Self-reported medical history and self-rated health at age 90. Agreement with medical records

Abstract

Background and aims: Taking medical history from a very old patient for either clinical or research purposes raises the question of the reliability of the information obtained. We ascertained whether the self-reported medical history and self-rated health of 90-year-olds would be in agreement with their medical records. Methods: Information on chronic diseases and self-rated health was collected using medical records and a mailed questionnaire in a population sample of community-living 90-year-old subjects in Tampere, Finland. The results were compared with earlier studies on self-reported medical history. Results: The inter-source agreement of the reported diseases was relatively good. As expected, many of the diseases diagnosed were under-reported in the mailed questionnaire. However, dementia, depression and arthritis were reported more often than doctors had recorded them. Of the respondents, 78% reported their current health as good or average. Subjects with heart disease, stroke, rheumatoid arthritis, Parkinson’s disease or depression reported poor health more often than those not having these diseases. Conclusions: The agreement between medical records and self-reported medical history obtained by questionnaire showed a similar pattern to earlier studies in younger old populations, but in the 90-year olds, the differences became larger. In future studies, special attention should be paid to the oldest old who under-report certain diagnosed medical conditions.