How the combined approach of subjective and functional health improves the early identification of the older adults at risk of adverse events?

Area of Science:

• Gerontology and Public Health
• Epidemiology of Aging
• Health Services Research

Background:

• Assessing both subjective and functional health provides a holistic view of older adults' needs.
• Integrating self-rated health (SRH) with instrumental activities of daily living (IADL) limitations offers a comprehensive health characterization.
• This approach is vital for developing targeted interventions for the aging population.

Purpose of the Study:

• To investigate the combined impact of self-rated health (SRH) and instrumental activities of daily living (IADL) limitations on adverse health outcomes.
• To explore the association between a combined health status indicator and the risks of mortality, ADL-limitation, and institutionalization.
• To identify early indicators of health decline in older adults.

Main Methods:

• Analysis of 4,429 participants aged 65+ from three French population-based cohorts with up to 20 years of follow-up.
• Creation of a health status indicator combining SRH and IADL-limitation into four groups.
• Utilized survival models to assess the relationship between health status and risks of death, ADL-limitation, and institutionalization.

Main Results:

• Poor SRH without IADL-limitation was associated with increased risks of mortality, ADL-limitation, and institutionalization.
• Individuals with IADL limitations faced at least double the risk of death and subsequent ADL-limitations, irrespective of their SRH.
• The combination of poor SRH and IADL limitations significantly elevated the risk of adverse health events.

Conclusions:

• Perceived poor SRH, even without functional limitations, elevates the risk of adverse health events in older adults.
• IADL limitations substantially increase adverse event risks, regardless of self-rated health status.
• Integrating subjective health perception with functional assessments aids in early identification of at-risk individuals for timely preventive interventions.