The contribution of self-rated health and depressive symptoms to disability severity as a predictor of 10-year mortality in European elderly men

Objectives. To investigate the effect of disability severity and the contribution of self-rated health and depressive symptoms to 10-year mortality. Methods. Longitudinal data were collected from 1141 men aged 70 to 89 years from the Finland, Italy, and the Netherlands Elderly Study from 1990 to 2000. Disability severity was classified into 4 categories: no disability, instrumental activities, mobility, and basic activities of daily living. Self-rated health and depressive symptoms were classified into 2 and 3 categories, respectively. Multivariate Cox proportional hazard models were used to calculate mortality risks. Results. Men with severe disability had a risk of mortality that was more than 2-fold higher (hazard ratio [HR] = 2.41; 95% confidence interval [CI] = 1.84, 3.16) than that of men without disability. Men who had severe disability and did not feel healthy had the highest mortality risk (HR = 3.30; 95% CI = 2.52, 4.33). This risk was lower at lower levels of disability and higher levels of self-rated health. The same trend was observed for depressive symptoms. Conclusions. For adequate prognoses on mortality or for developing intervention strategies, not only physical aspects of health but also other health outcomes should be taken into account.