Evolution of self-rated health status in the elderly: Cross-sectional vs. longitudinal estimates

We assessed the perceived health status evolution among elderly subjects an d examined the age-related differences in perceived health when comparing e stimates obtained from cross-sectional and longitudinal approaches. Data co me from a cohort of non-institutionalized individuals aged 65 years or olde r, living in Barcelona, Spain. One thousand three hundred fifteen (1315) el derly were successfully interviewed at baseline in 1986 and 754 (84.6% of t he eligible) at the re-assessment (1993-1994). Estimates of change in perce ived health status were calculated based on cross-sectional and longitudina l approaches. Cross-sectionally, no significant differences in the proporti on of individuals with poor self-rated health were found (40.5 vs. 42.5%, P = 0.90). Among survivors, the proportion of individuals with poor health i ncreased from 37.8% to 55.1% (P < 0.01), an 8.7-fold decline of perceived h ealth when compared with the cross-sectional estimates. Comorbidity (aOR 2. 1; 95%CI: 1.4-3.3) and no education (aOR 1.9; 95%CI: 1.1-3.2) were associat ed with a decline in health status after adjusting by baseline health statu s. We recommend the use of longitudinal studies to understand the evolution of perceived health in the elderly. (C) 2000 Elsevier Science Inc. All rig hts reserved.