Self-Rated Health Predicts Mortality in Very Old Men—the Manitoba Follow-Up Study

Abstract

Background
Self-rated health (SRH) predicts death, but there are few studies over long-time horizons that are able to explore the effect age may have on the relationship between SRH and mortality.

Objectives
1. To determine how SRH evolves over 20 years; and 2. To determine if SRH predicts death in very old men.

Methods
We analyzed a prospective cohort study of men who were fit for air crew training in the Second World War. In 1996, a regular questionnaire was administered to the 1,779 surviving participants. SRH was elicited with a 5-point Likert Scale with the categories: excellent, very good, good, fair and poor/bad. We examined the age-specific distribution of SRH in these categories from the age of 75 to 95 years, to the end of the follow-up period in 2018. We constructed age-specific Cox proportional hazard models with an outcome of time to death.

Results
SRH declined with age. The gradient in risk of death persisted across all ages; those with poor/fair/bad SRH had consistently higher mortality rates. However, the discrimination between good and excellent was less in those aged 85+.

Conclusions
SRH declines with advancing age, but continues to predict death in older men.