Disease or function? What matters most for self-rated health in older people depends on age

BACKGROUND: Self-rated health (SRH) holistically captures older adults’ health status from the perspective of the individual. AIMS: To explore the accuracy of five objective health indicators related to diseases, physical function, cognition and disability in discriminating SRH among the youngest and oldest old. METHODS: We used baseline data from 2196 participants of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden (years 2001–2004). Area under the receiver operating characteristic curves (AUROC) were obtained from logistic regressions adjusted by sex, age and education. RESULTS: Among the youngest old, having ≥ 4 chronic diseases showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.714). Among the oldest old, a walking speed < 1.0 m/s showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.683), followed by ≥ 1 limitations in IADL (AUROC: 0.664). CONCLUSION: What matters most for SRH in older people depends on age, with walking speed playing a major role among the oldest old. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40520-020-01507-1) contains supplementary material, which is available to authorized users.