SELF-RATED HEALTH, MORTALITY, AND CHRONIC DISEASES IN ELDERLY MEN - THE ZUTPHEN STUDY, 1985-1990

The value of self-rated health in predicting mortality and the inciden ce of chronic diseases was studied in a cohort of 783 elderly Dutch me n in the Zutphen Study. In 1985, 48% of the men felt ''healthy'', whil e 12% felt ''moderately healthy'' or ''not healthy.'' As of 1990, 23% of the 783 men had died. Survival analysis showed that self-rated heal th was highly predictive of subsequent 5-year mortality from all cause s (p < 0.001). When adjusted for the presence of major chronic disease s, age, medication use, smoking, alcohol consumption, physical activit y, body mass index, systolic blood pressure, serum cholesterol, educat ion, marital status, and family history of chronic diseases, the relat ive risk for ''moderately healthy'' or ''not healthy'' men compared wi th ''healthy'' men was 2.7 (95% confidence interval (Cl) 1.8-4.3). Ana lysis of cause-specific mortality revealed that self-rated health was associated with cardiovascular mortality (crude relative risk (RR) = 2 .7), but this finding resulted mainly from confounding by baseline pre valence of cardiovascular diseases (adjusted RR = 1.9, 95% Cl 0.9-3.8) . However, self-rated health was an independent risk factor for cancer mortality (adjusted RR = 4.2, 95% Cl 1.9-9.4) and mortality due to ot her causes (adjusted RR = 3.0, 95% Cl 1.2-7.8). Self-rated health did not independently predict the incidence of chronic diseases. This sugg ests that self-rated health especially affects fatality from chronic d iseases rather than their onset, and this issue should be pursued furt her.