Author(s): Giltay EJ, Vollaard AM, Kromhout D
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Abstract BACKGROUND: When assessing health status, physicians may focus on objective symptoms and diagnoses, whereas individuals may focus more on subjective symptoms, functional limitations and quality of life. METHODS: In the Zutphen Elderly Study, 710 community-living men (aged 64-84 years) were followed until death for 15 years. Self-rated health was assessed through a single-item question. Physician-rated health was estimated on a Likert scale by physicians after medical history assessment and physical examination. Both health ratings were categorised into three groups. All-cause, cardiovascular and cancer mortality rates were analysed in Cox proportional-hazards models. RESULTS: There were 352 (49.6\%) men who felt healthy and 225 (31.7\%) men with a good physician-rated health. During 15 years of follow-up 503 of 710 men (70.8\%) died, of whom 229 (45.5\%) from cardiovascular causes and 144 (28.6\%) from cancer. Self-rated and physician-rated health both predicted independently all-cause mortality (hazard ratios [HR] for worst vs. best health category: 1.72; 95\% confidence interval [CI]: 1.26-2.33, and 1.77; 95\% CI: 1.36-2.29; respectively; P-values of <0.005). When self-rated and physician-rated health were discordant, mortality risk was highest when physicians had a less favourable view on the health status than the participant. Self-rated health predicted independently cancer mortality (HR 2.41), whereas physician-rated health cardiovascular mortality (HR 2.13). CONCLUSION: Self-rated and physician-rated health status predicted both all-cause mortality, and showed a differential pattern for cancer and cardiovascular diseases mortality.
This article was published in Age Ageing
and referenced in Journal of Gerontology & Geriatric Research