Association of individual activities of daily living with self-rated health in older people

Objective: to evaluate the associations of 18 activities of daily living with self-rated health in older people. Design and setting: cross-sectional study of a representative sample of 781 people aged 65 or over (response rate: 89.9%). Methods: self-rated health was assessed by the question: "Overall, how would you rate your current health status-very good, good, fair, poor or very poor?" We used the Barthel index and Lawton and Brody's index for basic and instrumental activities of daily living, respectively. We classified subjects into three groups according to their Barthel index score: level 1 (score 100), level 2 (score 91 -99) and level 3 (score 0- 90). Logistic regression was used to identify associations between each activity and self-rated health. Results: use of stairs [odds ratio (OR) = 4.28, 95% confidence interval (95% CI): 2.82-6.52], ambulation (OR = 3.67, 95% CI: 2.39-5.64) and chair/bed transfer (OR = 3.00, 95% CI: 1.68-5.36) were the basic activities of daily living best associated with self-rated health. Among instrumental activities of daily living, ability to handle finances (OR = 2.20), laundry (OR = 2.15) and transport (OR = 2.12) were associated with self-rated health. On the Barthel index, only transport was associated with self-rated health in subjects at levels 1 (OR = 2.55) and 2 (OR = 2.72). For subjects with poor functional status (leveI 3), no instrumental activities of daily living were related to self-rated health. Conclusion: in terms of self-rated health, the most important activities of daily living were those involving mobility. The effect of each instrumental activity of daily living on self-rated health depends on the level of functional capacity in basic activities of daily living.