Self-rated health in later life – Age-related changes in associated factors

Abstract

Introduction: Self-rated health (SRH) is a commonly used health measure based on subjective evaluations. The meaning of associated factors has been shown to change its effect on SRH with age. However, knowledge about these changes in later life is limited. The aim is to investigate the effect of cardiovascular disorders and depression on SRH and whether this relationship changes with age among older adults. Methods: This study use data from the Gothenburg H70 Birth Cohort studies. The sample is born in 1930 have been divided in to two groups: younger old age 70-75 (n=892) and older old age 85-88 (n=475). SRH was measured using the question: “How would you rate your health”, with response options ranging from excellent to poor. Associated factors include cardiovascular disorders (atrial fibrillation, myocardial infarction, claudicatio intermittens, angina pectoris, hypertension, stroke/TIA) and depression. Linear regression was used to test the associations, adjusted for sex, low cognitive function (MMT ≤25), and education. In Model 1, cardiovascular disorders, and depression were analysed separately and in Model 2 they were combined in one variable. Results: The effect of cardiovascular disorders and depression differ between the two groups, with the largest effect on SRH seen in the younger old group. (Model 1: cardiovascular disorders β ,490 CI 95 % ,354– ,626) vs β ,158 (CI 95 % ,026– ,291), depression β ,788 (CI 95% ,625– ,950) vs β,276 (CI 95 % ,100– ,452 p <,001)). The effect of the associated factors increases in both groups for those with both cardiovascular disorders and depression (Model 2: cardiovascular disorders and depression β 1,043 CI 95 % 0,800 – 1,280 vs β ,594 (CI 95 % ,351 -,836). Discussion: The result show that cardiovascular disorders and depression were associated with poorer SRH in later life, and a combination of depression and cardiovascular disorders shows a stronger association with poorer SRH than the factors separately. Based on our findings, there appears to be a difference in the importance of these factors between the age groups, indicating that cardiovascular disorders and depression becomes less important for the subjective evaluation of health with xxxx