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Does Self-Rated Health Predict Death in Older Adults with Depressive Symptoms?*

  • Philip St. John (a1) (a2) and Patrick Montgomery (a3)


We analysed a prospective cohort study to determine (1) if self-rated health (SRH) predicts mortality in older adults with and without depressive symptoms, and (2) to determine if there is an interaction between SRH and depressive symptoms on mortality. We followed 1,751 community-dwelling adults aged 65 and older over five years. Measurements included age, gender, education, the Center for Epidemiological Studies-Depression (CES-D), SRH, the Modified Mini-Mental State Examination (3MS), and the Older Americans Resource Survey (OARS). Our outcome measure was time to death. Analyses were conducted in those with, and those without, depressive symptoms. We constructed Cox regression models with an interaction term for the CES-D and SRH. The hazard ratio (HR) for mortality was 1.63 for those with depressive symptoms; it was 1.68 for those without. No significant interaction was found between depressive symptoms and SRH for mortality.

Nous avons analysé une étude de cohorte prospective afin de déterminer (1) si l’auto-évaluation de son propre état de santé (AES) prédit la mortalité chez les personnes plus âgées, avec et sans symptômes dépressifs, et (2) de déterminer s’il y a une interaction entre l’AES et les symptômes dépressifs sur la mortalité. Nous avons suivi pendant cinq ans 1 751 adultes âgés de 65 ans qui habitaient dans les communautés. Les mesures comprenaient l’âge, le sexe, le niveau d’éducation, Center for Epidemiological Studies-Depression (CES-D), the Modified Mini-Mental State Examination (MMS), et le questionnaire Older Americans’ Research Survey (OARS). Notre indicateur de résultats était la duree de vie avant le décès. Les analyses ont été faites sur des sujets avant ou non des symptômes dépressifs. Nous avons construit des modèles de régression de Cox avec un terme d’interaction pour la CES-D et l’AES. L’indice de risque pour la mortalite était de 1,63 pour les sujets atteints de symptômes dépressifs ; il était de 1,68 pour les sujets sans symptômes. Aucune interaction significative n’a été trouvée entre les symptômes dépressifs et l’A-ES pour la mortalité.


Corresponding author

Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Philip St. John Associate Professor, Head Section of Geriatrics, University of Manitoba GE 545 Health Sciences Centre, 820 Sherbrook Street Winnipeg, MB, Canada R3A 1R9 (


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The Manitoba Study of Health and Aging (MSHA) was funded primarily by Manitoba Health, with additional funding provided through the Canadian Study of Health and Aging by the Seniors Independence Research Program of the National Health Research and Development Program of Health Canada. The second wave of the MSHA was funded primarily by Manitoba Health’s Healthy Communities Development Fund with additional funding provided through the Canadian Study of Health and Aging by the Seniors Independence Research Program of the National Health Research and Development Program of Health Canada (Project No. 6606-3954-MC[S])). The results and conclusions are those of the authors, and no official endorsement by Manitoba Health or other funding agencies is intended or should be inferred.

Conflict of Interest: Neither author has any financial, personal, or potential conflict of interest.

Authors and Sponsor’s role: Dr. Montgomery was involved in the initial planning of the MSHA. Dr. St. John and Dr. Montgomery conducted clinical examinations and planned these analyses. The sponsors played no role in interpreting the results.

This paper was presented at the American Geriatrics Society Annual meeting in Washington, DC, 2008.



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Bailis, D.S., Segall, A., & Chipperfield, J.G. (2003). Two views of self-rated general health status. Social Science & Medicine, 56(2), 203217.
Bardage, C., Isacson, D., & Pedersen, N.L. (2001). Self-rated health as a predictor of mortality among persons with cardiovascular disease in Sweden. Scandinavian Journal of Public Health, 29(1), 1322.
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 & Medicine, 59(6), 12971306.
Blazer, D.G. (2008). How do you feel about.? Health outcomes in late life and self-perceptions of health and well-being. The Gerontologist, 48(4), 415422.
Blazer, D.G., Hybels, C.F., & Pieper, C.F. (2001). The association of depression and mortality in elderly persons: A case for multiple, independent pathways. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(8), M505M509.
CSHA. (1994). Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899913.
DeSalvo, K.B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question. A meta-analysis. Journal of General Internal Medicine, 21(3), 267275.
Dowd, J.B., & Zajacova, A. (2007). Does the predictive power of self-rated health for subsequent mortality risk vary by socioeconomic status in the US? International Journal of Epidemiology, 36(6), 12141221.
Dubois, M.F., & Hebert, R. (2001). Imputation of missing dates of death or institutionalization for time-to-event analyses in the Canadian Study of Health and Aging. International Psychogeriatrics, 13(Suppl. 1), 9197.
Fillenbaum, G.G. (1988). Multidimensional functional assessment of older adults: The Duke Older Americans Resources and Services procedures. Hillsdale, NJ: Lawrence Erlbaum Associates.
Gama, E.V., Damian, J.E., de Perez, M.J., Lopez, M.R., Lopez, P.M., & Gavira Iglesias, F.J. (2000). Association of individual activities of daily living with self-rated health in older people. Age and Ageing, 29(3), 267270.
Han, B. (2002). Depressive symptoms and self-rated health in community-dwelling older adults: A longitudinal study. Journal of the American Geriatrics Society, 50(9), 15491556.
Heidrich, J., Liese, A.D., Lowel, H., & Keil, U. (2002). Self-rated health and its relation to all-cause and cardiovascular mortality in southern Germany. Results from the MONICA Augsburg cohort study 1984-1995. Annals of Epidemiology, 12(5), 338345.
Heistaro, S., Jousilahti, P., Lahelma, E., Vartiainen, E., & Puska, P. (2001). Self rated health and mortality: A long term prospective study in eastern Finland. Journal of Epidemiology and Community Health, 55(4), 227232.
Helmer, C., Barberger-Gateau, P., Letenneur, L., & Dartigues, J.F. (1999). Subjective health and mortality in French elderly women and men. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 54(2), S84S92.
Idler, E.L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 2137.
Jylha, M., Volpato, S., & Guralnik, J.M. (2006). Self-rated health showed a graded association with frequently used biomarkers in a large population sample. Journal of Clinical Epidemiology, 59(5), 465471.
Lee, S.J., Moody-Ayers, S.Y., Landefeld, C.S., Walter, L.C., Lindquist, K., Segal, M.R., et al. . (2007). The relationship between self-rated health and mortality in older black and white Americans. Journal of the American Geriatrics Society, 55(10), 16241629.
Lundberg, O., & Manderbacka, K. (1996). Assessing reliability of a measure of self-rated health. Scandinavian Journal of Social Medicine, 24(3), 218224.
Manderbacka, K. (1998). Examining what self-rated health question is understood to mean by respondents. Scandinavian Journal of Social Medicine, 26(2), 145153.
Menec, V.H., Shooshtari, S., & Lambert, P. (2007). Ethnic differences in self-rated health among older adults: A cross-sectional and longitudinal analysis. Journal of Aging and Health, 19(1), 6286.
Mossey, J.M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72(8), 800808.
Radloff, L. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.
Singh-Manoux, A., Dugravot, A., Shipley, M.J., Ferrie, J.E., Martikainen, P., Goldberg, M., et al. . (2007). The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. International Journal of Epidemiology, 36(6), 12221228.
Statistics Canada. (1992). Profile of census metropolitan areas and census agglomerations, 1991 census – 100% data. Ottawa, Ontario, Canada: Ministry of Industry, Science and Technology.
Walker, J.D., Maxwell, C.J., Hogan, D.B., & Ebly, E.M. (2004). Does self-rated health predict survival in older persons with cognitive impairment? Journal of the American Geriatrics Society, 52(11), 18951900.
Teng, E.L., & Chui, H.C. (1987). The Modified Mini-Mental State (3MS) examination. Journal of Clinical Psychiatry, 48(8), 314318.


Does Self-Rated Health Predict Death in Older Adults with Depressive Symptoms?*

  • Philip St. John (a1) (a2) and Patrick Montgomery (a3)


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