Re: Self-rated health and mortality in older men and women: A time-dependent covariate analysis

In article <1193405936.692962.117400@xxxxxxxxxxxxxxxxxxxxxxxxxxx>,
MarilynMann <mannm@xxxxxxxxxxx> wrote:

Self-rated health and mortality in older men and women: A time-
dependent covariate analysis

Tiina-Mari Lyyraa, , , Esko Leskinenb, Marja Jylhäc and Eino
Heikkinena
aThe Finnish Centre for Interdisciplinary Gerontology and Department
of Health Sciences, University of Jyväskylä, Finland
bDepartment of Mathematics and Statistics, University of Jyväskylä,
Finland
cSchool of Public Health, University of Tampere, Finland

Arch Gerontol & Geriatrics

Abstract
Although the relation between self-rated health (SRH) and mortality is
widely known, most of the studies have relied in baseline measurements
unheeding the dynamics of the phenomenon. Our aim was to analyze how
SRH both as a constant and as a time-dependent covariate predicts
mortality in older men and women and to compare these different
approaches. Subjects consisted of 110 male and 208 female (n = 318)
residents in the city of Jyväskylä, central Finland, aged 75 years at
the baseline in 1989. The follow-up data was gathered in 1994 and
mortality was followed for 10 years. Results showed that poor SRH was
strongly associated with higher mortality risk in women in all models.
In men, the association was found only in time-dependent and 5 year
follow-up models and these associations were explained by baseline
health status. To conclude, our analyses showed that there are gender
differences in association between SRH and mortality and that the use
of time-dependent covariate in a Cox regression model enables
advantage to be taken of all the information in a longitudinal study
design.

Corresponding author. Tel.: +358 14 260 2150; fax: +358 14 260 4600.

* * *
When I saw the title of this article, I thought to myself, "Self-rated
mortality? That's a neat trick."

Seriously, I only read the abstract, but I suspect that women are more
realistic about their own health status and men are more into denial,
on average. (Men posting messages on health-related usenet may not be
average.) My husband's internist retired last spring, and my husband
still hasn't found a new doctor. How convenient for him!

Marilyn

Marilyn

I think of SRH as an image or idea of health perception. If we think
we are sick that premise may conclude we are. Sort of like how self
esteem affects our ability to interact with others. Defining health as
more than having more than no symptoms. Muddies the waters.

Bill


...........................

J Health Psychol. 2007 Nov;12(6):895-906.

Relationships between Felt Age and Perceived Disability, Satisfaction
with Recovery, Self-efficacy Beliefs and Coping Strategies.

Boehmer S.
Freie Universiltät Berlin, Germany. boehmers@xxxxxxxxx
Subjective age is related to health and to life satisfaction, and
adaptation to stressful life events is associated with self-efficacy
beliefs and coping. The present study on cancer survivors addressed two
objectives: the relationship between felt age and perceived disability
and satisfaction with recovery, and the feeding back of felt age on
general self-efficacy beliefs and coping strategies. Data were collected
one and six months after surgery. Individuals with younger age
identities reported lower levels of perceived disability and
avoidance-oriented coping and higher levels of satisfaction with
recovery, self-efficacy and meaning-focused coping than individuals with
older age identities. Individuals with decreased or stable felt age
indicated increased meaning-focused coping or avoidance-oriented coping,
respectively. Explanations for these associations are discussed.
PMID: 17956969 [PubMed - in process]

..............

J Soc Psychol. 2007 Aug;147(4):345-69.

Comparative risk and perceived control: implications for psychological
and physical well-being among older adults.

Ruthig JC, Chipperfield JG, Perry RP, Newall NE, Swift A.
Department of Psychology, University of North Dakota, Grand Forks, ND
58202, USA. joelle.ruthig@xxxxxxxxxxxxx
As older adults become more susceptible to certain health crises, their
preoccupation with their risk of suffering such events increases.
Understanding the implications of risk perceptions is critical because
they may have consequences for psychological and physical well-being in
later life. In the present study of older adults living in the
community, the authors examined participants' comparative risk estimates
(CREs)--their perceptions of their own risk relative to a similar
other's risk--of suffering a hip fracture. Using multiple regression
analyses, the authors examined the role of CREs on psychological
well-being (negative emotions, life satisfaction) and self-rated
physical well-being (general physical health, recent physical health).
The authors expected perceived control (PC) to moderate the relationship
between CREs and well-being. The predicted interaction did occur: Among
individuals with high PC, comparative optimism (perceiving a
comparatively low risk) was associated with better psychological
well-being (fewer negative emotions and greater life satisfaction) and
better physical well-being (general and recent physical health) relative
to comparative pessimism (perceiving a comparatively high risk). Among
individuals with low PC, there were no differences in well-being between
comparative optimists and comparative pessimists. These findings suggest
that the protective effect of comparative optimism on well-being is
limited to older adults who have a strong sense of control.
PMID: 17955748 [PubMed - in process]

--

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