Schoenfeld D E, Malmrose L C, Blazer D G, Gold D T, Seeman T E
Duke University School of Medicine.
J Gerontol. 1994 May;49(3):M109-15. doi: 10.1093/geronj/49.3.m109.
This study tested the predictive value of self-rated health on 3-year mortality, with attention focused on healthy, high-functioning elders.
Data from the MacArthur Field Study of Successful Aging were utilized. Subjects were 70-79-year-old (at baseline) residents of the communities of East Boston, MA, New Haven, CT, and a five-county area in and around Durham County, NC (N = 1192) which comprise three sites of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). In-home interviews were conducted in 1988 and 1991. Logistic regression was performed to create odds ratios adjusted for age, sex, race, marital status, education, alcohol consumption, cigarette smoking, chronic diseases, past hospitalizations, and cognitive function. The sample was then divided into healthy and less healthy cohorts based on number of chronic diseases, and the analyses were repeated.
The adjusted odds ratios for self-rated health (poor/bad ratings compared to excellent ratings) in relation to mortality were 19.56 in the general sample, 93.51 in the healthy cohort, and 2.75 in the less healthy cohort.
Self-rated health is predictive of mortality in controlled analyses, with the greatest impact seen in healthy individuals. Health care professionals should be sensitive to the significance of poor self-rated health in apparently healthy patients.
本研究检验了自评健康状况对3年死亡率的预测价值，重点关注健康、功能良好的老年人。
利用了麦克阿瑟成功老龄化实地研究的数据。研究对象为马萨诸塞州东波士顿、康涅狄格州纽黑文以及北卡罗来纳州达勒姆县及其周边五县地区（N = 1192）70 - 79岁（基线时）的居民，这些地区构成了老年流行病学研究的既定人群（EPESE）的三个研究地点。1988年和1991年进行了入户访谈。进行逻辑回归以得出经年龄、性别、种族、婚姻状况、教育程度、饮酒量、吸烟情况、慢性病、既往住院史和认知功能调整后的比值比。然后根据慢性病数量将样本分为健康组和健康状况较差组，并重复进行分析。
在总体样本中，自评健康状况（与优秀评级相比为差/不良评级）与死亡率相关的调整后比值比为19.56，在健康组中为93.51，在健康状况较差组中为2.75。
在对照分析中，自评健康状况可预测死亡率，对健康个体的影响最大。医疗保健专业人员应意识到自评健康状况差在看似健康的患者中的重要性。
