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自评健康及其与波兰老年人全因死亡率的关系:PolSenior 项目。

Self-rated health and its association with all-cause mortality of older adults in Poland: The PolSenior project.

机构信息

International Institute of Molecular and Cell Biology in Warsaw, Warsaw, Poland.

Department of Geriatrics, Medical University of Warsaw, Warsaw, Poland.

出版信息

Arch Gerontol Geriatr. 2018 Nov-Dec;79:13-20. doi: 10.1016/j.archger.2018.07.016. Epub 2018 Jul 24.

DOI:10.1016/j.archger.2018.07.016
PMID:30075413
Abstract

OBJECTIVES

Predictive effect of self-rated health (SRH) on mortality in older adults has been observed. The purpose of the study was to analyze this association in Poles aged 65+.

METHODS

Data were obtained from the nationwide, multidisciplinary PolSenior project, conducted in a representative sample of older population. The study group comprised 4049 respondents (48.0% women) without significant cognitive deficit. SRH was measured using Visual Analog Scale. The analysis included selected socio-economic, health status and life-style factors. Mortality data were retrieved from the state registry.

RESULTS

During 5-year period, 414 women (21.4%) and 672 men (31.8%) have died, including 17.5% of women and 26.6% of men with good, 21.6% and 32.9% with fair, 36.2% and 55.3% with poor SRH, respectively. Kaplan-Meier survival curves for SRH revealed significant differences for both genders. Univariate Cox regression analysis revealed significant hazard ratios (HRs) for mortality among women and men with poor compared to good SRH [2.48 (1.83-3.37); 2.62 (2.04-3.36), respectively] and those with fair compared to good SRH [1.29 (1.03-1.60); 1.29 (1.10-1.52), respectively]. Age-adjusted HRs for mortality were significant between groups with poor and good SRH [women: 1.98 (1.46-2.68), men: 2.06 (1.60-2.64)]. Multivariate Cox proportional hazard regression model including revealed significant HRs for mortality between women with poor and good SRH [1.67 (1.06-2.64)].

CONCLUSIONS

SRH was associated with mortality in both genders. After adjustment for age, this relationship was maintained in respondents with poor compared to good SRH. Inclusion of potential confounders demonstrated that SRH was an independent predictor of mortality only in women.

摘要

目的

自感健康(SRH)对老年人死亡率的预测作用已有观察。本研究的目的是分析波兰 65 岁以上老年人的这种相关性。

方法

数据来自全国性的多学科 PolSenior 项目,该项目在老年人群的代表性样本中进行。研究组包括 4049 名无明显认知障碍的应答者(48.0%为女性)。SRH 使用视觉模拟量表进行测量。分析包括选定的社会经济、健康状况和生活方式因素。死亡率数据从国家登记处获取。

结果

在 5 年期间,414 名女性(21.4%)和 672 名男性(31.8%)死亡,其中女性中良好、一般和较差自感健康状况的死亡率分别为 17.5%、21.6%和 36.2%,男性中分别为 26.6%、32.9%和 55.3%。SRH 的 Kaplan-Meier 生存曲线表明,两性之间存在显著差异。单变量 Cox 回归分析显示,与良好自感健康状况相比,女性和男性中较差自感健康状况的死亡风险比(HR)显著升高[2.48(1.83-3.37);2.62(2.04-3.36)],一般自感健康状况的死亡风险比也显著升高[1.29(1.03-1.60);1.29(1.10-1.52)]。调整年龄后,较差和良好自感健康状况组之间的死亡风险比具有统计学意义[女性:1.98(1.46-2.68),男性:2.06(1.60-2.64)]。包含潜在混杂因素的多变量 Cox 比例风险回归模型显示,女性中较差和良好自感健康状况之间的死亡风险比显著升高[1.67(1.06-2.64)]。

结论

SRH 与两性的死亡率相关。在调整年龄后,与良好自感健康状况相比,较差自感健康状况的应答者中这种关系仍然存在。纳入潜在混杂因素表明,SRH 仅在女性中是死亡率的独立预测因素。

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