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AJPH First Look, published online ahead of print Sep 29, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.050914

Research and Practice

The Contribution of Self-Rated Health and Depressive Symptoms to Disability Severity As Predictor of 10-Year Mortality in European Elderly Men

Carolien L. van den Brink 1*, Marja Tijhuis 1, Geertrudis A.M. van den Bos 2, Simona Giampaoli 3, Aulikki Nissinen 4, Daan Kromhout 1

1 National Institute for Public Health and the Environment
2 Academic Medical Center, University of Amsterdam
3 Instituto Superiore di Sanita
4 National Public Health Institute

* To whom correspondence should be addressed. E-mail: carolienvandenbrink{at}wanadoo.nl.


  Abstract

Objectives: To investigate the effect of disability severity and the contribution of self-rated health and depressive symptoms to 10-year mortality. Methods: Longitudinal data was collected of 1,141 men aged 70-89 years from the Finland, Italy, and the Netherlands Elderly Study in the period 1990-2000. Disability severity was classified into four categories: no disability, instrumental activities, mobility, and basic activities of daily living. Self-rated health and depressive symptoms were classified into two and three categories respectively. Multivariate Cox proportional hazard models were used to calculate mortality risks. Results: Men with severe disability had a more than twofold (2.41; 95% confidence interval 1.84-3.16) higher risk of mortality than men without disability. Men who had severe disability and felt not healthy had the highest mortality risk (HR: 3.30; 95% CI: 2.52, 4.33). This risk was lower at lower levels of disability and higher levels of self-rated health. The same trend was observed for depressive symptoms. Conclusions: For adequate prognoses on mortality or for developing intervention strategies, not only physical aspects of health, but also other health outcomes should be taken into account.

Key Words: Aging, Disability, Epidemiology, Mortality




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