Association of individual activities of daily living with self-rated health in older people

Objective: to evaluate the associations of 18 activities of daily living wi th self-rated health in older people. Design and setting: cross-sectional study of a representative sample of 781 people aged 65 or over (response rate: 89.9%). Methods: self-rated health was assessed by the question: "Overall, how woul d you rate your current health status-very good, good, fair, poor or very p oor?" We used the Barthel index and Lawton and Brody's index for basic and instrumental activities of daily living, respectively. We classified subjec ts into three groups according to their Barthel index score: level 1 (score 100), level 2 (score 91 -99) and level 3 (score 0- 90). Logistic regressio n was used to identify associations between each activity and self-rated he alth. Results: use of stairs [odds ratio (OR) = 4.28, 95% confidence interval (95 % CI): 2.82-6.52], ambulation (OR = 3.67, 95% CI: 2.39-5.64) and chair/bed transfer (OR = 3.00, 95% CI: 1.68-5.36) were the basic activities of daily living best associated with self-rated health. Among instrumental activitie s of daily living, ability to handle finances (OR = 2.20), laundry (OR = 2. 15) and transport (OR = 2.12) were associated with self-rated health. On th e Barthel index, only transport was associated with self-rated health in su bjects at levels 1 (OR = 2.55) and 2 (OR = 2.72). For subjects with poor fu nctional status (leveI 3), no instrumental activities of daily living were related to self-rated health. Conclusion: in terms of self-rated health, the most important activities of daily living were those involving mobility. The effect of each instrumenta l activity of daily living on self-rated health depends on the level of fun ctional capacity in basic activities of daily living.