The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women

R. Dankner*, L. Olmer, G. Kaplan, A. Chetrit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years. Methods: During the years 2000–2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnoseddiabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality. Results: A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71–6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25–3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01). Conclusions: Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.

Original languageEnglish
Pages (from-to)2889-2896
Number of pages8
JournalQuality of Life Research
Issue number11
StatePublished - 1 Nov 2016


  • Cohort
  • Diabetes
  • Elderly
  • Glycemic state
  • Joint association
  • Mortality
  • Predictor
  • Self-rated health


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