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Predictors of decline in self-assessments of health among older people -- a 5-year longitudinal study

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  • Leinonen, Raija
  • Heikkinen, Eino
  • Jylhä, Marja

Abstract

Within the framework of the Evergreen project we examined how changes in several indicators of health and functioning and physical activity predicted a decline in self-assessments of health evaluated over a 5-year period in older people by two different measurements: self-rated health (SRH) and self-assessed change in health (SACH). The study group comprised all 75-year-old persons born in 1914 (N=382) and living in Jyväskylä, a town in central Finland. At baseline in 1989, 91.6%, and at follow-up 5 years later in 1994, 87.3% of those eligible participated in the interview and 77.2 and 71.3%, respectively, in the examinations in the study centre, focusing on different domains of health and functional capacity. One-fifth of the subjects reported a deterioration in and one-fifth an improvement in SRH over the 5 years. The rest gave identical self-assessments of their health at baseline and at follow-up in response to the same question. Decline in SRH was associated with a decrease in physical activity and cognitive capacity. When asked directly about changes in their health (SACH), however, half the subjects said their health had declined. Negative SACH over the 5-year period was related to an increased number of chronic conditions, deterioration in functional performance and physical activity, and to the number of chronic conditions at baseline. We suggest that ageing people adapt to changes in their objective health and functional performance: the majority tend to assess their health as similar to or even better with increasing age despite an increase in chronic diseases and decline in functional performance. However, a negative SACH indicates that older people are realistic about these negative changes. These results support the assumption that the two subjective measurements of change in health are based on different criteria: assessment of current general health status tends to be based on inter-individual comparison, whereas assessment of change in health over a given time period may be based on intra-individual comparison. Physical activity seems to be an important factor when older people assess their health.

Suggested Citation

  • Leinonen, Raija & Heikkinen, Eino & Jylhä, Marja, 2001. "Predictors of decline in self-assessments of health among older people -- a 5-year longitudinal study," Social Science & Medicine, Elsevier, vol. 52(9), pages 1329-1341, May.
  • Handle: RePEc:eee:socmed:v:52:y:2001:i:9:p:1329-1341
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    Citations

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    Cited by:

    1. Leonie Sundmacher, 2012. "The effect of health shocks on smoking and obesity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 451-460, August.
    2. Layes, Audrey & Asada, Yukiko & Kephart, George, 2012. "Whiners and deniers – What does self-rated health measure?," Social Science & Medicine, Elsevier, vol. 75(1), pages 1-9.
    3. Peleg, Shira & Nudelman, Gabriel, 2021. "Associations between self-rated health and depressive symptoms among older adults: Does age matter?," Social Science & Medicine, Elsevier, vol. 280(C).
    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. Perruccio, Anthony V. & Badley, Elizabeth M. & Hogg-Johnson, Sheilah & Davis, Aileen M., 2010. "Characterizing self-rated health during a period of changing health status," Social Science & Medicine, Elsevier, vol. 71(9), pages 1636-1643, November.
    6. Jordi Alonso & Gemma Vilagut & Núria D Adroher & Somnath Chatterji & Yanling He & Laura Helena Andrade & Evelyn Bromet & Ronny Bruffaerts & John Fayyad & Silvia Florescu & Giovanni de Girolamo & Oye G, 2013. "Disability Mediates the Impact of Common Conditions on Perceived Health," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-13, June.
    7. Alexis Sossa Rojas, 2024. "Physical Exercise and Older People: Always a Happy Relationship? Four Qualitative Reflections to Deepen Understanding," Social Sciences, MDPI, vol. 13(2), pages 1-13, February.
    8. Jylhä, Marja, 2009. "What is self-rated health and why does it predict mortality? Towards a unified conceptual model," Social Science & Medicine, Elsevier, vol. 69(3), pages 307-316, August.
    9. Gunasekara, Fiona Imlach & Carter, Kristie & Blakely, Tony, 2012. "Comparing self-rated health and self-assessed change in health in a longitudinal survey: Which is more valid?," Social Science & Medicine, Elsevier, vol. 74(7), pages 1117-1124.
    10. Wight, Richard G. & Cummings, Janet R. & Miller-Martinez, Dana & Karlamangla, Arun S. & Seeman, Teresa E. & Aneshensel, Carol S., 2008. "A multilevel analysis of urban neighborhood socioeconomic disadvantage and health in late life," Social Science & Medicine, Elsevier, vol. 66(4), pages 862-872, February.
    11. Ania Filus & Doerte U. Junghaenel & Stefan Schneider & Joan E. Broderick & Arthur A. Stone, 2020. "Age Effects of Frames of Reference in Self-Reports of Health, Well-Being, Fatigue and Pain," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 15(1), pages 35-54, March.

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