@article{3085864,
    title = "Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium",
    author = "Bamia, C. and Orfanos, P. and Juerges, H. and Schöttker, B. and Brenner, H. and Lorbeer, R. and Aadahl, M. and Matthews, C.E. and Klinaki, E. and Katsoulis, M. and Lagiou, P. and Bueno-de-mesquita, H.B. and Eriksson, S. and Mons, U. and Saum, K.-U. and Kubinova, R. and Pajak, A. and Tamosiunas, A. and Malyutina, S. and Gardiner, J. and Peasey, A. and de Groot, L.C. and Wilsgaard, T. and Boffetta, P. and Trichopoulou, A. and Trichopoulos, D.",
    journal = "Maturitas",
    year = "2017",
    volume = "103",
    pages = "37-44",
    publisher = "Elsevier Ireland Ltd",
    issn = "0378-5122",
    doi = "10.1016/j.maturitas.2017.06.023",
    keywords = "accounting;  aged;  alcohol consumption;  anthropometry;  Article;  body mass;  cancer mortality;  cardiovascular mortality;  cause of death;  cohort analysis;  controlled study;  demography;  European;  female;  follow up;  health;  human;  lifestyle;  male;  marriage;  medical history;  physical activity;  prospective study;  self rated health;  social psychology;  United States;  cardiovascular disease;  epidemiology;  Europe;  health status;  meta analysis;  mortality;  neoplasm;  proportional hazards model;  self report, Cardiovascular Diseases;  Europe;  Health Status;  Humans;  Neoplasms;  Proportional Hazards Models;  Prospective Studies;  Self Report;  United States",
    abstract = "Objectives To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”. Study design Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. Main outcome measures All-cause, cardiovascular and cancer mortality. Results Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). Conclusion SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”. © 2017"
}