Self-rated health trajectory and frailty among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

Abstract

ObjectivesSelf-rated health (SRH) is an assessment and predictor of health based on an individual’s general condition; however, evidence of the value of SRH for predicting frailty remains scarce for older Asian adults. This study aimed to evaluate the relationship between SRH score trajectory and frailty among older individuals in Taiwan.DesignAn 8-year retrospective cohort study.SettingData were retrieved from the Taiwan Longitudinal Study on Aging from 1999 to 2007.ParticipantsRespondents aged 53–69 years old who were not frail or disabled in 1999 (n=1956).Primary and secondary outcome measuresFrailty was defined using the Fried criteria. The group-based trajectory modelling technique was used to estimate SRH trajectories. Logistic regression analysis was used to examine the associations between changes in SRH and frailty.ResultsFour SRH trajectory classes were identified across the 8-year follow-up: 232 participants (11.9%) were classified into the constantly poor SRH group, 1123 (57.4%) into the constantly fair SRH group, 335 (17.1%) into the constantly good SRH group and 266 (13.6%) into the good-to-fair SRH group. After adjusting for gender, age, level of education, income, social participation, health behaviours and major comorbidities, it was found that age, poor income satisfaction, without job and constantly poor SRH were associated with increased risk of frailty, while constantly good SRH (OR 0.04, 95% CI (0.01 to 0.32)) and good-to-fair SRH (OR 0.19, 95% CI (0.06 to 0.63)) were associated with reduced risks of frailty.ConclusionsConstantly poor SRH was associated with an increased risk of frailty in older age. SRH in older adults should be recognised as a predictive tool for future frailty. Diet and exercise interventions may help to prevent frailty among high-risk older individuals with constantly low SRH.

Development and Assessment of the Validity and Reliability of the Short-Form Life Satisfaction Index (LSI-SF) among the Elderly Population

“…Because we retrieved data from TLSA questionnaires, we used a modified definition for these five traits. It has been widely used and validated in the literature [ 35 , 36 ]. We used ‘loss of appetite’ to refer to nutritional status and to indicate ‘shrinking’.…”

“…We used ‘loss of appetite’ to refer to nutritional status and to indicate ‘shrinking’. Participants who reported frequent loss of appetite in the previous week were classified as shrinking [ 30 , 31 , 32 , 33 , 35 , 36 ]. Participants who found it difficult to carry 12 kg of groceries were classified as having weakness [ 30 , 31 , 32 , 33 , 35 , 36 ].…”

“…Participants who reported frequent loss of appetite in the previous week were classified as shrinking [ 30 , 31 , 32 , 33 , 35 , 36 ]. Participants who found it difficult to carry 12 kg of groceries were classified as having weakness [ 30 , 31 , 32 , 33 , 35 , 36 ]. We used the Center for Epidemiologic Studies Depression Scale (CES-D) to define ‘exhaustion’.…”

“…We used the Center for Epidemiologic Studies Depression Scale (CES-D) to define ‘exhaustion’. Participants who answered ‘I could not get going’ or ‘I felt everything I did was an effort’ frequently or most of the previous week were characterized as having exhaustion [ 30 , 31 , 32 , 33 , 35 , 36 ]. We used walking or moving in and around the house to show gait speed and indicate ‘slowness’.…”

“…We used walking or moving in and around the house to show gait speed and indicate ‘slowness’. Participants who were unable to walk a distance of 200 to 300 m or found it difficult were classified as having slowness [ 30 , 31 , 32 , 33 , 35 , 36 ]. We used the frequency of leisure time/physical activity per week to show the level of physical activity to indicate ‘low physical activity’.…”