Changes in health, functional performance and activity predict changes in self-rated health: a 10-year follow-up study in older people.

The purpose was to examine changes in self-rated health (SRH) in older people and associations between these changes and various self-reported and objectively measured indicators of health status, functional performance and activity at three time-points 5 years apart. Further, our aim was to examine whether SRH takes the form of a continuum. The study group comprised all the baseline 75-year-old inhabitants of the City of Jyväskylä, Finland (N=382). Four groups were formed according to change/stability in SRH: 'good-good', 'good-bad', 'bad-good' and 'bad-bad'. Cross-tabulation and one-way analysis of variance (ANOVA) was used to examine the cross-sectional differences, and GLM Repeated Measures to analyze the differences in changes in the determinants of SRH over time. Stability was more common than change in SRH, although in most participants there was a decline in most of the determinants of SRH. A systematic relation was found between the SRH groups and the indicators of health status, functional performance and physical and social activity, especially over the first 5-year period. A substantial decrease in these indicators was associated with a decline in SRH. Among older people change and stability in SRH over time systematically reflect health status, functional performance, and physical and social activity. The relatively high stability found in SRH indicates that with increasing age older people adapt to their worsening health conditions. SRH seems to form a continuum when a wide range of self-reported and objectively measured indicators on physical, psychological and social components of health are taken into account.