Public Health and Environment, National School of Public Health/Oswaldo Cruz Foundation, Leopoldo Bulhões 1480/817 Manguinhos, Rio de Janeiro, RJ 21041-210, Brazil.
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):e88-93. doi: 10.1016/j.archger.2010.01.004. Epub 2010 Feb 4.
The objective was to examine the role of SRH as a predictor of mortality in elderly men in a medium-size Brazilian city. In 2 years of follow-up, 120 deaths occurred in the study population, with the following main causes: cardiovascular diseases (40%), neoplasms (22.5%), and respiratory diseases (10%). In practically all of the target variable strata, elderly men with fair or poor SRH showed a higher risk of dying as compared to those with excellent or good SRH. In the final model, the variables fair/poor SRH (hazard risk=HR=1.88, 95% confidence interval=95%CI=1.29-2.72), age (HR=1.05, 95%CI=1.03-1.08), public health system as the regular source of care (HR=1.69, 95%CI=1.10-2.60), current smoking (HR=1.94, 95%CI=1.24-3.04), and acute cardiovascular disease (HR=1.62, 95%CI=1.06-2.47) were associated with mortality. We concluded that SRH proved to be a predictive variable for mortality in elderly men after 2 years of follow-up, with nearly a twofold risk of death among men that reported fair or poor health, after adjusting for age, regular use of the public health system, current smoking, and acute cardiovascular disease. Given the importance of poor SRH for predicting mortality in elderly men, health services should incorporate this indicator into health assessments in this population.
本研究旨在探讨巴西某中等城市老年人的健康自评(SRH)与死亡率之间的关系。在为期 2 年的随访期间,研究人群中有 120 人死亡,主要死亡原因为心血管疾病(40%)、肿瘤(22.5%)和呼吸系统疾病(10%)。在几乎所有目标变量分层中,健康自评一般或差的老年人死亡风险均高于健康自评极好或好的老年人。在最终模型中,健康自评一般或差(风险比[HR]=1.88,95%置信区间[95%CI]=1.29-2.72)、年龄(HR=1.05,95%CI=1.03-1.08)、以公立卫生系统为常规医疗来源(HR=1.69,95%CI=1.10-2.60)、当前吸烟(HR=1.94,95%CI=1.24-3.04)和急性心血管疾病(HR=1.62,95%CI=1.06-2.47)与死亡率相关。综上所述,经过 2 年的随访,SRH 是老年人死亡率的预测变量,与健康自评极好或好的老年人相比,健康自评一般或差的男性死亡风险增加近两倍,且在校正年龄、常规使用公立卫生系统、当前吸烟和急性心血管疾病等因素后仍具有统计学意义。鉴于健康自评差与老年人死亡率的相关性,卫生服务机构应为该人群的健康评估纳入该指标。