Epidemiology and Health

Original Articles

Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016): Goun Park, Wankyo Chung; Epidemiol Health. 2021;43:e2021021. Published online April 7, 2021; DOI: https://doi.org/10.4178/epih.e2021021

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably.

METHODS

This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status.

RESULTS

For cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2).

CONCLUSIONS

Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.

Summary

Korean summary
본 연구는 인지 저하 여부에 따라 주관적 건강의 사망예측력이 달라지는지 확인하기 위해 K-MMSE 로 인지 저하 여부를 나누고 콕스 비례위험모델을 사용하여 분석을 시행하였다. 그 결과, 인지 저하군이 평가한 주관적 건강은 사망을 통계적으로 유의하게 예측하였다. 인구의 고령화로 지역 사회 내에서 인지 저하자가 지속적으로 증가하고 있는 상황에서 주관적 건강은 유효한 사망예측 인자이며 신뢰할 만한 건강지표이다.

Key Message
This study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. We used the Cox proportional hazard models for analysis. Cognitive status was classified based on the K-MMSE score. We found that self-rated health by cognitively impaired individuals remains useful in predicting mortality.

Citations

Citations to this article as recorded by

Factores sociodemográficos y de bienestar mediadores y moderadores de la relación entre la depresión y la demencia
Maria del Pilar Santacruz-Ortega, Bertha Lucia Avendaño, Maria Fernanda Cobo, Silvia Mejia-Arango
Neurología Argentina.2023; 15(3): 149. CrossRef
Impact of urban green space on self-rated health: Evidence from Beijing
Dongsheng Zhan, Qianyun Zhang, Mei-Po Kwan, Jian Liu, Bochuan Zhan, Wenzhong Zhang
Frontiers in Public Health.2022;[Epub] CrossRef
Association of the number of teeth and self-rated mastication with self-rated health in community-dwelling Japanese aged 40 years and older: the Yamagata cohort study
Shigeo Ishikawa, Tsuneo Konta, Shinji Susa, Kenichi Ishizawa, Naohiko Makino, Yoshiyuki Ueno, Naoki Okuyama, Mitsuyoshi Iino
Scientific Reports.2022;[Epub] CrossRef

Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea: Ikhan Kim, Jinwook Bahk, Sung-Cheol Yun, Young-Ho Khang; Epidemiol Health. 2017;39:e2017011. Published online March 15, 2017; DOI: https://doi.org/10.4178/epih.e2017011

16,258 View
230 Download
12 Web of Science
11 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
To examine the income gaps associated with self-rated poor health at the district level in Korea and to identify the geographical correlations between self-rated poor health, life expectancy, and the associated income gaps.

METHODS

We analyzed data for 1,578,189 participants from the Community Health Survey of Korea collected between 2008 and 2014. The age-standardized prevalence of self-rated poor health and the associated income gaps were calculated. Previously released data on life expectancy and the associated income gaps were also used. We performed correlation and regression analyses for self-rated poor health, life expectancy, and associated income gaps.

RESULTS

Across 245 districts, the median prevalence of self-rated poor health was 15.7% (95% confidence interval [CI], 14.6 to 16.8%), with interquartile range (IQR) of 3.1 percentage points (%p). The median interquintile gaps in the prevalence of self-rated poor health was 11.1%p (95% CI, 8.1 to 14.5%p), with IQR of 3.6%p. Pro-rich inequalities in self-rated health were observed across all 245 districts of Korea. The correlation coefficients for the association between self-rated poor health and the associated income gaps, self-rated poor health and life expectancy, and income gaps associated with self-rated poor health and life expectancy were 0.59, 0.78 and 0.55 respectively.

CONCLUSIONS

Income gaps associated with self-rated poor health were evident across all districts in Korea. The magnitude of income gaps associated with self-rated poor health was larger in the districts with greater prevalence of self-rated poor health. A strong correlation between self-rated poor health and life expectancy was also observed.

Summary

Korean summary
본 연구에서는 우리나라 245개 시군구의 자가평가 불건강 유병률의 소득수준 간 격차 크기를 규명하고, 시군구 단위 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 및 기대수명의 소득수준 간 격차의 상관성에 대하여 분석하였다. 연구 결과, 우리나라 245개 모든 시군구에서 자가평가 불건강 유병률에서의 저소득층에 불리한 불평등이 존재하였다. 또한, 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 그리고 자가평가 불건강 유병률의 소득수준 간 격차와 기대수명의 소득수준 간 격차는 높은 상관성이 나타났다. 이 연구는 지방정부 차원에서 건강 형평성 현황에 관한 유의미한 정보를 제공하여 지역별 보건정책 수립의 근거로 활용할 수 있다는데 의의를 찾을 수 있다.

Citations

Citations to this article as recorded by

The effect of body mass index on self-rated health in middle-aged and older adults: evidence from the China health and retirement longitudinal study
Jingyi Wang, Yingying Cai, Xiaohe Ren, Bin Ma, Ou Chen
Aging Clinical and Experimental Research.2023; 35(12): 2929. CrossRef
Health status and public health education for internal older migrants in China: Evidence from a nationally representative survey
Wen Zeng, Cui Wang, Hongbo Chen, Beibei Tong, Dan Li, Ziqiu Zou, Peiyuan Liu, Yuanrong Yao, Shaomei Shang
Frontiers in Public Health.2022;[Epub] CrossRef
Spatio-temporal Analysis of District-level Life Expectancy from 2004 to 2017 in Korea
Hwa-Kyung Lim, Hee-Yeon Kang, Ikhan Kim, Young-Ho Khang
Journal of Korean Medical Science.2021;[Epub] CrossRef
Self-rated health status in relation to aircraft noise exposure, noise annoyance or noise sensitivity: the results of a cross-sectional study in France
Clémence BAUDIN, Marie LEFÈVRE, Patricia CHAMPELOVIER, Jacques LAMBERT, Bernard LAUMON, Anne-Sophie EVRARD
BMC Public Health.2021;[Epub] CrossRef
The Effects of Social Support and Morbidities on Self-Rated Health among Migrant Elderly Following Children to Jinan, China
Suqing Wei, Fanlei Kong, Shixue Li
Healthcare.2021; 9(6): 686. CrossRef
Statin use for primary prevention in patients with type 2 diabetes: Can it benefit all ages? – A nationwide propensity-matched cohort study
Ji Eun Jun, In-Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung, You-Cheol Hwang
Diabetes Research and Clinical Practice.2021; 180: 109044. CrossRef
Cancer-free Life Expectancy in Small Administrative Areas in South Korea and Its Associations with Regional Health Insurance Premiums
Eunjeong Noh, Hee-Yeon Kang, Jinwook Bahk, Ikhan Kim, Young-Ho Khang
Journal of Korean Medical Science.2021;[Epub] CrossRef
Socioeconomic Status and Mental Health among Low-income Employees: A Systematic Literature Review
Errna Nadhirah Kamalulil, Siti Aisyah Panatik
Pertanika Journal of Social Sciences and Humanities.2021;[Epub] CrossRef
Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach
Camila Vaz, Amanda Cristina Andrade, Uriel Silva, Daniel Rodríguez, Xize Wang, Kari Moore, Amélia Augusta Friche, Ana Victoria Diez-Roux, Waleska Teixeira Caiaffa
International Journal of Environmental Research and Public Health.2020; 17(23): 8956. CrossRef
A publicly well-accepted measure versus an academically desirable measure of health inequality: cross-sectional comparison of the difference between income quintiles with the slope index of inequality
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BMJ Open.2019; 9(6): e028687. CrossRef
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Global Economic Review.2018; 47(3): 337. CrossRef

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