaluative, quantitative and qualitative studies were identified and critically appraised under six key themes of modernisation: integration, independence, consistency, support for carers, meeting individuals' needs, and the workforce. This paper lists the principal features of each study, provides an overview of the literature, and presents substantive findings relating to three of the modernisation themes (integration, independence and individuals' needs). The account provides a systematic portrayal both of the state of social care for older people prior to the modernisation process and of the relative strengths and weaknesses of the evidence base. It suggests that, for evidence-based practice and policy to become a reality in social care for older people, there is a general need for higher quality studies in this area.
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Weiner DK, Perera S, Rudy TE, Glick RM, Shenoy S, Delitto A. Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial. Pain 2008; 140:344-357. [PMID: 18930352 DOI: 10.1016/j.pain.2008.09.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 08/09/2008] [Accepted: 09/04/2008] [Indexed: 11/30/2022]
Abstract
Chronic low back pain (CLBP) in older adults may be disabling and therapeutically challenging, largely because of the inefficacy and/or morbidity associated with traditional pain treatment. We conducted a randomized controlled trial in 200 men and women > or = age 65 with CLBP to evaluate the efficacy of percutaneous electrical nerve stimulation (PENS) with and without general conditioning and aerobic exercise (GCAE), for reducing pain and improving physical function. Participants were randomized to receive (1) PENS, (2) control-PENS (brief electrical stimulation to control for treatment expectancy), (3) PENS+GCAE, or (4) control-PENS+GCAE, twice a week for 6 weeks. All four groups experienced significantly reduced pain (range -2.3 to -4.1 on the McGill Pain Questionnaire short form), improved self-reported disability (range -2.1 to -3.0 on Roland scale) and improved gait velocity (0.04-0.07 m/s), sustained at 6 months. The GCAE groups experienced significantly fewer fear avoidance beliefs immediately post-intervention and at 6 months than non-GCAE groups. There were no significant side effects. Since brief electrical stimulation (i.e., control-PENS) facilitated comparably reduced pain and improved function at 6 months as compared with PENS, the exact dose of electrical stimulation required for analgesia cannot be determined. GCAE was more effective than PENS alone in reducing fear avoidance beliefs, but not in reducing pain or in improving physical function.
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Affiliation(s)
- Debra K Weiner
- Department of Medicine, University of Pittsburgh, PA, USA Department of Anesthesiology, University of Pittsburgh, PA, USA Department of Psychiatry, University of Pittsburgh, PA, USA Department of Biostatistics, University of Pittsburgh, PA, USA Center for Integrative Medicine, University of Pittsburgh, PA, USA Department of Physical Therapy, University of Pittsburgh, PA, USA Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
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Heller DA, Ahern FM, Pringle KE, Brown TV. Among older adults, the responsiveness of self-rated health to changes in Charlson comorbidity was moderated by age and baseline comorbidity. J Clin Epidemiol 2008; 62:177-87. [PMID: 18722090 DOI: 10.1016/j.jclinepi.2008.05.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 03/16/2008] [Accepted: 05/05/2008] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the impact of changes in comorbidity--as measured by the Charlson comorbidity index--on self-rated health in a large sample of community-dwelling elderly over a 1-year period, and to examine the differential effects of changes in specific Charlson diagnostic categories. STUDY DESIGN AND SETTING Longitudinal survey data on self-rated health were linked with Medicare inpatient, outpatient, and physician visit data for 30,535 U.S. elderly residing in Pennsylvania. Multivariate logistic regression with fractional polynomials was used to model relationships involving baseline and changing Charlson comorbidity with self-rated health decline, and to evaluate covariate interactions. RESULTS Comorbidity change was associated with greater likelihood of worsened self-rated health, but the relationship was nonlinear and was moderated by age and baseline comorbidity. The impact of comorbidity change appeared to be less among older individuals and those with higher baseline comorbidity. Declines in self-rated health were most likely following new diagnoses for metastatic tumors, paralysis, and dementia. CONCLUSION Self-rated health is responsive to changes in Charlson comorbidity, but nonlinearity and interactions suggest complexity in how elderly respond to comorbidity change. Younger individuals and those with initially low comorbidity are more likely to reduce self-ratings of health following new diagnoses for chronic conditions.
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Affiliation(s)
- Debra A Heller
- First Health Services Corporation/PACE, 4000 Crums Mill Road, Suite 301, Harrisburg, PA 17112, USA.
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22
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Ho PM, Masoudi FA, Peterson PN, Shroyer AL, McCarthy M, Grover FL, Hammermeister KE, Rumsfeld JS. Health‐Related Quality of Life Predicts Mortality in Older but Not Younger Patients Following Cardiac Surgery. ACTA ACUST UNITED AC 2007; 14:176-82. [PMID: 16015058 DOI: 10.1111/j.1076-7460.2005.04312.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The investigators assessed preoperative health-related quality of life as a predictor of 6-month mortality after cardiac surgery in older (65 years of age and older) vs. younger patients. Multivariable regression, stratified by age groups, was used to compare the association between preoperative Physical Component Summary and Mental Component Summary scores from the Short Form-36 health status survey and mortality. In multivariable analyses of older patients, lower preoperative Physical Component Summary (odds ratio, 1.54; 95% confidence interval, 1.19-2.00; p=0.01) and Mental Component Summary (odds ratio, 1.26; 95% confidence interval, 1.06-1.49; p=0.03) scores were independently associated with mortality. In contrast, neither Physical Component Summary (p=0.82) nor Mental Component Summary (p=0.79) scores were associated with mortality in the younger subgroup. This study demonstrated that preoperative health status is an independent predictor of mortality following cardiac surgery in older but not younger patients. Preoperative patient self-report of health status may be particularly useful in refining risk stratification and informing decision-making before and following cardiac surgery in older patients.
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Affiliation(s)
- P Michael Ho
- Cardiology and Cardiovascular Outcomes Research, Denver VA Medical Center, Denver, CO 80220, USA.
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DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med 2006; 21:267-75. [PMID: 16336622 PMCID: PMC1828094 DOI: 10.1111/j.1525-1497.2005.00291.x] [Citation(s) in RCA: 1390] [Impact Index Per Article: 77.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Health planners and policy makers are increasingly asking for a feasible method to identify vulnerable persons with the greatest health needs. We conducted a systematic review of the association between a single item assessing general self-rated health (GSRH) and mortality. DATA SOURCES Systematic MEDLINE and EMBASE database searches for studies published from January 1966 to September 2003. REVIEW METHODS Two investigators independently searched English language prospective, community-based cohort studies that reported (1) all-cause mortality, (2) a question assessing GSRH; and (3) an adjusted relative risk or equivalent. The investigators searched the citations to determine inclusion eligibility and abstracted data by following a standardized protocol. Of the 163 relevant studies identified, 22 cohorts met the inclusion criteria. Using a random effects model, compared with persons reporting "excellent" health status, the relative risk (95% confidence interval) for all-cause mortality was 1.23 [1.09, 1.39], 1.44 [1.21, 1.71], and 1.92 [1.64, 2.25] for those reporting "good,""fair," and "poor" health status, respectively. This relationship was robust in sensitivity analyses, limited to studies that adjusted for co-morbid illness, functional status, cognitive status, and depression, and across subgroups defined by gender and country of origin. CONCLUSIONS Persons with "poor" self-rated health had a 2-fold higher mortality risk compared with persons with "excellent" self-rated health. Subjects' responses to a simple, single-item GSRH question maintained a strong association with mortality even after adjustment for key covariates such as functional status, depression, and co-morbidity.
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Affiliation(s)
- Karen B DeSalvo
- Section of General Internal Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
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Weiner DK. Pain and Aging: A Call to Those with the Power of Inquiry, the Skills to Teach, and the Desire to Heal. PAIN MEDICINE 2006; 7:57-9. [PMID: 16533198 DOI: 10.1111/j.1526-4637.2006.00090.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Baron-Epel O, Kaplan G, Haviv-Messika A, Tarabeia J, Green MS, Kaluski DN. Self-reported health as a cultural health determinant in Arab and Jewish Israelis. Soc Sci Med 2005; 61:1256-66. [PMID: 15970235 DOI: 10.1016/j.socscimed.2005.01.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2004] [Accepted: 01/25/2005] [Indexed: 11/25/2022]
Abstract
Subjective health (SH) status serves as a measure of health in many studies of health-related issues as it is a good predictor of mortality, morbidity, and use of health services. The measure is used in many population groups. However, the degree to which it measures the same condition in different ethnic groups is not clear. Within Israel's first National Health and Nutrition Survey (MABAT) conducted during 1999-2001, face-to-face interviews were held with 3222 Israeli interviewees, 2379 Jews and 843 Arabs, aged between 25-64 years. Respondents reported their SH, co-morbidity, and other socioeconomic characteristics. Arabs reported higher levels of SH than Jews. In logistic regression analysis, co-morbidity was a much stronger correlate of poorer SH in the Arab than in the Jewish population. The association between socioeconomic variables depended on ethnic group and sex. The findings indicate that SH in Jews and Arabs does not necessarily have the same meaning in relation to objective measures of health, and caution should be exercised in the use of this measure in different population groups with different cultures. Arabs tend to evaluate health better than Jews even though life expectancy is lower and morbidity and mortality are higher in the former population group. Yet diagnosis of a disease increases the frequency of reporting lower SH, more in Arabs than in Jews.
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Affiliation(s)
- Orna Baron-Epel
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel.
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26
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Steele JC, Patrick JH, Goins RT, Brown DK. Self-rated health among vulnerable older adults in rural Appalachia. J Rural Health 2005; 21:182-6. [PMID: 15859057 DOI: 10.1111/j.1748-0361.2005.tb00080.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
CONTEXT Self-rated health (SRH) predicts service use, morbidity, and mortality. Additionally, SRH has been associated with indices of psychological well-being. PURPOSE The main focus of the study was to investigate important differences among the lower spectrum of SRH (ie, fair and poor) on indices of well-being. METHODS In-person interviews collected data from 207 (M age = 75.8) older rural adults. Data were used to examine differences between those reporting poor, fair, and good or excellent SRH on measures of demographics, and physical and psychological health. RESULTS Significant differences emerged between levels of SRH in relation to measures of physical and psychological health. Specifically, individuals with poor SRH were significantly more likely to have (1) illnesses, (2) problems with basic and cognitive tasks of daily living, and (3) depressed affect than individuals reporting good or excellent health. Individuals with poor SRH were significantly more likely to have problems with basic and cognitive tasks of daily living than individuals with fair SRH. No significant differences were found between people reporting fair and good or excellent SRH on illnesses and depressed affect. CONCLUSIONS Results suggest that future research should investigate the expansion of the lower-end of the SRH measure to more accurately assess SRH among vulnerable, rural older adults. Such efforts would better inform health care providers, practitioners, and policy makers in rural areas as to how SRH affects the well-being of vulnerable older adults.
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Affiliation(s)
- Jenessa C Steele
- Department of Human Services, Gerontology, Bowling Green State University, Bowling Green, Ohio 43403, USA.
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Long MJ, McQueen DA, Bangalore VG, Schurman JR. Using self-assessed health to predict patient outcomes after total knee replacement. Clin Orthop Relat Res 2005:189-92. [PMID: 15864051 DOI: 10.1097/01.blo.0000152886.60098.fe] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Self-assessed health status has been shown to be a powerful predictor of mortality, service use, and total cost of medical care treatment. We investigated the potential for self-assessed health to further serve as a predictor of improvement in health status after a clinical intervention. Using the five-category measure of self-assessed health (excellent, very good, good, fair, or poor), we examined patients' improvements in health status after total knee arthroplasty in each of the WOMAC-defined categories for health status in patients. The results indicate that the greater patients rated their preoperative health, the greater their postoperative improvement. The results suggest that a simple process of asking patients to rate their own health in a presurgery clinic could be a powerful tool in predicting patient outcome. This also suggests that by stratifying preoperative self-assessed health, potential improvements in health status will be more fully captured.
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Affiliation(s)
- Michael J Long
- Department of Public Health Sciences, Wichita State University, Wichita, KS, USA.
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Dominick KL, Ahern FM, Gold CH, Heller DA. Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Care Res (Hoboken) 2004; 51:326-31. [PMID: 15188315 DOI: 10.1002/art.20390] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the relationship between health-related quality of life (HRQOL) and health service use among older adults with osteoarthritis (OA). METHODS Subjects were 9,043 Medicare-enrolled survey respondents with a prior International Classification of Diseases, Ninth Revision code for OA. Analyses examined the relationship of 5 Centers for Disease Control and Prevention HRQOL items (general health, mental health, pain, activity limitation, and sleep) to physician visits, prescription analgesic or antiinflammatory use, and arthroplasty during 1 year of followup. RESULTS In analyses controlling for demographic and health-related variables, greater pain frequency was associated with increased odds of visiting a physician, using analgesic or antiinflammatory drugs, and having arthroplasty (P < 0.001). Poorer general health was associated with increased odds of analgesic or antiinflammatory use but decreased odds of arthroplasty (P < 0.01). More days of activity limitation and poor mental health were associated with decreased odds of analgesic or antiinflammatory use (P < 0.01). CONCLUSION These HRQOL variables, especially pain frequency, can be valuable tools for estimating future health care use among older adults with OA.
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Affiliation(s)
- Kelli L Dominick
- Durham Veterans Administration Medical Center, HSR&D, Durham North Carolina 27705, USA
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Bell IR, Lewis DA, Brooks AJ, Schwartz GE, Lewis SE, Caspi O, Cunningham V, Baldwin CM. Individual Differences in Response to Randomly Assigned Active Individualized Homeopathic and Placebo Treatment in Fibromyalgia: Implications of a Double-Blinded Optional Crossover Design. J Altern Complement Med 2004; 10:269-83. [PMID: 15165408 DOI: 10.1089/107555304323062266] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess individual difference characteristics of subgroups of patients with fibromyalgia (FM) patients with respect to the decision to stay in or switch from randomly-assigned verum or placebo treatment during an optional crossover phase of a double-blinded homeopathy study. DESIGN Double-blinded, randomized, placebo-controlled, optional crossover clinical trial. PARTICIPANTS Fifty-three (53) community-recruited patients with FM entered the optional crossover phase. INTERVENTION Two homeopaths jointly selected an individualized homeopathic remedy for all patients. The pharmacy dispensed either verum LM remedy or indistinguishable placebo in accord with randomized assignment for 4 months and the patient's optional crossover decision for an additional 2 months. OUTCOME MEASURES Patients completed a battery of baseline state/trait questionnaires, including mood, childhood neglect and abuse, and trait absorption. They rated global health (whole person-centered) and tender point pain on physical examination (disease-specific) at baseline, 3 months, and 6 months. RESULTS Rates of optional crossover from verum to placebo or placebo to verum were comparable (p = 0.6; 31%, and 41%, respectively). The switch subgroups had greater baseline psychologic issues (emotional neglect in placebo-switch; depression and anger in verum-switch). The verum-stay subgroup scored highest on treatment helpfulness and included all six exceptional responders who fell, prior to crossover, into the top terciles for improvement in both global health and pain. Patients staying in their randomly assigned groups, active or placebo (n = 34), scored significantly higher in trait absorption than did those who switched groups (n = 19). CONCLUSION Individual difference factors may predict better and poorer responders with FM to specific and nonspecific effects of homeopathic and placebo treatment.
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Affiliation(s)
- Iris R Bell
- Department of Medicine, University of Arizona, Tucson, AZ, USA.
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Bell IR, Cunningham V, Caspi O, Meek P, Ferro L. Development and validation of a new global well-being outcomes rating scale for integrative medicine research. Altern Ther Health Med 2004; 4:1. [PMID: 14725717 PMCID: PMC343287 DOI: 10.1186/1472-6882-4-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2003] [Accepted: 01/15/2004] [Indexed: 11/10/2022]
Abstract
BACKGROUND Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM). METHODS Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS), which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50) from healthy individuals (n = 50) in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI) in undergraduate college students (N = 458). The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale) in a different sample of undergraduate students (N = 62). RESULTS Substudy (i) Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50; controls r = 0.45). AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36; controls r = 0.50). Controls (r = 0.64) had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33), which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii) In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40). Substudy (iii) AIOS scores were significantly correlated with positive affect (rAIOS24h = 0.56, rAIOS1month = 0.57) and positive states of mind (rAIOS24h = 0.42, rAIOS1month = 0.45), and inversely correlated with negative affect (rAIOS24h = -0.41, rAIOS1month = -0.59). CONCLUSIONS The AIOS is able to distinguish relatively sicker from relatively healthier individuals; and correlates in expected directions with a measure of distress and indicators of positive and negative affect and positive states of mind. The AIOS offers a tool for CAM/IM research that extends beyond a disease emphasis.
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Affiliation(s)
- Iris R Bell
- Program in Integrative Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Psychiatry, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
- Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Surgery, The University of Arizona College of Medicine, Tucson, AZ, USA
- Mel and Enid Zuckerman Arizona College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Victoria Cunningham
- Program in Integrative Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Opher Caspi
- Program in Integrative Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
- Department of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Paula Meek
- College of Nursing, The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Lynn Ferro
- Program in Integrative Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA
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Weiner DK, Haggerty CL, Kritchevsky SB, Harris T, Simonsick EM, Nevitt M, Newman A. How Does Low Back Pain Impact Physical Function in Independent, Well-Functioning Older Adults? Evidence from the Health ABC Cohort and Implications for the Future. PAIN MEDICINE 2003; 4:311-20. [PMID: 14750907 DOI: 10.1111/j.1526-4637.2003.03042.x] [Citation(s) in RCA: 152] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. DESIGN Cross-sectional survey and examination. SETTING Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study. PARTICIPANTS Participants were 2,766 community-dwelling adults, aged 70-79; 42% were African American, 52% were men. OUTCOME MEASURES 1) Back pain-location, frequency, intensity; 2) Hip and/or knee pain; 3) Body mass index (BMI); 4) Self-reported difficulty doing functional tasks; 5) Lower extremity function, using the battery from the Established Populations for Epidemiologic Studies in the Elderly (EPESE); 6) Self-rated health; 7) Comorbidity; 8) Depressive symptoms, using the Center for Epidemiological Studies-Depression (CES-D) scale. RESULTS LBP was common (36%), and its frequency/intensity was significantly associated with other pain and comorbidities. In gender-specific models, LBP frequency/intensity was not significantly associated with EPESE performance score after adjusting for age, race, BMI, CES-D score, knee pain, hip pain, and other comorbidities. LBP frequency/intensity, however, was significantly associated with self-reported difficulty with most functional tasks after adjusting for important confounders. CONCLUSIONS Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of independence in older adults and whether therapeutic interventions can ameliorate decline and, therefore, preserve independence.
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Affiliation(s)
- Debra K Weiner
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15206, USA.
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Abstract
The purpose of this study was to identify how sociodemographic characteristics such as age, race, and socioeconomic status; psychosocial factors of hardiness, health promotion practices, and social support; health status; and pain are related to the ability of older, community-residing individuals with osteoarthritis (OA) to maintain psychological equilibrium and physical function. A total of 81 older adults with OA completed a survey that included a sociodemographic data form, a hardiness scale, a measure of health promoting practices, and five subscales from the Arthritis Impact Measure Scale 2 on social support, general health status, pain, and psychological status and physical function. Analyses using multiple regression showed that hardiness, pain, and social support were significant contributors to psychological status and physical function and, respectively, accounted for 53% and 54% of the variance. By knowing about OA and being aware of factors that contribute to maintaining independence in individuals with OA, nurses can provide expert help to aging individuals.
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Affiliation(s)
- Carolyn C Kee
- Byrdine F. Lewis School of Nursing, Atlanta, Georgia, USA
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Bath PA. Differences between older men and women in the self-rated health-mortality relationship. THE GERONTOLOGIST 2003; 43:387-95; discussion 372-5. [PMID: 12810903 DOI: 10.1093/geront/43.3.387] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The aims of this study were to examine differences between older men and women: (a) in the ability of self-rated health to predict mortality, (b) in the effect of different follow-up periods on the self-rated health mortality relationship, and (c) in the relative importance of self-rated health and self-rated change in health in predicting mortality. DESIGN AND METHODS By using data from the Nottingham Longitudinal Study of Activity and Ageing, the author assessed relationships between self-rated health and self-rated change in health and 4- and 12-year mortality in separate unadjusted and adjusted Cox proportional hazards regression models in men and women. RESULTS The differences between men and women in the hazard ratios for poor self-rated health were not significant, although there were differences in the explanatory factors. The relationship between self-rated health and short-term and long-term mortality was explained by age and health among men. The relationship between self-rated health and short-term mortality was explained by age, physical and mental health, and physical activity among women. The relationship between self-rated health and long-term mortality was explained by age, physical health, and physical activity among women. The relationship between self-rated change in health and short-term mortality was explained by age among men and women. The relationship between self-rated change in health and long-term mortality was explained by age and physical health among men and women. Social engagement was an independent predictor of short- and long-term mortality among men and women in this study. IMPLICATIONS The finding that low self-rated health was not an independent predictor of mortality among men or women, contrary to many, but not all, previous studies, may be related to differences in study design and/or across cultures. Further research investigating relationships between self-rated health and mortality and potential explanatory variables should analyze men and women separately and should consider the length of follow-up period. The benefits of individual physical and social activities in reducing mortality merit further investigation.
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Affiliation(s)
- Peter A Bath
- Health Informatics Research Group, Centre for Health Information Management Research, Department of Information Studies, University of Sheffield, Western Bank, United Kingdom.
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Månsson NO, Merlo J, Ostergren PO. Is there an interaction between self-rated health and medication with analgesics and hypnotics in the prediction of disability pension? Scand J Public Health 2003; 30:267-73. [PMID: 12680502 DOI: 10.1080/14034940210134004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS Several studies have shown that self-rated health (SRH) is associated with drug use. The aim of this study was to investigate the possible interaction between SRH and use of analgesics and hypnotics and its ability to predict disability pension. METHODS In 1974-78. complete birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited to a health screening, and the cohort in this study comprised 5,798 men with complete data followed up for 11 years. RESULTS At inclusion, 27% rated their health as less than perfect, 11% used analgesics, 3% used hypnotics and, during follow-up. 12% received a disability pension. The adjusted hazard ratios of disability pension were 3.1 (CI: 2.6, 3.6) for those who had rated their health as less than perfect and 2.7 (2.3, 3.2) for subjects who used analgesics and/or hypnotics. For subjects with the combined risk of poor SRH and medication, the hazard ratio was 5.5 (4.6, 6.5). The granting of disability pension attributable to the interaction between poor SRH and medication was estimated at 47%, which was statistically significant. CONCLUSIONS Disability pension among middle-aged men was associated with self-rated health as well as medication and clear evidence of synergism between the two factors was found, while there were no indications of medication acting as a causal link between poor SRH and disability pension. Several mechanisms may contribute to the findings, but the information gained may be used as means to identify those at risk for disability pension.
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Affiliation(s)
- Nils-Ove Månsson
- Department of Community Medicine, Lund University, Malmö University Hospital, Malmö, Sweden.
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Dominick KL, Ahern FM, Gold CH, Heller DA. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res 2002; 14:499-508. [PMID: 12674491 DOI: 10.1007/bf03327351] [Citation(s) in RCA: 189] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS This investigation examined the ability of a four-item Health-Related Quality of Life (HRQOL) scale to predict short-term (30-day) and long-term (1-year) physician visits, hospitalization, and mortality among older adults. METHODS Subjects included 84065 individuals aged 65 and older who completed a mail version of the Centers for Diseases Control's Behavioral Risk Factor Surveillance System (BRFSS) Core HRQOL Module. HRQOL dimensions represented by the module include global self-rated general health, recent physical health, recent mental health, and recent activity limitation. RESULTS In analysis of covariance models controlling for demographic factors and comorbidity, the number of physician visits within 30 days and 1 year differed significantly across categories of each HRQOL item. In Cox regression models controlling for the same covariates, all four HRQOL questions were significant predictors of 30-day and 1-year hospitalization and mortality. CONCLUSIONS These results signify that all four dimensions of HRQOL represented by the BRFSS Core HRQOL Module are important predictors of both short-term and long-term adverse health events among older adults. This brief scale may be particularly useful for assessing the health of older adults in clinical settings and large-scale epidemiological studies.
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Affiliation(s)
- Kelli L Dominick
- Health Services Research and Development, Durham VA Medical Center, Durham, North Carolina 27705, USA.
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Weiner DK. Improving pain management for older adults: an urgent agenda for the educator, investigator, and practitioner. Pain 2002; 97:1-4. [PMID: 12031773 DOI: 10.1016/s0304-3959(01)00421-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bell IR, Baldwin CM, Schwartz GE, Davidson JRT. Homeopathic constitutional type questionnaire correlates of conventional psychological and physical health scales: individual difference characteristics of young adults. HOMEOPATHY 2002; 91:63-74. [PMID: 12371459 DOI: 10.1054/homp.2002.0003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined associations between scores for 19 different remedies on the constitutional type questionnaire (CTQ) and scores on standardized psychological and medical trait and state scales from health psychology research. Subjects were 104 young adult American college students (mean age 20 years; 67% female). Scales included the chemical intolerance index (CII) for environmental sensitivity, the NEO personality inventory, Marlowe-Crowne social desirability (MCSD) Scale for defensiveness, Harvard parental caring scale (HPCS) for perceived mother and father traits, Profile of Mood State (POMS) scale, Pennebaker symptom checklist (PSC), and a 3-item global health rating scale. The majority of CTQ constitutional type scores correlated significantly with greater NEO neuroticism, lower MCSD defensiveness, and greater psychological distress on the POMS subscales. NEO Extraversion and Openness subscales correlated with specific CTQ scores in directions consistent with clinical remedy pictures. CTQ Carcinosin differed from other remedies, showing no significant correlations with other scales. As hypothesized (a) persons high on CTQ scores for Carcinosin and low in parental caring (HPCS) had the highest symptom score; (b) those high on CTQ scores for Sulphur and low on HPCS had the poorest global health ratings; (c) individuals high on four different CTQ type scores (Carcinosin, Lachesis, Nux vomica, Sulphur) and high on environmental sensitivity (CII) exhibited the highest symptom scores. Taken together, the data offer additional validation of the CTQ and provide a foundation for studying interactions of constitutional type with both psychosocial and physicochemical environmental factors in homeopathic provers and patients.
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Affiliation(s)
- Iris R Bell
- Program in Integrative Medicine, The University of Arizona Health Sciences Center, Tucson 85719, USA.
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