Skip to main content

Advertisement

SpringerLink
Log in

The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years.

Methods

During the years 2000–2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality.

Results

A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71–6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25–3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01).

Conclusions

Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mavaddat, N., Parker, R. A., Sanderson, S., Mant, J., & Kinmonth, A. L. (2014). Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: A systematic review and meta-analysis. PLoS ONE, 9(7), e103509.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Okamoto, K., Momose, Y., Fujino, A., & Osawa, Y. (2008). Gender differences in the relationship between self-rated health (SRH) and 6-year mortality risks among the elderly in Japan. Archives of Gerontology and Geriatrics, 47, 311–317.

    Article  PubMed  Google Scholar 

  3. McEwen, L. N., Kim, C., Haan, M. N., Ghosh, D., Lantz, P. M., Thompson, T. J., & Herman, W. H. (2009). Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD). Primary Care Diabetes, 3, 37–42.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bopp, M., Braun, J., Gutzwiller, F., & Faeh, D. (2012). Swiss National Cohort Study Group. Health risk or resource? Gradual and independent association between self-rated health and mortality persists over 30 years. PLoS ONE, 7, e30795.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Giltay, E. J., Vollaard, A. M., & Kromhout, D. (2012). Netherlands self-rated health and physician-rated health as independent predictors of mortality in elderly men. Age and Ageing, 41, 165–171.

    Article  PubMed  Google Scholar 

  6. Lima-Costa, M. F., Cesar, C. C., Chor, D., & Proietti, F. A. (2012). Self-rated health compared with objectively measured health status as a tool for mortality risk screening in older adults: 10-year follow-up of the Bambuí Cohort Study of Aging. American Journal of Epidemiology, 175, 228–235.

    Article  PubMed  Google Scholar 

  7. Halford, C., Wallman, T., Welin, L., Rosengren, A., Bardel, A., Johansson, S., et al. (2012). Effects of self-rated health on sick leave, disability pension, hospital admissions and mortality. A population-based longitudinal study of nearly 15,000 observations among Swedish women and men. BMC Public Health, 12, 1103.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tamayo-Fonseca, N., Quesada, J. A., Nolasco, A., Melchor, I., Moncho, J., Pereyra-Zamora, P., et al. (2013). Self-rated health and mortality: A follow-up study of a Spanish population. Public Health, 127, 1097–1104.

    Article  CAS  PubMed  Google Scholar 

  9. Berger, N., Van der Heyden, J., & Van Oyen, H. (2015). The global activity limitation indicator and self-rated health: Two complementary predictors of mortality. Archives of Public Health, 73(1), 25.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Desalvo, K. B., & Muntner, P. (2011). Discordance between physician and patient self-rated health and all-cause mortality. The Ochsner Journal, 11, 232–240.

    PubMed  PubMed Central  Google Scholar 

  11. Benyamini, Y., Blumstein, T., Lusky, A., & Modan, B. (2003). Gender differences in the self-rated health-mortality association: Is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? Gerontologist, 43, 396.

    Article  PubMed  Google Scholar 

  12. Henry, P., Thomas, F., Benetos, A., & Guize, L. (2002). Impaired fasting glucose, blood pressure and cardiovascular disease mortality. Hypertension, 40, 458–463.

    Article  CAS  PubMed  Google Scholar 

  13. Wen, C. P., Cheng, T. Y., Tsai, S. P., Hsu, H. L., & Wang, S. L. (2005). Increased mortality risks of pre-diabetes (impaired fasting glucose) in Taiwan. Diabetes Care, 28, 2756–2761.

    Article  PubMed  Google Scholar 

  14. McMaster University Evidence Based Practice Center. (2014). Diagnosis, prognosis and treatment of impaired glucose tolerance and impaired fasting glucose. Evidence Report 128. http://archive.ahrq.gov/downloads/pub/evidence/pdf/impglucose/impglucose.pdf. Accessed May 23, 2014.

  15. Barr, E. L., Zimmet, P. Z., Welborn, T. A., Jolley, D., Magliano, D. J., Dunstan, D. W., et al. (2007). Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation, 116, 151–157.

    Article  CAS  PubMed  Google Scholar 

  16. Huang, Y., Cai, X., Chen, P., Mai, W., Tang, H., Huang, Y., & Hu, Y. (2014). Associations of prediabetes with all-cause and cardiovascular mortality: A meta-analysis. Annals of Medicine, 46(8), 684–692.

    Article  CAS  PubMed  Google Scholar 

  17. Trivin, C., Metzger, M., Haymann, J. P., Boffa, J. J., Flamant, M., Vrtovsnik, F., et al. (2015). Glycated hemoglobin level and mortality in a nondiabetic population with CKD. Clinical Journal of the American Society of Nephrology, 10(6), 957–964.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hiltunen, L. (2005). Ten-year mortality and glucose tolerance status in an elderly Finnish population. Diabetes Research and Clinical Practice, 69, 81–87.

    Article  CAS  PubMed  Google Scholar 

  19. Wennberg, P., Rolandsson, O., Van der A, D. L., Spijkerman, A. M., Kaaks, R., Boeing, H., et al. (2013). Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study: A case-cohort study. BMJ Open, 3, e002436.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Andersson, S., Ekman, I., Friberg, F., Daka, B., Lindblad, U., & Larsson, C. A. (2013). The association between self-rated health and impaired glucose tolerance in Swedish adults: A cross-sectional study. Scandinavian Journal of Primary Health Care, 31, 111–118.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Modan, M., Halkin, H., Almog, S., Lusky, A., Eshkol, A., Shefi, M., et al. (1985). Hyperinsulinemia: A link between hypertension obesity and glucose intolerance. Journal of Clinical Investigation, 1985(75), 809–817.

    Article  Google Scholar 

  22. Knol, M. J., & VanderWeele, T. J. (2012). Recommendations for presenting analyses of effect modification and interaction. International Journal of Epidemiology, 41, 514–520. doi:10.1093/ije/dyr218.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wennberg, P., Rolandsson, O., Jerdén, L., Boeing, H., Sluik, D., Kaaks, R., et al. (2012). Self-rated health and mortality in individuals with diabetes mellitus: Prospective cohort study. BMJ Open, 2, e000760.

    Article  PubMed  PubMed Central  Google Scholar 

  24. de Fine Olivarius, N., Siersma, V., Nielsen, A. B., Hansen, L. J., Rosenvinge, L., & Mogensen, C. E. (2010). Predictors of mortality of patients newly diagnosed with clinical type 2 diabetes: A 5-year follow up study. BMC Endocrine Disorders, 10, 14.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Leosdottir, M., Willenheimer, R., Persson, M., & Nilsson, P. M. (2011). The association between glucometabolic disturbances, traditional cardiovascular risk factors and self-rated health by age and gender: A cross-sectional analysis within the Malmö Preventive Project. Cardiovasc Diabetol, 10, 118.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Dankner, R., Geulayov, G., Olmer, L., & Kaplan, G. (2009). Undetected type 2 diabetes in older adults. Age and Ageing, 38(1), 56–62.

    Article  PubMed  Google Scholar 

  27. Latham, K., & Peek, C. W. (2013). Self-rated health and morbidity onset among late midlife U.S. adults. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 68, 107–116.

    Article  Google Scholar 

  28. Jørgensen, P., Langhammer, A., Krokstad, S., & Forsmo, S. (2015). Diagnostic labelling influences self-rated health. A prospective cohort study: The HUNT Study, Norway. Family Practice, 32(5), 492–499.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Benjamins, M. R., Hummer, R. A., Eberstein, I. W., & Nam, C. B. (2004). Self-reported health and adult mortality risk: An analysis of cause-specific mortality. Social Science and Medicine, 59, 1297–1306.

    Article  PubMed  Google Scholar 

  30. Mavaddat, N., Parker, R. A., Sanderson, S., Mant, J., & Kinmonth, A. L. (2014). Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: A systematic review and meta-analysis. PLoS ONE, 9, e103509.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Deedwania, P., Patel, K., Fonarow, G. C., Desai, R. V., Zhang, Y., Feller, M. A., et al. (2013). Prediabetes is not an independent risk factor for incident heart failure, other cardiovascular events or mortality in older adults: Findings from a population-based cohort study. International Journal of Cardiology, 168, 3616–3622.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Shah, R. V., Abbasi, S. A., Yamal, J. M., Davis, B. R., Barzilay, J., Einhorn, P. T., et al. (2014). Impaired fasting glucose and body mass index as determinants of mortality in ALLHAT: Is the obesity paradox real? The Journal of Clinical Hypertension (Greenwich), 16, 451–458.

    Article  Google Scholar 

  33. Cerasi, E., Ependic, S., & Luft, R. (1973). Dose-response relation between plasma-insulin and blood-glucose levels during oral glucose loads in prediabetic and diabetic subjects. Lancet, 1, 794–797.

    Article  CAS  PubMed  Google Scholar 

  34. DECODE Study Group. (2003). Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts. Diabetes Care, 26, 61–69.

    Article  Google Scholar 

Download references

Acknowledgments

This work was supported by the Sapir Pais Foundation and Israeli Ministry of Health.

Author contributions

Dankner was responsible for study concept and design. Dankner and Chetrit were responsible for acquisition of subjects and data. Dankner, Chetrit, Olmer, and Kaplan participated in analysis and interpretation of data and preparation of the manuscript.

Sponsor’s role

The sponsor had no role in the design, methods, subject recruitment, data collection, analysis, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel

    R. Dankner & A. Chetrit

  2. Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, 61390, Ramat Aviv, Tel Aviv, Israel

    R. Dankner

  3. Patient Oriented Research, The Feinstein Institute for Medical Research, Manhasset, North Shore, NY, 11030, USA

    R. Dankner

  4. Biostatistics Unit, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel

    L. Olmer

  5. Psychosocial Aspects of Health, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Tel Hashomer, Israel

    G. Kaplan

Authors
  1. R. Dankner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Olmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Kaplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Chetrit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Dankner.

Ethics declarations

Conflict of interest

Dankner, Chetrit, Olmer, and Kaplan have no conflict of interest to disclose with the supporting institutions.

Informed consent

This study was approved by the institutional review board. All participants signed an informed consent form.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 41 kb)

Supplementary material 2 (DOC 54 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dankner, R., Olmer, L., Kaplan, G. et al. The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women. Qual Life Res 25, 2889–2896 (2016). https://doi.org/10.1007/s11136-016-1291-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-016-1291-9

Keywords

Search

Navigation