Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study

Objectives Poor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identifie...

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Main Authors: Barbara C van Munster, Nynke Smidt, Sophia E de Rooij, Marlies Feenstra, Janet L MacNeil Vroomen
Format: Article
Language:English
Published: BMJ Publishing Group 2020-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/2/e035012.full
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author Barbara C van Munster
Nynke Smidt
Sophia E de Rooij
Marlies Feenstra
Janet L MacNeil Vroomen
author_facet Barbara C van Munster
Nynke Smidt
Sophia E de Rooij
Marlies Feenstra
Janet L MacNeil Vroomen
author_sort Barbara C van Munster
collection DOAJ
description Objectives Poor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and setting Prospective general population cohort.Participants Trajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measures Trajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).Results Four stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.Conclusion SRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.
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spelling doaj-art-0544061112174cc4b6d0d39c558e556d2025-02-07T14:10:12ZengBMJ Publishing GroupBMJ Open2044-60552020-02-0110210.1136/bmjopen-2019-035012Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort StudyBarbara C van Munster0Nynke Smidt1Sophia E de Rooij2Marlies Feenstra3Janet L MacNeil Vroomen4Department of Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands5 Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands1 Department of Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands3 Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsObjectives Poor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and setting Prospective general population cohort.Participants Trajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measures Trajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).Results Four stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.Conclusion SRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.https://bmjopen.bmj.com/content/10/2/e035012.full
spellingShingle Barbara C van Munster
Nynke Smidt
Sophia E de Rooij
Marlies Feenstra
Janet L MacNeil Vroomen
Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
BMJ Open
title Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
title_full Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
title_fullStr Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
title_full_unstemmed Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
title_short Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study
title_sort trajectories of self rated health in an older general population and their determinants the lifelines cohort study
url https://bmjopen.bmj.com/content/10/2/e035012.full
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