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Discrepancies between self-reported and observed physical function in the elderly: the influence of response shift and other factors

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  • Daltroy, Lawren H.
  • Larson, Martin G.
  • Eaton, Holley M.
  • Phillips, Charlotte B.
  • Liang, Matthew H.

Abstract

Goal: To explore the influence of social, psychological, and health factors on self-report of function. Subjects: A convenience sample of 289 community-dwelling elderly aged 65-97 years. Methods: We compared a measure of function based on observed performance, the Physical Capacity Evaluation (PCE) with a self-reported measure of functional limitations (HAQ), in a cross-sectional study. Stepwise multiple regression identified variables predicting self-reported disability, controlling for observed function. Results: Controlling for PCE, self-reports of greater disability (HAQ) were predicted by current joint pain or stiffness, use of prescription medications, urban dwelling, depression, female gender, lack of memory problems, arthritis and lack of exercise. A final model included recent decline in function, dissatisfaction with function, gender, joint pain or stiffness, and observed function, explaining 85% of the variance in self-reported disability. The hypothesis that aging is associated with declining expectations of functional ability was not supported. However, recent health problems affected participants' reporting of limitations, consistent with a recalibration-type response shift. Perceived decline in function over the past six months, a fall within the last month, illness in the last week and pain or stiffness on the day of the exam all raised self-reports of disability. As suggested by adaptation level theory, subjects with recent problems might have an inflated perception of limitations due to shifts in their internal standards. When administered first, the observed performance test improved correlations between observed and self-reported function, primarily among those who did not report a recent decline in function. This suggests that this group may have benefited more from salient information about their abilities provided by performing the PCE before self-report. Conclusion: Our data confirm the importance of social, psychological, and health influences in self-report of disability, and are consistent with the hypothesis that people may recalibrate their self assessments based on recent health problems.

Suggested Citation

  • Daltroy, Lawren H. & Larson, Martin G. & Eaton, Holley M. & Phillips, Charlotte B. & Liang, Matthew H., 1999. "Discrepancies between self-reported and observed physical function in the elderly: the influence of response shift and other factors," Social Science & Medicine, Elsevier, vol. 48(11), pages 1549-1561, June.
  • Handle: RePEc:eee:socmed:v:48:y:1999:i:11:p:1549-1561
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    Cited by:

    1. Maria Sironi & George B. Ploubidis & Emily M. Grundy, 2020. "Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 529-558, April.
    2. Mark Fabian, 2022. "Scale Norming Undermines the Use of Life Satisfaction Scale Data for Welfare Analysis," Journal of Happiness Studies, Springer, vol. 23(4), pages 1509-1541, April.
    3. Wim Groot, 2003. "Scale of reference bias and the evolution of health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 176-183, September.
    4. Andrey Jorge Serra & Paulo de Tarso Camillo de Carvalho & Fernanda Lanza & Camila de Amorim Flandes & Shirley Cardoso Silva & Frank Shiguemitsu Suzuki & Danilo Sales Bocalini & Erinaldo Andrade & Ceza, 2015. "Correlation of Six-Minute Walking Performance with Quality of Life is Domain- and Gender-Specific in Healthy Older Adults," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-8, February.
    5. Chris Muris & Pedro Raposo & Sotiris Vandoros, 2020. "A dynamic ordered logit model with fixed effects," Papers 2008.05517, arXiv.org.
    6. Peña-Longobardo, L.M. & Rodríguez-Sánchez, B. & Oliva-Moreno, J., 2021. "The impact of widowhood on wellbeing, health, and care use: A longitudinal analysis across Europe," Economics & Human Biology, Elsevier, vol. 43(C).
    7. Patricia Cubí‐Mollá & Mireia Jofre‐Bonet & Victoria Serra‐Sastre, 2017. "Adaptation to health states: Sick yet better off?," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1826-1843, December.
    8. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    9. Denise Doiron & Glenn Jones & Elizabeth Savage, 2006. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance, CHERE Working Paper 2006/2," Working Papers 2006/2, CHERE, University of Technology, Sydney.
    10. Nahum-Shani, Inbal & Bamberger, Peter A., 2011. "Explaining the variable effects of social support on work-based stressor-strain relations: The role of perceived pattern of support exchange," Organizational Behavior and Human Decision Processes, Elsevier, vol. 114(1), pages 49-63, January.

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