Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults

BMC Geriatrics

Minna Löppönen¹  Marika Salminen²  Tero Vahlberg³  Elisa Heikkilä⁴  Kerttu Irjala⁴  Päivi Korhonen⁵  Raimo Isoaho⁶  Sirkka-Liisa Kivelä⁷  Laura Viikari⁸  Maarit Wuorela⁸  Matti Viitanen⁹  Anna Viljanen^1,10 

[1] City of Raisio, Social and Health Care for Elderly, Sairaalakatu 5, 21200, Raisio, Finland;City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Biostatistics, University of Turku, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLAB, 20521, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland;City of Vaasa, Social and Health Care, Ruutikellarintie 4, 65101, Vaasa, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University Hospital, 20014, Turku, Finland;Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland;City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland;Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, Sweden;Municipality of Lieto, Health Care Center, Hyvättyläntie 7, 21420, Lieto, Finland;Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland;

关键词: Institutionalization;    Mortality;    Objective health;    Older people;    Registered illnesses;    Self-rated health;    Subjective health;   

DOI  :  10.1186/s12877-021-02311-w

来源: Springer

【 摘 要 】

BackgroundObjective health measures, such as registered illnesses or frailty, predict mortality and institutionalization in older adults. Also, self-reported assessment of health by simple self-rated health (SRH) has been shown to predict mortality and institutionalization. The aim of this study was to assess the association of objective and subjective health with mortality and institutionalization in Finnish community-dwelling older adults.MethodsIn this prospective study with 10- and 18-year follow-ups, objective health was measured by registered illnesses and subjective health was evaluated by simple SRH, self-reported walking ability (400 m) and self-reported satisfaction in life. The participants were categorized into four groups according to their objective and subjective health: 1. subjectively and objectively healthy, 2. subjectively healthy and objectively unhealthy, 3. subjectively unhealthy and objectively healthy and 4. subjectively and objectively unhealthy. Cox regression model was used in the analyses. Death was used as a competing factor in the institutionalization analyses.ResultsThe mean age of the participants (n = 1259) was 73.5 years (range 64.0–100.0). During the 10- and 18-year follow-ups, 466 (37%) and 877 (70%) died, respectively. In the institutionalization analyses (n = 1106), 162 (15%) and 328 (30%) participants were institutionalized during the 10- and 18-year follow-ups, respectively. In both follow-ups, being subjectively and objectively unhealthy, compared to being subjectively and objectively healthy, was significantly associated with a higher risk of institutionalization in unadjusted models and with death both in unadjusted and adjusted models.ConclusionsThe categorization of objective and subjective health into four health groups was good at predicting the risk of death during 10- and 18-year follow-ups, and seemed to also predict the risk of institutionalization in the unadjusted models during both follow-ups. Poor subjective health had an additive effect on poor objective health in predicting mortality and could therefore be used as part of an older individual’s health evaluation when screening for future adverse outcomes.

【 授权许可】

CC BY