Ayalon Liat, Covinsky Kenneth E
Bar-Ilan University, Ramat Gan, Israel.
Arch Intern Med. 2009 Dec 14;169(22):2156-61. doi: 10.1001/archinternmed.2009.386.
The Health and Retirement Study is a national sample of Americans older than 50 years and their spouses. The present study evaluated cross-sectional and longitudinal data from January 2000 through December 2006. The objective of the study was to evaluate the roles of spouse-rated vs self-rated health as predictors of all-cause mortality among adults older than 50 years.
A total of 673 dyads of married couples were randomly selected to participate in a Health and Retirement Study module examining spouse-rated health. For each couple, one member was asked to rate his or her overall health status, and his or her spouse was asked to report the partner's overall health status. Mortality data were available through 2006.
Our findings demonstrate that spouse-rated health (area under the curve, 0.75) is as strong a predictor of mortality as self-rated health (area under the curve, 0.73) (chi(2)(1) = 0.36, P = .54). Combining spouse-rated and self-rated health predicts mortality better than using self-rated health alone (area under the curve, 0.77) (chi(2)(1) = 6.72, P = .009).
Spouse ratings of health are at least as strongly predictive of mortality as self-rated health. This suggests that, when self-rated health is elicited as a prognostic indicator, spouse ratings can be used when self-ratings are unavailable. Both measures together may be more informative than either measure alone.
健康与退休研究是一项针对50岁及以上美国人和其配偶的全国性抽样研究。本研究评估了2000年1月至2006年12月的横断面数据和纵向数据。该研究的目的是评估配偶评价的健康状况与自我评价的健康状况作为50岁以上成年人全因死亡率预测指标的作用。
总共随机选择了673对已婚夫妇参与一项健康与退休研究模块,该模块考察配偶评价的健康状况。对于每对夫妇,要求其中一方对其整体健康状况进行评分,并要求其配偶报告另一方的整体健康状况。可获取截至2006年的死亡率数据。
我们的研究结果表明,配偶评价的健康状况(曲线下面积,0.75)与自我评价的健康状况(曲线下面积,0.73)对死亡率的预测能力相当(χ²(1)=0.36,P = 0.54)。将配偶评价的健康状况和自我评价的健康状况相结合,比单独使用自我评价的健康状况能更好地预测死亡率(曲线下面积,0.77)(χ²(1)=6.72,P = 0.009)。
配偶对健康状况的评价至少与自我对健康状况的评价对死亡率的预测能力一样强。这表明,当将自我评价的健康状况作为预后指标时,在无法获得自我评价时可以使用配偶评价。两种测量方法结合起来可能比单独使用任何一种方法提供更多信息。