SELF-RATED HEALTH AND MORTALITY IN CHINESE INSTITUTIONAL ELDERLY PERSONS

The relationship between self-rated health (SRH) and subsequent mortal ity was examined in a cohort of 411 Chinese elderly individuals living in institutions. SRH was assessed by a global health rating, by compa ring health with others of the same age, and by perception of recent p hysical condition. Covariates including age, sex, daily activity funct ion, instrumental daily activity function, cognitive function, self-re ported Visual acuity, urinary function, number of chronic conditions, number of medications, and history of falls were controlled by the Cox proportional hazard model. Elderly people who rated their global heal th as ''fair or poor had increased mortality compared to those in the ''good'' category (RR = 6.00; 95% CI 1.39-25.1) and a borderline signi ficant increase in mortality risk for those who rated themselves in th e ''average'' category (RR = 4.05; 95% CI 0.93-17.70). Elderly people who compared their health with others of the same age as ''worse or wo rst'' and ''similar'' had an RR of 2.75; 95% CI of 0.64-11.83 and RR o f 2.40; 95% CI of 0.64-8.96, respectively. Elderly people who rated th eir physical symptoms as ''moderate or severe'' and ''slight'' had an RR of 2.54; 95% CI 0.65-9.80 and RR of 1.05; 95% CI 0.32-3.41, respect ively. Age, institutional factors, and history of multiple falls were associated with an increased risk of mortality. We concluded that only the global health rating has direct predictive power for mortality in institutionalized elderly people. (C) 1997 Elsevier Science Inc.