Liu Yuzhi, Li Qiang Institute of Population Research, Center for Healthy Aging

1. Self-rated Health and Mortality Risk in the Oldest Old in ChinaChinese Longitudinal Healthy Longevity Study Liu Yuzhi, Li Qiang Institute of Population Research, Center for Healthy Aging and Family Studies, Peking University, Beijing, China

2. Self-rated Health Mortality risk Introduction Risk factors e.g. Socio-demographic characteristics Engagement with life Functional ability Disease burden

3. Introduction • Many studies have suggested that self-rated health (SRH) is significantly associated with mortality risk in young people, adults and the young old (e.g. Benyamini & Idler, 1999; Idler & Benyamini, 1997). Moreover, early research have proposed that self-rated health reflect the effects of disease burden and functional ability on the mortality. • Several research have pointed out that that older persons reported weaker associations between self-rated health and mortality compared with younger (Ilder & Angel, 1990; Strawbridge & Wallhagen, 1999). • Meanwhile, previous studies have proposed that the oldest old (Fourth Age) is very different from the young old (Third Age: e.g. Baltes & Smith, 2003; Maier and Smith, 1999; Suzman, et al., 1992; Zeng et al., 2002). • However, few studies investigated the relationship between self-rated health and mortality in the oldest old (Cai, 2004).

4. Research Questions • Is there significant association between self-rated health and mortality risk in the Chinese oldest old? • Is there the gender differences of the predictability of self-rated health for mortality risk? • Is missing values (as the additional level) in self-rated health related to higher mortality risk?

5. 851 Lost 565 Lost Final sample:7623 (3026 for censor; 4597 for death) 8,805 Participants Age 80~105 4,690 Participants 2,563 Participants 3,264 Died 1,563 Died 1998 2000 2002 Sample Three waves of Chinese Longitudinal Healthy Longevity Study.N=7623; 60.03% women; 3 Age cohort: 80~89 (n=2962); 90~99(n=2651);100~105 (n=2010)

6. Models Hazard model with piecewise linear baseline intensity the logarithm of the force of mortality at attained age x; the log-hazard baseline with nodes at 85, 90, 95, and 100 years of age; Self-rated health, the only time-varying variable in the model; the coefficients of self-rated health; covariates in the model; coefficients of covariates.

7. Measures Central Variable: Self-rated health: “How do you rate your health at present?” Sex Type of residence; Years of schooling; Occupation before 60 years old; Marital Status; Caregivers while serious illness. Socio-demographic characteristics: Engagement with life:Number of activities includinghousework, reading, watch TV, religious activities et al. Covariates Self-reported ADL; MMSE; Vision; Hearing; Bedridden. Functional ability: Self-reported Number of illness

8. Results Piecewise-Linear Baseline Log-Harzard of Mortality in the Oldest Old Log-Hazard Age

9. Results Mortality risk associated with Self-rated health in the oldest old Note: *p<. 1; **p<.05; ***p<.01.

10. Results Self-rated Health Mortality risk Risk factors e.g. Socio-demographic characteristics Engagement with life Functional ability Number of illness

11. Results Mortality risk associated with self-rated health by gender Note: *p<.05; **p<.01; ***p<.001. Gender Pattern is similar as the total pattern. No significant gender difference was found in our sample.

12. Discussion • Self-rated health is a significant predictor of mortality risk in the oldest old in China with controls for socio-demographic characteristics, engagement with life, functional ability, and number of illness! Engagement with life and functional ability partly explain the relationship between self-rated health and mortality risk in the oldest old. The impact of number of illness can be negligible. • No gender difference on the relationship between self-rated health and mortality risk is founded in our sample. • Missing values in self-rated health is highly associated with mortality risk. And more, participants with incomplete data in the self-rated health have the highest mortality risks.

13. Follow-up Analyses • Covariates: time-varying variables.

14. Thank you