Goun Park1, Wankyo Chung1. 1. Graduate School of Public Heath, Seoul National University, Seoul, Korea.
Abstract
Objectives: Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. Methods: This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging(2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the K-MMSE score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status. Results: For cognitively intact individuals, the adjusted hazard ratios of mortality were 2.0 (95%CI:1.18-3.41, Model 4) for those with 'bad' self-rated health and 2.40 (95%CI:1.35-4.25, Model 4) for those with 'very bad' self-rated heath, respectively, compared with those with 'very good' health. The results remain statistically significant even after adjusting for sociodemographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the adjusted hazard ratio of mortality was statistically significant for those with 'very bad' self-rated health, compared with those with 'very good' health, when sociodemographic factors were accounted for (aHR: 3.03, 95% CI:1.11-8.28, Model 2). Conclusion: Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.
Objectives: Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. Methods: This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging(2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the K-MMSE score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status. Results: For cognitively intact individuals, the adjusted hazard ratios of mortality were 2.0 (95%CI:1.18-3.41, Model 4) for those with 'bad' self-rated health and 2.40 (95%CI:1.35-4.25, Model 4) for those with 'very bad' self-rated heath, respectively, compared with those with 'very good' health. The results remain statistically significant even after adjusting for sociodemographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the adjusted hazard ratio of mortality was statistically significant for those with 'very bad' self-rated health, compared with those with 'very good' health, when sociodemographic factors were accounted for (aHR: 3.03, 95% CI:1.11-8.28, Model 2). Conclusion: Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.
Entities:
Keywords:
Cognitive impairment; Korea; Mortality; Self-rated health