Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

Objectives Self-rated health (SRH) is an assessment and predictor of health based on an individual’s general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and f...

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Main Authors: Wei-Min Chu, Meng-Chih Lee, Chih-Jung Yeh, Hsin-En Ho, Yu-Han Hsiao, Pi-Shan Hsu, Shu-Hsin Lee
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e049795.full
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author Wei-Min Chu
Meng-Chih Lee
Chih-Jung Yeh
Hsin-En Ho
Yu-Han Hsiao
Pi-Shan Hsu
Shu-Hsin Lee
author_facet Wei-Min Chu
Meng-Chih Lee
Chih-Jung Yeh
Hsin-En Ho
Yu-Han Hsiao
Pi-Shan Hsu
Shu-Hsin Lee
author_sort Wei-Min Chu
collection DOAJ
description Objectives Self-rated health (SRH) is an assessment and predictor of health based on an individual’s general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and frailty among older individuals in Taiwan.Design An 8-year retrospective cohort study.Setting Data were retrieved from the Taiwan Longitudinal Study on Aging from 1999 to 2007.Participants Respondents aged 53–69 years old who were not frail or disabled in 1999 (n=1956).Primary and secondary outcome measures Frailty was defined using the Fried criteria. The group-based trajectory modelling technique was used to estimate SRH trajectories. Logistic regression analysis was used to examine the associations between changes in SRH and frailty.Results Four SRH trajectory classes were identified across the 8-year follow-up: 232 participants (11.9%) were classified into the constantly poor SRH group, 1123 (57.4%) into the constantly fair SRH group, 335 (17.1%) into the constantly good SRH group and 266 (13.6%) into the good-to-fair SRH group. After adjusting for gender, age, level of education, income, social participation, health behaviours and major comorbidities, it was found that age, poor income satisfaction, without job and constantly poor SRH were associated with increased risk of frailty, while constantly good SRH (OR 0.04, 95% CI (0.01 to 0.32)) and good-to-fair SRH (OR 0.19, 95% CI (0.06 to 0.63)) were associated with reduced risks of frailty.Conclusions Constantly poor SRH was associated with an increased risk of frailty in older age. SRH in older adults should be recognised as a predictive tool for future frailty. Diet and exercise interventions may help to prevent frailty among high-risk older individuals with constantly low SRH.
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spelling doaj-art-e5aacd688dc94c6997c52b15d427fa7a2025-08-20T02:38:59ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-049795Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)Wei-Min Chu0Meng-Chih Lee1Chih-Jung Yeh2Hsin-En Ho3Yu-Han Hsiao4Pi-Shan Hsu5Shu-Hsin Lee6School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan15 College of Management, Chaoyang University of Technology, Taichung, Taiwan9 Department of Public Health, Chung Shan Medical University, Taichung, Taiwan6 Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan9 Department of Public Health, Chung Shan Medical University, Taichung, Taiwan1 Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan12 School of Nursing, Chung Shan Medical University, Taichung, TaiwanObjectives Self-rated health (SRH) is an assessment and predictor of health based on an individual’s general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and frailty among older individuals in Taiwan.Design An 8-year retrospective cohort study.Setting Data were retrieved from the Taiwan Longitudinal Study on Aging from 1999 to 2007.Participants Respondents aged 53–69 years old who were not frail or disabled in 1999 (n=1956).Primary and secondary outcome measures Frailty was defined using the Fried criteria. The group-based trajectory modelling technique was used to estimate SRH trajectories. Logistic regression analysis was used to examine the associations between changes in SRH and frailty.Results Four SRH trajectory classes were identified across the 8-year follow-up: 232 participants (11.9%) were classified into the constantly poor SRH group, 1123 (57.4%) into the constantly fair SRH group, 335 (17.1%) into the constantly good SRH group and 266 (13.6%) into the good-to-fair SRH group. After adjusting for gender, age, level of education, income, social participation, health behaviours and major comorbidities, it was found that age, poor income satisfaction, without job and constantly poor SRH were associated with increased risk of frailty, while constantly good SRH (OR 0.04, 95% CI (0.01 to 0.32)) and good-to-fair SRH (OR 0.19, 95% CI (0.06 to 0.63)) were associated with reduced risks of frailty.Conclusions Constantly poor SRH was associated with an increased risk of frailty in older age. SRH in older adults should be recognised as a predictive tool for future frailty. Diet and exercise interventions may help to prevent frailty among high-risk older individuals with constantly low SRH.https://bmjopen.bmj.com/content/11/8/e049795.full
spellingShingle Wei-Min Chu
Meng-Chih Lee
Chih-Jung Yeh
Hsin-En Ho
Yu-Han Hsiao
Pi-Shan Hsu
Shu-Hsin Lee
Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
BMJ Open
title Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
title_full Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
title_fullStr Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
title_full_unstemmed Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
title_short Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)
title_sort self rated health trajectory and frailty among community dwelling older adults evidence from the taiwan longitudinal study on aging tlsa
url https://bmjopen.bmj.com/content/11/8/e049795.full
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