Vuorisalmi Merja, Lintonen Tomi, Jylhä Marja
School of Public Health, University of Tampere, 33014 Tampere, Finland.
Aging Clin Exp Res. 2006 Jun;18(3):211-7. doi: 10.1007/BF03324651.
This study examined the relationship of age and functional ability with comparative (age-referential) and global self-rated health (SRH), and the possible effect of selection bias. The focus is on differences between these questions and on the consequences which these differences have in research.
The data came from the second wave of the Tampere Longitudinal Study on Ageing (TamELSA), consisting of 830 persons aged 60-99 years. The associations of both self-rated health measures with age and functional ability were examined using multinomial regression analyses.
People with increasing age, particularly over 80-year-old, are inclined to rate their health better than that of their age peers. The association of older age with better comparative SRH became even stronger after adjustment for functional ability, chronic diseases and sociodemographic factors. The relation of older age with global SRH was weaker than that with age-referential SRH. By contrast, functional ability was more strongly associated with global than with comparative SRH.
Our results suggest that comparative and global self-rated health cannot be used interchangeably. The comparative measure is more strongly "calibrated" by age. Therefore, when SRH is used as a measure in survey studies or in clinical settings, the global question should be preferred.
本研究探讨了年龄和功能能力与比较性（年龄参照）自评健康（SRH）及总体自评健康之间的关系，以及选择偏倚可能产生的影响。重点在于这些问题之间的差异以及这些差异在研究中的后果。
数据来自坦佩雷老龄化纵向研究（TamELSA）的第二轮，包括830名年龄在60 - 99岁之间的人。使用多项回归分析检验了两种自评健康指标与年龄和功能能力之间的关联。
年龄越大，尤其是80岁以上的人，倾向于认为自己的健康状况比同龄人更好。在对功能能力、慢性病和社会人口学因素进行调整后，年龄较大与更好的比较性SRH之间的关联变得更强。年龄与总体SRH的关系比与年龄参照性SRH的关系更弱。相比之下，功能能力与总体SRH的关联比与比较性SRH的关联更强。
我们的结果表明，比较性自评健康和总体自评健康不能互换使用。比较性指标受年龄的“校准”更强。因此，当在调查研究或临床环境中使用SRH作为一项指标时，应优先选择总体问题。
