Self-perceptions can predict future health events for older people

An older person’s perceptions of their health – known as health-related liveability (HRQoL) – may predict their health in the future, according to new Monash research.

Four studies led by researchers at the Monash School of Public Health and Preventive Medicine found that self-perceptions of health were a valuable tool to assist in identifying older adults at risk of death and adverse health events, and were able to assist physicians in patient care.

In the latest study, researchers found that older adults who reported a decline in physical aspects of liveability over nearly five years were 51% more likely to develop cardiovascular disease compared with those who reported high physical HRQoL. A consistently low physical HRQoL trajectory was associated with greater chance of stardom compared to the highest ranking.

Researchers analyzed self-reported quality of life data in 16,871 participants in the ASPREE (ASPirin in reducing events in the elderly) problem and tracked their health for a further two years in the next ASPREE-XT study. Study participants were mostly over 70 years old, healthy and living independently in Australia and the US at enrollment in ASPREE. Participants reported HRQoL – a method of assessing aspects of their physical, psychological and social (mental) well-being – at the start of the study and annually averaged 4.7 years.

Sixty-seven percent of participants consistently rated their physical HRQoL in the high category; 13% if intermediate; 14% as decreasing; and 7% so low.

Previously, in separate analyzes of ASPREE data that only examined HRQoL at the beginning of the study, researchers found:

  • Better physical HRQoL at enrollment was associated with lower risks of cardiovascular disease (14%), cognitive decline (6%), and death (17%) over an average of 4.7 years.
  • Higher mental HRQoL at baseline was associated with lower risks of cognitive decline (12%) and dementia (15%) over the same period.
  • The strong correlation between low physical HRQoL at enrollment and cardiovascular disease and death led researchers to the final analysis, monitoring participants’ health perceptions (i.e. HRQoL) over a longer period of almost five years.

Lead researcher and PhD candidate Aung Zaw Zaw Phyo said: “The studies indicate that self-reported HRQoL could be used to supplement objective measures such as weight, blood pressure and cholesterol in outpatient health evaluations and care.

“Our research reinforces the importance of HRQoL as a predictive measure of cardiovascular disease, dementia, cognitive decline and death among older adults living independently in later life.”

The studies – reported in papers published in four separate journals – were conducted with Monash researchers Dr Rosanne Freak-Poli and Associate Professor Joanne Ryan, together with Associate Professor David Gonzalez-Chica and Professor Nigel Stocks of Adelaide Medical School (University of Adelaide) and co-researchers from the University of Tasmania and Curtin University (Australia); the University of Edinburgh (UK); and Rush University Medical Center and Hennepin HealthCare Research Institute (USA).

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Self-perceptions can predict future health events for older people

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