Changing predictors of self-rated health: Disentangling age and cohort effects.

Abstract

Previous studies have shown that some predictors of self-rated health (SRH) become more important with age, while others become less important. Although based on cross-sectional data, these findings are often interpreted as age-related changes in evaluation criteria. However, results could be due to cohort effects as well. We attempted to disentangle age and cohort effects by combining and comparing cross-sectional and longitudinal data from a large-scale longitudinal survey. The sample consisted of 2,982 community-dwelling participants from 2 measurement occasions of the German Ageing Survey ages 40-81 years at baseline. Multigroup latent regression models were used to examine whether associations between various predictors and SRH differed between age groups and whether they changed over time. Comparisons of cross-sectional age differences in SRH-predictor associations and longitudinal age changes in the same associations allow the identification of cohort effects. Number of chronic conditions showed a constant negative association with SRH independently of age and cohort. In contrast, the association between SRH and all other predictors (physical functioning, exercise, life satisfaction, depressive symptoms, and positive affect) changed longitudinally, pointing to an age effect. Prediction of SRH by depressive symptoms and positive affect showed an additional cohort effect: The negative associations between depressive symptoms and SRH and the positive associations between positive affect and SRH were stronger among younger cohorts. The findings provide not only longitudinal support for previous cross-sectional studies, but also show the impact of historical change: Emotional facets of psychological well-being increase in relevance for SRH across cohorts.

The Role of the Five–factor Personality Traits in General Self–rated Health

“…This might have had a significant effect on the outcome, because there is considerable reason to believe that the predictors of SRH might be somewhat different across age groups. Namely, earlier studies suggest that the associations of SRH with personality traits, positive affect and depressive symptoms increase with age (Benyamini et al, 2000;Duberstein et al, 2003;Spuling et al, 2015) whereas the association between physical functioning and SRH tends to decrease with age, as impairments and functional limitations become more common and even expected (Spuling et al, 2015). Our findings, however, suggest that the importance of objectively measured (mostly physical) health problems, health-related quality of life and SWB for general SRH is relatively stable/invariant across the examined age range.…”

“…Much of the previous research on the association between SRH and personality traits (Löckenhoff et al, 2008) or SWB (Spuling et al, 2015) has relied on self-reports of medical conditions or hospital stays. This is problematic because it might lead to self-reports of illness, personality and SWB that follow similar patterns (Diener & Chan, 2011) due to common-method variance (Podsakoff, MacKenzie, Lee, & Podsakoff, 2003).…”

Longitudinal Twin Study of Subjective Health: Differences in Genetic and Environmental Components of Variance Across Age and Sex

“…In particular, evidence suggests that with increasing age, older adults rely more on perceptions of psychological well being and less on estimations and comparisons of physical functioning (both with self and age peers) to rate their own health, at least until late old age. (Benyamini et al, 2000;Jylhä et al, 1986;Meng & D'Arcy, 2016;Shooshtari et al, 2007;Spuling et al, 2015;Verropoulou, 2012). To the extent that physical health reflects genetic variance (Finkel et al, 2014), genetic components of variance in measures of SH should decline with increasing age as adults focus their attention more on other facets of their health experience, particular their cultural conceptions of "good health," in later adulthood.…”

“…Given its predictive value, research has shifted to identifying factors that contribute to SH (Arnadottir, Gunnarsdottir, Stenlund, & Lundin-Olsson, 2011;Bailis, Segall, & Chipperfield, 2003;Darviri et al, 2012;Meng & D'Arcy, 2016;Shooshtari, Menec, & Tate, 2007), and evidence demonstrates that it is a multifaceted concept that taps physical, cognitive, and emotional dimensions, as well as cultural constructs of health (Benyamini, 2011;Jylhä, 2009). Moreover, research suggests that the variables that predict SH vary by age, sex, and even the phrasing of the SH item (Sargent-Cox, Anstey, & Luszcz, 2008;Spuling, Wurm, Tesch-Römer, & Huxhold, 2015). To date, attempts to identify these varied predictive relationships for SH have produced mixed results; therefore, our aim is to apply the longitudinal twin design as means for understanding the mechanisms contributing to in SH and how these may change with age.…”

“…According to Jylhä's (2009) model of SH, the individual conceptualization of what constitutes "good health" may change with age, resulting in a recombination of factors contributing to the self-evaluation. In fact, research suggests that whereas the number of chronic conditions may be an important component of SH for both younger and older adults (Meng & D'Arcy, 2016;Spuling et al, 2015), older adults tend to rely less on evaluations of physical functioning and more on measures of psychological well-being, such as positive affect or depressive symptoms (Benyamini, Idler, Leventhal, & Leventhal, 2000;Jylhä, Leskinen, Alanen, Leskinen, & Heikkinen, 1986;Meng & D'Arcy, 2016;Shooshtari et al, 2007;Spuling et al, 2015;Verropoulou, 2012).…”