SELF-PERCEIVED HEALTH AND 5-YEAR MORTALITY RISKS AMONG THE ELDERLY INSHANGHAI, CHINA

Studies of the elderly worldwide over the last 3 decades have reported that a self-rating of ''poor'' compared with ''excellent/good'' healt h increases the relative risk of dying. The authors tested the strengt h of this association by performing age-stratified Cox regression anal yses on a 5-year longitudinal study of a representative sample of noni nstitutionalized elderly aged 65 years and older (n = 3,094) in a dist rict of Shanghai, China. More than 20 potential confounders that were only partially controlled in other studies and threats to response val idity due to cognitive impairment or diagnosed dementia that were not considered in previous studies were taken into account in this analysi s. The results showed that among those aged 65-74 years, ''poor'' perc eived health increases the adjusted relative risk of death by 1.93 (95 % confidence interval 1.20-3.11) compared with ''excellent/good'' heal th. The adjusted relative risk of a ''fair'' rating of health is 2.16 (95% confidence interval 1.44-3.25). In the order age group, mortality risks for the ratings of fair as well as poor compared with excellent /good health were not statistically significant. The authors posit tha t several mechanisms related to host vulnerability markers and greater -than-expected utilization of health services may explain the associat ion between self-assessed health and mortality risks. Future research should strive to develop more precise measures of these and related va riables.