The Predictive Power of Self‐Rated Health, Activities of Daily Living, and Ambulatory Activity for Cause‐Specific Mortality among the Elderly: A Three‐year Follow‐up in Urban Japan

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Abstract
Objective:To examine the predictive power of self‐rated health, activities of daily living (ADL), and ambulatory activity for different causes of death in a representative sample of older persons.Design:Three‐year prospective cohort study.Setting:Sendai City, Japan.Participants:2,552 persons 65 years and older at baseline in 1988.Measurements:Independent variables (measured by self‐report of participants) were age, sex, self‐rated health, ADL, ambulatory activity level, and use of medical care. Dependent variables were mortalities from cancer, stroke, and heart disease.Main Results:Self‐rated health significantly predicted cancer mortality but not the other two causes of mortality. ADL disability was a significant predictor for stroke mortality, and limitation in ambulatory activity significantly increased the risk of heart disease mortality. The associations between ADL and stroke mortality as well as between ambulatory activity and heart disease mortality remained significant even after excluding those who reported having the index disease in 1988.Conclusion:The predictive powers of self‐rated health, ADL function, and ambulatory activity varied significantly with the underlying causes of death among the elderly.