The contribution of chronic conditions and disabilities to poor self-rated health in elderly men.

BACKGROUND The aim of the study was to investigate the contribution of chronic conditions and disabilities to poor self-rated health from the perspectives of the patient and the population: (a) What is the impact of seven somatic chronic conditions on self-rated health, independent of disabilities? and (b) To what extent can poor self-rated health be attributed to the selected chronic conditions and disabilities? METHODS Data came from the 1990 (n = 509), 1993 (n = 381), and 1995 (n = 340) surveys of the Zutphen Elderly Study. Odds ratios (OR) and population attributable risks (PAR) were calculated to quantify the contribution of chronic conditions and disabilities to poor self-rated health. RESULTS From the patient perspective, stroke was most strongly associated with poor self-rated health (OR = 3.5, 95% confidence interval: 1.8-6.9). From the population perspective, 63% of poor self-rated health could be attributed to the selected chronic conditions, with respiratory symptoms (28%), musculoskeletal complaints (24%), and coronary heart disease (13%) making the largest contribution. A total of 73% could be attributed to chronic conditions and disabilities. CONCLUSIONS In this population of elderly men, stroke resulted in the largest losses in self-rated health in individual patients, whereas the largest contributions to poor self-rated health in the population were made by respiratory symptoms and musculoskeletal complaints.