Disease or function? What matters most for self-rated health in older people depends on age

Self-rated health (SRH) holistically captures older adults' health status from the perspective of the individual.

To explore the accuracy of five objective health indicators related to diseases, physical function, cognition and disability in discriminating SRH among the youngest and oldest old.

We used baseline data from 2196 participants of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden (years 2001-2004). Area under the receiver operating characteristic curves (AUROC) were obtained from logistic regressions adjusted by sex, age and education.

Among the youngest old, having ≥ 4 chronic diseases showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.714). Among the oldest old, a walking speed < 1.0 m/s showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.683), followed by ≥ 1 limitations in IADL (AUROC: 0.664).

What matters most for SRH in older people depends on age, with walking speed playing a major role among the oldest old.