European Journal of Ageing

, Volume 2, Issue 2, pp 149–158 | Cite as

Self-rated health among older adults: a cross-national comparison

  • Carola BardageEmail author
  • Saskia M. F. Pluijm
  • Nancy L. Pedersen
  • Dorly J. H. Deeg
  • Marja Jylhä
  • Marianna Noale
  • Tzvia Blumstein
  • Ángel Otero
Original Investigation


Self-rated health (SRH) may have different implications in various social and cultural settings. However, few studies are available concerning SRH among older persons across countries. The aim of this study was to analyse whether there are cross-national differences in the association between status characteristics, several diseases common among older persons, activities of daily living (ADL), and SRH. The study base was the Comparison of Longitudinal European Studies on Aging (CLESA), which includes data from six population-based studies on aging conducted in Finland, Israel, Italy, The Netherlands, Spain and Sweden. The study population comprised 5,629 persons, with participants from all countries except Italy. Logistic regression analyses were used to assess the relationship between status characteristics, health conditions, ADL and SRH. To examine whether the association among status characteristics, health conditions, ADL and outcome differed across the CLESA countries, interaction terms defined as “variable*country” were considered separately for each variable. Regression analyses revealed that sex, education, lifetime occupation, heart disease and respiratory disease were differently distributed across countries. Among homogeneous factors, marital status (OR=1.21), hypertension (OR=1.41), stroke (OR=1.67), diabetes (OR=2.15), cancer (OR=1.47), musculoskeletal diseases (OR=2.44), and ADL (OR=2.72) turned out to be significantly associated with fair or poor SRH. The results indicate that there are differences in self-ratings of health across countries. These differences cannot be explained entirely by status characteristics, self-reported diseases or functional ability. However, an important finding was that in all countries most of the indicators of medical and functional health were homogeneously associated with SRH.


CLESA project Self-rated health Cross-national comparison Ageing 



The CLESA Working Group: Finland: M. Jylhä (Principal Investigator), S. Nikula, V. Autio. Israel: J. Gindin (Principal Investigator; First Principal Investigator: the late Modan Baruch of the Chaim Sheba Medical Center), T. Blumstein, A. Chetrit, A. Walter-Ginzburg, K. Shamay. Italy: S. Maggi (Project Leader), N. Minicuci, M. Noale, C. Marzari. The Netherlands: D.J.H. Deeg (Principal Investigator), S.M.F. Pluijm. Spain: A. Otero (Principal Investigator), M.J. Garcia de Yebenes, A. Rodríguez-Laso, M.V. Zunzunegui. Sweden: N.L. Pedersen (Principal Investigator), C. Bardage. The CLESA Project is supported by EU QoL2000-00664. LASA is supported by The Netherlands Ministry of Health, Welfare and Sports and the Vrije Universiteit. ILSA was supported by the CNR (National Research Council) and the Italian Department of Health—National Institutes of Health. Aging in Leganés is supported by the Spanish Health Research Fund (FIS), the Madrid Regional Research Fund and private foundations (La Caixa, BBVA). CALAS was supported by the US National Institute on Aging grants R01-5885-03 and R01-5885-06. The TamELSA is supported by the Academy of Finland, the Juho Vainio Foundation, the Yrjö Jahnsson Foundation, and the Medical Research Fund of Tampere University Hospital. SATSA is supported by the US National Institute on Aging (AG 04563, 10175) and the Swedish Social Research Council.


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Carola Bardage
    • 1
    Email author
  • Saskia M. F. Pluijm
    • 2
  • Nancy L. Pedersen
    • 1
  • Dorly J. H. Deeg
    • 2
  • Marja Jylhä
    • 3
  • Marianna Noale
    • 4
  • Tzvia Blumstein
    • 5
  • Ángel Otero
    • 6
  1. 1.Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
  2. 2.Institute for Research in Extramural MedicineVrije UniversityAmsterdamThe Netherlands
  3. 3.School of Public HealthUniversity of Tampere and Pirkanmaa District Hospital Research UnitTampereFinland
  4. 4.Institute of Neuroscience, Aging UnitNational Council ResearchPadovaItaly
  5. 5.The Gertner Institute for Epidemiology and Health Policy ResearchChaim Sheba Medical CenterTel-HashomerIsrael
  6. 6.Centro Universitario de Salud PúblicaUniversidad Autónoma de MadridMadridSpain

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