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Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016)
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Goun Park, Wankyo Chung
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Epidemiol Health. 2021;43:e2021021. Published online April 7, 2021
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DOI: https://doi.org/10.4178/epih.e2021021
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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.
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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.
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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
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Scientific Reports.2022;[Epub] CrossRef
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