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Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil

Fernandes SGG1Pirkle CM2Sentell T2Costa JV3Maciel ACC4da Câmara SMA1.

PeerJ. 2020 Apr 10;8:e8876. doi: 10.7717/peerj.8876. eCollection 2020.




Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings.


Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil.


This is a cross-sectional study of 571 middle-aged (40-59 years old) and older (60-80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the «SRH good» or «SRH poor» groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity).


Middle-aged women from the «SRH good» group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47-3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00-2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18-0.94]; p = 0.009) than those who reported «SRH poor». No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH.


This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities.