自评健康、访谈者评定健康和客观健康及其随时间的变化和轨迹，以及中国成年人的死亡风险。

Self-rated health, interviewer-rated health, and objective health, their changes and trajectories over time, and the risk of mortality in Chinese adults.

机构信息

School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

School of Public Health, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Front Public Health. 2023 Jun 20;11:1137527. doi: 10.3389/fpubh.2023.1137527. eCollection 2023.

DOI:10.3389/fpubh.2023.1137527

PMID:37408749

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10318337/

Abstract

BACKGROUND

Self-rated health (SRH), interviewer-rated health (IRH), and objective health reflect the overall health status from different aspects. This study aimed to investigate the associations of SRH, IRH, and objective health with mortality among Chinese older adults.

METHODS

This study used data from the 2008 (baseline), 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. SRH and IRH were evaluated by questionnaire. Objective health was evaluated by the Chinese multimorbidity-weighted index (CMWI), which incorporated 14 diagnosed chronic diseases. SRH, IRH, and CMWI were assessed as: (1) baseline levels; (2) longitudinal changes by subtracting the values obtained in 2008 from the corresponding values in 2014; (3) trajectories by Group-Based Trajectory Modeling, respectively. The Cox proportional hazards model was used to explore the associations of baseline SRH, IRH, and CMWI, their changes, and trajectories with mortality.

RESULTS

A total of 13,800 participants were included at baseline (2008). The baseline SRH ([hazard ratio] 0.93, [95% confidence interval] 0.91-0.96), IRH (0.84, 0.81-0.87), and CMWI (0.99, 0.98-1.00) in 2008 were significantly associated with 10-year mortality (2008 to 2018). Among 3,610 participants, the changes of SRH (0.93, 0.87-0.98), IRH (0.77, 0.71-0.83), and CMWI (0.97, 0.95-0.99) from 2008 to 2014 were significantly associated with 4-year mortality (2014-2018). The trajectories were divided into "high SRH/IRH/CMWI" and "low and declining SRH/IRH/CMWI." Compared with "low and declining SRH/IRH/CMWI," "high SRH" (0.58, 0.48-0.70), "high IRH" (0.66, 0.55-0.80), and "high CMWI" (0.74, 0.61-0.89) from 2008 to 2014 were significantly associated with 4-year mortality (2014-2018).

CONCLUSION

Baseline SRH, IRH, and CMWI, their changes and trajectories are all associated with mortality in Chinese older adults. It is possibly necessary to promote the use of cost-effective indicators in primary medical institutions to improve the health management of the older adults.

摘要

背景

自评健康（SRH）、访谈者评定健康（IRH）和客观健康从不同方面反映了整体健康状况。本研究旨在探讨中国老年人的 SRH、IRH 和客观健康与死亡率之间的关系。

方法

本研究使用了中国长寿纵向研究 2008 年（基线）、2011 年、2014 年和 2018 年的数据。SRH 和 IRH 通过问卷进行评估。客观健康通过中国多疾病加权指数（CMWI）进行评估，该指数纳入了 14 种已诊断的慢性疾病。SRH、IRH 和 CMWI 分别评估为：（1）基线水平；（2）通过从 2008 年的相应值中减去 2014 年的值得到的纵向变化；（3）通过基于群组的轨迹建模进行轨迹分析。Cox 比例风险模型用于探讨基线 SRH、IRH 和 CMWI 及其变化和轨迹与死亡率之间的关系。

结果

共纳入了 13800 名参与者作为基线（2008 年）。2008 年基线 SRH（[风险比] 0.93，[95%置信区间] 0.91-0.96）、IRH（0.84，0.81-0.87）和 CMWI（0.99，0.98-1.00）与 10 年死亡率（2008 年至 2018 年）显著相关。在 3610 名参与者中，SRH（0.93，0.87-0.98）、IRH（0.77，0.71-0.83）和 CMWI（0.97，0.95-0.99）从 2008 年到 2014 年的变化与 4 年死亡率（2014 年至 2018 年）显著相关。轨迹分为“高 SRH/IRH/CMWI”和“低和下降的 SRH/IRH/CMWI”。与“低和下降的 SRH/IRH/CMWI”相比，2008 年至 2014 年期间“高 SRH”（0.58，0.48-0.70）、“高 IRH”（0.66，0.55-0.80）和“高 CMWI”（0.74，0.61-0.89）与 4 年死亡率（2014 年至 2018 年）显著相关。