Relationship of self-rated health to stroke incidence and mortality in older individuals with and without a history of stroke: A longitudinal study of the MRC Cognitive Function and Ageing (CFAS) population

Mavaddat, Nahal, Van Der Linde, Rianne, Parker, Richard, Savva, George, Kinmonth, Ann Louise, Brayne, Carol and Mant, Jonathan (2016) Relationship of self-rated health to stroke incidence and mortality in older individuals with and without a history of stroke: A longitudinal study of the MRC Cognitive Function and Ageing (CFAS) population. PLoS One, 11 (2). ISSN 1932-6203

[img]
Preview
PDF (journal.pone.0150178) - Published Version
Available under License Creative Commons Attribution.

Download (251kB) | Preview

Abstract

Introduction: Poor self-rated health (SRH) has been associated with increased risk of death and poor health outcomes even after adjusting for confounders. However its’ relationship with disease-specific mortality and morbidity has been less studied. SRH may also be particularly predictive of health outcomes in those with pre-existing conditions. We studied whether SRH predicts new stroke in older people who have never had a stroke, or a recurrence in those with a prior history of stroke. Methods: MRC CFAS I is a multicentre cohort study of a population representative sample of people in their 65th year and older. A comprehensive interview at baseline included questions about presence of stroke, self-rated health and functional disability. Follow-up at 2 years included self-report of stroke and stroke death obtained from death certificates. Multiple logistical regression determined odds of stroke at 2 years adjusting for confounders including disability and health behaviours. Survival analysis was performed until June 2014 with follow-up for up to 13 years. Results: 11,957 participants were included, of whom 11,181 (93.8%) had no history of stroke and 776 (6.2%) one or more previous strokes. Fewer with no history of stroke reported poor SRH than those with stroke (5 versus 21%). In those with no history of stroke, poor self-rated health predicted stroke incidence (OR 1.5 (1.1–1.9)), but not stroke mortality (OR 1.2 (0.8–1.9)) at 2 years nor for up to 13 years (OR 1.2(0.9–1.7)). In those with a history of stroke, self-rated health did not predict stroke incidence (OR 0.9(0.6–1.4)), stroke mortality (OR 1.1(0.5–2.5)), or survival (OR 1.1(0.6–2.1)). Conclusions: Poor self-rated health predicts risk of stroke at 2 years but not stroke mortality among the older population without a previous history of stroke. SRH may be helpful in predicting who may be at risk of developing a stroke in the near future.

Item Type: Article
Additional Information: © 2016 Mavaddat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Pure Connector
Date Deposited: 06 Apr 2016 13:01
Last Modified: 24 Jul 2019 22:09
URI: https://ueaeprints.uea.ac.uk/id/eprint/58151
DOI: 10.1371/journal.pone.0150178

Actions (login required)

View Item View Item