Self-rated health is associated with subsequent functional decline among older adults in Japan

Mayumi Hirosaki, Kiyohito Okumiya, Taizo Wada, Masayuki Ishine, Ryota Sakamoto, Yasuko Ishimoto, Yoriko Kasahara, Yumi Kimura, Eriko Fukutomi, Wen Ling Chen, Masahiro Nakatsuka, Michiko Fujisawa, Kuniaki Otsuka, Kozo Matsubayashi

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background: Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan. Methods: A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later. Results: One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61). Conclusions: SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

Original languageEnglish
Pages (from-to)1475-1483
Number of pages9
JournalInternational Psychogeriatrics
Issue number9
Publication statusPublished - 2017 Sep 1
Externally publishedYes


  • Japan
  • basic activities of daily living
  • community-dwelling elderly
  • depression
  • prospective study
  • self-rated health

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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