Siegel Michele, Bradley Elizabeth H, Kasl Stanislav V
Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Gerontology. 2003 Jul-Aug;49(4):265-71. doi: 10.1159/000070409.
An extensive literature has demonstrated that self-ratings of health predict mortality, even after controlling for more objective measures of health, health habits and sociodemographic characteristics. We examine the role of a related concept, self-rated life expectancy, in predicting mortality.
To assess whether self-rated life expectancy predicts mortality after controlling for measures of health, self-rated health, and sociodemographic characteristics.
Using data from the 1992 Health and Retirement Survey (HRS), the 1993 Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, and the second Tracker file (2.0), Cox proportional hazard models were estimated to assess whether self-rated life expectancy predicts mortality, after adjusting for self-rated health and several potential confounders that might otherwise explain this relationship. The AHEAD sample included 2,102 men and 3,160 women. During the 2 years of follow-up, 9% (n = 185) of the men died and 5% (n = 166) of the women died. The HRS sample was comprised of 4,090 men and 4,885 women. Four percent (n = 164) of the men died and 2% (n = 99) of the women died in the 3 years of follow-up.
In the older, AHEAD sample, both self-rated life expectancy (p < 0.01) and self-rated health (p < 0.05) predicted mortality for both men and women, even when the two measures were included in the model together. In the younger, HRS sample, self-rated life expectancy was not significantly associated with mortality when self-rated health was included in the model.
Our findings suggest that, although self-rated life expectancy and self-rated health may be conceptually related, they have independent empirical effects on mortality.
大量文献表明,即使在控制了更客观的健康指标、健康习惯和社会人口学特征之后,自我健康评分仍能预测死亡率。我们研究了一个相关概念——自我评定的预期寿命在预测死亡率方面的作用。
评估在控制了健康指标、自我健康评分和社会人口学特征之后,自我评定的预期寿命是否能预测死亡率。
利用1992年健康与退休调查(HRS)、1993年老年资产与健康动态调查(AHEAD)以及第二个跟踪文件(2.0)的数据,估计Cox比例风险模型,以评估在调整了自我健康评分和其他一些可能解释这种关系的潜在混杂因素之后,自我评定的预期寿命是否能预测死亡率。AHEAD样本包括2102名男性和3160名女性。在2年的随访期间,9%(n = 185)的男性死亡,5%(n = 166)的女性死亡。HRS样本由4090名男性和4885名女性组成。在3年的随访中,4%(n = 164)的男性死亡,2%(n = 99)的女性死亡。
在年龄较大的AHEAD样本中,自我评定的预期寿命(p < 0.01)和自我健康评分(p < 0.05)都能预测男性和女性的死亡率,即使这两个指标同时纳入模型也是如此。在年龄较小的HRS样本中,当模型中纳入自我健康评分时,自我评定的预期寿命与死亡率没有显著关联。
我们的研究结果表明,尽管自我评定的预期寿命和自我健康评分在概念上可能相关,但它们对死亡率有独立的实证影响。