Population Attributed Risk Proportion Associated with Poor Self-Rated Health in the Elderly: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Ai ^1# , XU Li ^2# , LI Ting ³ , YANG Ming ¹ , DONG Birong ¹ , LIU Guanjian ⁴ ,  WU Hongmei ¹

1. Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;2. Chengdu Hospital of Tibet, Chengdu 610041, China;3. Department of Geriatrics, No.5 People’s Hospital of Chengdu, Chengdu 610041, China;4. Center for Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WU Hongmei, Email: drwhm@163.com

Keywords：

Self-rated health; Risk factor; Population attributable risk proportion; Systematic review; Cross-sectional study; Cohort study

DOI：

10.7507/1672-2531.20120169

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Objective 　To systematically review the evidence of the factors associated with self-rated health (SRH) and estimating the population attributable risk proportion (PARP) of interests in the elderly.
Methods 　MEDLINE, EMbase, CBM, CNKI, VIP and WanFang Data were searched (from January 1960 to April 2011) for relevant literature. The combined effect on each factor associated with poor SRH was expressed as RR or OR (95%CI). The contribution of each factor to poor SRH in the elderly population was estimated with PARP. Meta-analysis was performed using RevMan 5.1 software.
Results 　Twelve studies involving a total of 35 349 participants aged 60 or above were eligible in this systematic review. Ten studies were conducted in China and the rest two studies were from the USA and Brazil. Of them, only one was prospective cohort study and 11 studies were cross-sectional. The results of meta-analysis showed that the main factors associated with poor SRH in the elderly were dependency, diabetes and coronary heart disease with the corresponding OR and 95%CI as 12.10 (6.31, 23.20), 6.49 (3.21, 13.09) and 5.60 (1.07, 29.42), respectively. However, the top three factors contributing to poor SRH in the elderly population were coronary heart disease, having illness half one year ago and chronic disorders with the corresponding PARP as 53.91%, 52.56%, and 50.09%, respectively. It was not possible to perform sub-group analysis because of the limited quantity of studies on each factor associated with poor SRH.
Conclusion 　Based on the current available evidence, it appears that chronic disorders are closely related to poor SRH and contribute most in the elderly population. However, due to the limitation of the included predominantly cross sectional studies which are not enough for causal argument, it is insufficient to determine the association of many factors with poor SRH. Further high-quality prospective cohort studies are needed.

Citation： YANG Ai,XU Li,LI Ting,YANG Ming,DONG Birong,LIU Guanjian,WU Hongmei. Population Attributed Risk Proportion Associated with Poor Self-Rated Health in the Elderly: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2012, 12(9): 1083-1089. doi: 10.7507/1672-2531.20120169 Copy

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14.	王德全, 陈少贤, 燕芬, 等. 广州市老年人行为生活方式和自感健康状况研究. 中国初级卫生保健, 1998, 12(10): 38-39.
15.	张凤梅, 徐恒戬. 健康自评与老年人群慢性病关系的研究. 中国老年学杂志, 2008, 28(23): 2353-2355.
16.	周玉芳, 刘向红, 朱华, 等. 老年人健康自评的相关因素分析. 老年学杂志, 1990,10(1): 35-38.
17.	王方刃, 阮召锐. 农村老年人自感健康状况及社会、心理因素分析. 医学与社会, 1999, 12(2): 6-8.
18.	谷琳, 杜鹏. 我国老年人健康自评的差异性分析——基于2002 年和2005 年全国老年跟踪调查数据. 南方人口, 2007, 22(2): 58-64.
19.	宫权, 林明鲜, 王飞鹏. 烟台市老年人健康自评的城乡对比研究. 中国老年学杂志, 2008, 28(9): 908-910.
20.	王方刃, 扬艺明, 石剑锋. 城镇老年人健康自我感觉影响因素的分析. 海峡预防医学杂志, 1999, 5(2): 1-3.
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22.	于普林, 刘雪荣, 叶文, 等. 三河市开发区老年人健康状况的多维评价. 中华老年医学杂志, 2003, 22(9): 554-558.

1. 全球人口老龄化现状. 党政论坛, 2002, (6).
2. 王殉, 刘毅强. 略论健康老龄化. 医学与哲学, 1996, 17(9): 456-459.
3. Phillips LJ, Hammock RL, Blanton JM. Predictors of Self-rated Health Status Among Texas Residents. Prev Chronic Dis, 2005, 2(4): 1-10.
4. Rohrer JE, Young R, Sicola V, et al. Overall self-rated health: a new quality indicator for primary care. J Eval Clin Pract, 2007,13(1): 150-153.
5. 汤哲, 吴晓光, 孟琛, 等. 老年人健康评价指标对死亡预测的分析. 中国老年学杂志, 1997, 17(4): 194-196.
6. Singh-Manoux A, Dugravot A, Shipley MJ, et al. The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. Int J Epidemiol, 2007, 36(6): 1222-1228.
7. Desalvo KB, Bloser N, Reynolds K, et al. Mortality prediction with a single general self-rated health question. J Gen Intern Med, 2006, 21(3): 267-275.
8. Singh-Manoux A, Guéguen A, Martikainen P, et al. Self-rated health and mortality: short-and long-team associations in the Whitehall II study. Psychosom Med, 2007, 69(2): 138-143.
9. Han B. Depressive Symptoms and Self-Rated Health in Community-Dwelling Older Adults: A-Longitudinal Study. J Am Geriatr Soc, 2002, 50(9): 1549-1556.
10. 宋晓飞, 徐凌忠, 王兴洲, 等. 威海市老年人自感健康状况及其影响因素的分析. 中国老年学杂志, 2007, 27(21): 2130-2133.
11. Daniilidou NV, Gregory S, Kyriopoulos JH, et al. Factors associated with self-rated health in Greece. Eur J Public Health, 2004, 14(2): 209-211.
12. Lima-Costa MF, Firmo JOA, Uchoa E. The structure of self-rated health among older adults: the Bambui health and ageing study (BHAS). Rev Saude Publica, 2004, 38(6): 827-834.
13. Gordon G, Drummond R, Meade M, et al. User’s Guides to the medical literature: a manual for evidence-based clinical practice, second edition. The McGraw-Hill Companies, Inc. 2008.
14. 王德全, 陈少贤, 燕芬, 等. 广州市老年人行为生活方式和自感健康状况研究. 中国初级卫生保健, 1998, 12(10): 38-39.
15. 张凤梅, 徐恒戬. 健康自评与老年人群慢性病关系的研究. 中国老年学杂志, 2008, 28(23): 2353-2355.
16. 周玉芳, 刘向红, 朱华, 等. 老年人健康自评的相关因素分析. 老年学杂志, 1990,10(1): 35-38.
17. 王方刃, 阮召锐. 农村老年人自感健康状况及社会、心理因素分析. 医学与社会, 1999, 12(2): 6-8.
18. 谷琳, 杜鹏. 我国老年人健康自评的差异性分析——基于2002 年和2005 年全国老年跟踪调查数据. 南方人口, 2007, 22(2): 58-64.
19. 宫权, 林明鲜, 王飞鹏. 烟台市老年人健康自评的城乡对比研究. 中国老年学杂志, 2008, 28(9): 908-910.
20. 王方刃, 扬艺明, 石剑锋. 城镇老年人健康自我感觉影响因素的分析. 海峡预防医学杂志, 1999, 5(2): 1-3.
21. 涂彧, 沈月平, 朱永烈, 等. 老年人健康自我感觉因素的研究. 中国社会医学, 1995, 6: 7-8.
22. 于普林, 刘雪荣, 叶文, 等. 三河市开发区老年人健康状况的多维评价. 中华老年医学杂志, 2003, 22(9): 554-558.

Chinese Journal of Evidence-Based Medicine

Population Attributed Risk Proportion Associated with Poor Self-Rated Health in the Elderly: A Systematic Review

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