Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults
Abstract Background Objective 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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-021-02311-w |
| _version_ | 1798034983613366272 |
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| author | Anna Viljanen Marika Salminen Kerttu Irjala Elisa Heikkilä Raimo Isoaho Sirkka-Liisa Kivelä Päivi Korhonen Tero Vahlberg Matti Viitanen Maarit Wuorela Minna Löppönen Laura Viikari |
| author_facet | Anna Viljanen Marika Salminen Kerttu Irjala Elisa Heikkilä Raimo Isoaho Sirkka-Liisa Kivelä Päivi Korhonen Tero Vahlberg Matti Viitanen Maarit Wuorela Minna Löppönen Laura Viikari |
| author_sort | Anna Viljanen |
| collection | DOAJ |
| description | Abstract Background Objective 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. Methods In 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. Results The 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. Conclusions The 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. |
| first_indexed | 2024-04-11T20:51:55Z |
| format | Article |
| id | doaj.art-5c743258dee8493098ec74e476268305 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-11T20:51:55Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-5c743258dee8493098ec74e4762683052022-12-22T04:03:49ZengBMCBMC Geriatrics1471-23182021-06-012111910.1186/s12877-021-02311-wSubjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adultsAnna Viljanen0Marika Salminen1Kerttu Irjala2Elisa Heikkilä3Raimo Isoaho4Sirkka-Liisa Kivelä5Päivi Korhonen6Tero Vahlberg7Matti Viitanen8Maarit Wuorela9Minna Löppönen10Laura Viikari11Municipality of Lieto, Health Care CenterCity of Turku, Welfare DivisionFaculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLABFaculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLABFaculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University HospitalFaculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University HospitalFaculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku and Turku University HospitalFaculty of Medicine, Department of Clinical Medicine, Unit of Biostatistics, University of TurkuFaculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City HospitalFaculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City HospitalCity of Raisio, Social and Health Care for ElderlyFaculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, FI-20014 University of Turku, Turku City HospitalAbstract Background Objective 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. Methods In 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. Results The 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. Conclusions The 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.https://doi.org/10.1186/s12877-021-02311-wInstitutionalizationMortalityObjective healthOlder peopleRegistered illnessesSelf-rated health |
| spellingShingle | Anna Viljanen Marika Salminen Kerttu Irjala Elisa Heikkilä Raimo Isoaho Sirkka-Liisa Kivelä Päivi Korhonen Tero Vahlberg Matti Viitanen Maarit Wuorela Minna Löppönen Laura Viikari Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults BMC Geriatrics Institutionalization Mortality Objective health Older people Registered illnesses Self-rated health |
| title | Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults |
| title_full | Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults |
| title_fullStr | Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults |
| title_full_unstemmed | Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults |
| title_short | Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults |
| title_sort | subjective and objective health predicting mortality and institutionalization an 18 year population based follow up study among community dwelling finnish older adults |
| topic | Institutionalization Mortality Objective health Older people Registered illnesses Self-rated health |
| url | https://doi.org/10.1186/s12877-021-02311-w |
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