R Dankner1,2,3, L Olmer4, G Kaplan5, A Chetrit6. 1. Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel. racheld@gertner.health.gov.il. 2. Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, 61390, Ramat Aviv, Tel Aviv, Israel. racheld@gertner.health.gov.il. 3. Patient Oriented Research, The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA. racheld@gertner.health.gov.il. 4. Biostatistics Unit, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel. 5. Psychosocial Aspects of Health, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel. 6. Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel.
Abstract
PURPOSE: Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years. METHODS: During the years 2000-2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality. RESULTS: A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71-6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25-3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01). CONCLUSIONS: Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.
PURPOSE: Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years. METHODS: During the years 2000-2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality. RESULTS: A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71-6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25-3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01). CONCLUSIONS: Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.
Authors: Elizabeth L M Barr; Paul Z Zimmet; Timothy A Welborn; Damien Jolley; Dianna J Magliano; David W Dunstan; Adrian J Cameron; Terry Dwyer; Hugh R Taylor; Andrew M Tonkin; Tien Y Wong; John McNeil; Jonathan E Shaw Journal: Circulation Date: 2007-06-18 Impact factor: 29.690
Authors: Susanne Andersson; Inger Ekman; Febe Friberg; Bledar Daka; Ulf Lindblad; Charlotte A Larsson Journal: Scand J Prim Health Care Date: 2013-04-29 Impact factor: 2.581
Authors: Patrik Wennberg; Olov Rolandsson; Daphne L van der A; Annemieke M W Spijkerman; Rudolf Kaaks; Heiner Boeing; Silke Feller; Manuela M Bergmann; Claudia Langenberg; Stephen J Sharp; Nita Forouhi; Elio Riboli; Nicholas Wareham Journal: BMJ Open Date: 2013-03-06 Impact factor: 2.692
Authors: Christina Halford; Thorne Wallman; Lennart Welin; Annika Rosengren; Annika Bardel; Saga Johansson; Henry Eriksson; Ed Palmer; Lars Wilhelmsen; Kurt Svärdsudd Journal: BMC Public Health Date: 2012-12-22 Impact factor: 3.295