• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Feb 2000; 54(2): 123–129.
PMCID: PMC1731623

The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults


OBJECTIVE—To examine the extent to which older people's self assessments of general health, physical health, and mental health predict functional decline and mortality.
DESIGN—The study uses population-based secondary data from the US Longitudinal Study of Aging (LSOA).
PARTICIPANTS—A total of 7527 persons aged 70 years or above living in the community.
METHODS—Eight different measures on self reported general, physical, and mental health were used. Change in functional status was measured using a composite index of ADLs and IADLs over a period of six years. Duration of survival was calculated over a period of seven years. Adjusting for age and gender, multiple logistic regression was used in analysing functional decline, and Cox proportional hazard model, for mortality. Then all of the self assessed health measures were incorporated into the final model—controlling for baseline sociodemographic characteristics, functional status, disease/conditions, and use of health and social services—to assess the independent contribution of each measure in predicting future health outcomes.
MAIN RESULTS—Overall, older people's self assessed general, physical, and mental health were predictive of functional decline and mortality. In multivariate analyses, older people who assessed their global health, self care ability, and physical activity less favourably were more likely to experience poor health outcomes. Gender disparity, however, was observed with poor global health affecting functional decline in men only. Self care ability was predictive of functioning in women only, whereas it was predictive of mortality in men only.
CONCLUSIONS—Self assessed global health, as well as, specific dimensions of health act as significant, independent predictors of functioning and mortality in a community dwelling older people.

Keywords: age; self assessed health; functional status; mortality

Full Text

The Full Text of this article is available as a PDF (143K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Idler EL, Kasl SV, Lemke JH. Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington counties, Iowa, 1982-1986. Am J Epidemiol. 1990 Jan;131(1):91–103. [PubMed]
  • Kaplan G, Barell V, Lusky A. Subjective state of health and survival in elderly adults. J Gerontol. 1988 Jul;43(4):S114–S120. [PubMed]
  • Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983 Mar;117(3):292–304. [PubMed]
  • Mor V, Wilcox V, Rakowski W, Hiris J. Functional transitions among the elderly: patterns, predictors, and related hospital use. Am J Public Health. 1994 Aug;84(8):1274–1280. [PMC free article] [PubMed]
  • Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982 Aug;72(8):800–808. [PMC free article] [PubMed]
  • Wolinsky FD, Johnson RJ. Perceived health status and mortality among older men and women. J Gerontol. 1992 Nov;47(6):S304–S312. [PubMed]
  • Grant MD, Piotrowski ZH, Chappell R. Self-reported health and survival in the Longitudinal Study of Aging, 1984-1986. J Clin Epidemiol. 1995 Mar;48(3):375–387. [PubMed]
  • Hays JC, Schoenfeld D, Blazer DG, Gold DT. Global self-ratings of health and mortality: hazard in the North Carolina Piedmont. J Clin Epidemiol. 1996 Sep;49(9):969–979. [PubMed]
  • Idler EL, Angel RJ. Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study. Am J Public Health. 1990 Apr;80(4):446–452. [PMC free article] [PubMed]
  • McCallum J, Shadbolt B, Wang D. Self-rated health and survival: a 7-year follow-up study of Australian elderly. Am J Public Health. 1994 Jul;84(7):1100–1105. [PMC free article] [PubMed]
  • Schoenfeld DE, Malmrose LC, Blazer DG, Gold DT, Seeman TE. Self-rated health and mortality in the high-functioning elderly--a closer look at healthy individuals: MacArthur field study of successful aging. J Gerontol. 1994 May;49(3):M109–M115. [PubMed]
  • Idler EL, Kasl SV. Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci. 1995 Nov;50(6):S344–S353. [PubMed]
  • Palmore EB, Burchett BM. Predictors of disability in the final year of life. J Aging Health. 1997 Aug;9(3):283–297. [PubMed]
  • Wolinsky FD, Stump TE, Clark DO. Antecedents and consequences of physical activity and exercise among older adults. Gerontologist. 1995 Aug;35(4):451–462. [PubMed]
  • Greiner PA, Snowdon DA, Greiner LH. The relationship of self-rated function and self-rated health to concurrent functional ability, functional decline, and mortality: findings from the Nun Study. J Gerontol B Psychol Sci Soc Sci. 1996 Sep;51(5):S234–S241. [PubMed]
  • Bernard SL, Kincade JE, Konrad TR, Arcury TA, Rabiner DJ, Woomert A, DeFriese GH, Ory MG. Predicting mortality from community surveys of older adults: the importance of self-rated functional ability. J Gerontol B Psychol Sci Soc Sci. 1997 May;52(3):S155–S163. [PubMed]
  • Kempen GI, Miedema I, van den Bos GA, Ormel J. Relationship of domain-specific measures of health to perceived overall health among older subjects. J Clin Epidemiol. 1998 Jan;51(1):11–18. [PubMed]
  • Kempen GI. The MOS Short-Form General Health Survey: single item vs multiple measures of health-related quality of life: some nuances. Psychol Rep. 1992 Apr;70(2):608–610. [PubMed]
  • Spector WD, Katz S, Murphy JB, Fulton JP. The hierarchical relationship between activities of daily living and instrumental activities of daily living. J Chronic Dis. 1987;40(6):481–489. [PubMed]
  • Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed]
  • Krause NM, Jay GM. What do global self-rated health items measure? Med Care. 1994 Sep;32(9):930–942. [PubMed]
  • Clark DO. The effect of walking on lower body disability among older blacks and whites. Am J Public Health. 1996 Jan;86(1):57–61. [PMC free article] [PubMed]
  • Mor V, Murphy J, Masterson-Allen S, Willey C, Razmpour A, Jackson ME, Greer D, Katz S. Risk of functional decline among well elders. J Clin Epidemiol. 1989;42(9):895–904. [PubMed]
  • Gill TM, Williams CS, Richardson ED, Tinetti ME. Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M283–M288. [PubMed]
  • Greiner PA, Snowdon DA, Schmitt FA. The loss of independence in activities of daily living: the role of low normal cognitive function in elderly nuns. Am J Public Health. 1996 Jan;86(1):62–66. [PMC free article] [PubMed]
  • Mihelic AH, Crimmins EM. Loss to folow-up in a sample of Americans 70 years of age and older: The LSOA 1984-1990. J Gerontol B Psychol Sci Soc Sci. 1997 Jan;52(1):S37–S48. [PubMed]
  • Kivinen P, Halonen P, Eronen M, Nissinen A. Self-rated health, physician-rated health and associated factors among elderly men: the Finnish cohorts of the Seven Countries Study. Age Ageing. 1998 Jan;27(1):41–47. [PubMed]
  • Mulsant BH, Ganguli M, Seaberg EC. The relationship between self-rated health and depressive symptoms in an epidemiological sample of community-dwelling older adults. J Am Geriatr Soc. 1997 Aug;45(8):954–958. [PubMed]
  • Johnson RJ, Wolinsky FD. The structure of health status among older adults: disease, disability, functional limitation, and perceived health. J Health Soc Behav. 1993 Jun;34(2):105–121. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...