PREDICTORS OF PERCEIVED HEALTH IN HOSPITALIZED OLDER PERSONS - A CROSS-SECTIONAL AND LONGITUDINAL-STUDY

OBJECTIVES: To identify the predictors of perceived health and predict ors of changes in perceived health in frail hospitalized older persons during the year after hospitalization. DESIGN: Both cross-sectional a nd longitudinal multivariate analysis of data from a cohort followed f or 1 year. SETTING: Six hospitals in a group practice model health mai ntenance organization (HMO) in Southern California. PARTICIPANTS: A to tal of 1889 persons aged 65 or older who met at least one of 13 inclus ionary criteria for a randomized trial of Comprehensive Geriatric Asse ssment consultation at admission and completed three Functional and He alth Status Questionnaires (FHSQ) during a 12-month period. MEASUREMEN TS: Functional and health status measures included basic and intermedi ate activities of daily living (BADL and IADL) and social activities ( SA) scales from the Functional Status Questionnaire as well as the men tal health index (MHI) and current health perception (CHP) scales from the Medical Outcomes Study short form. Subject's severity of disease was measured by the Resource Demand Scale (RD Scale). RESULTS: In the cross-sectional analyses, MHI score, IADL score, RD Scale, history of falls during the 3 months before hospitalization, and female gender we re significant predictors of perceived health in all models for each t ime point. BADL score, age, presence of incontinence, and ethnicity we re significant in the model for baseline only, and SA score was signif icant in models for 3 months and 12 months only. In the longitudinal a nalyses, the baseline CHP score and the changes in MHI, IADL, and BADL score predicted CHP change from 0 to 3 months and from 3 to 12 months . CONCLUSIONS: Functional and psychosocial health indicaters are the m ost important and most consistent predictors of perceived health. Our study showed that several predictors of perceived health in cross-sect ional analysis did not predict changes in perceived health over a 1-ye ar period. Hence, to fully understand the medical and social contribut ors to perceived health, a comprehensive approach using both cross-sec tional and longitudinal analyses is necessary.