Objective vs. Subjective Health in Very Advanced Ages: Looking for Discordance in Centenarians

Abstract

Background: Living beyond 100 years of age is associated with several functional and health constraints but their impact depends on one's perception of the situation. Associations between self-rated health (SRH) with sociodemographic and psychosocial variables have been explored in several studies, revealing that one's health appraisal depends of factors beyond the objective health condition. There is a large body of literature concerning SRH in later life but lack of evidence about centenarians' perception of health and its associated factors, which could increase the available knowledge on the strengths and resources individuals in very advanced ages have for facing daily life limitations.Objective and Methods: This study aims to analyse the relationship between subjective and objective health status in a sample of centenarians (n = 127). Subjective health was assessed by a single-item health measure, and objective health by considering the number of reported diseases and a functional capacity scale (BADL and IADL). Main health characteristics are described as well as examined the association between objective and subjective health.Results: 46.5% of the sample has a good, very good, or excellent appraisal of their own health. SRH was associated (p < 0.05) with BADL and IADL scores and with the total number of diagnosis; when analyzing SRH according to the level of functional capacity, results revealed that most individuals with severe and moderate dependence have a reasonable to excellent SRH (p > 0.05).Conclusion: Having diseases and functional dependence at 100 years old may not mean to have a bad SRH. The high variability in SRH and the discordance between objective and subjective measures are a proof of centenarian's capacity of adaptation and the existence of individual resources, which may be decisive for one' perception and handling of health situation at such an advanced age.

The complex journey into longevity: helping the oldest-old to live happier

“…As we can understand from the work done by Cheng et al (2019), the various studies conducted on longevity are too heterogenous, and they often do not consider that how a person perceives her/his mental and/or physical health depends on factors that often are beyond the objective health condition. As Ribeiro points out, "There is a large body of literature concerning SRH (self-rated health) in later life but lack of evidence about centenarians' perception of health and its associated factors, which could increase the available knowledge on the strengths and resources individuals in very advanced ages have for facing daily life limitations" (Araújo et al, 2018).…”

Expecting the best or fearing the worst: Discrepancies between self‐rated health and frailty in an ageing Irish population

“…Given the multi‐dimensional nature of health, a gold‐standard objective health scale is unrealistic. Previous studies have operationalized objective health as the amount of disease diagnoses a patient has received, combined with measures of functional capacity, such as Instrumental Activities of Daily Living (IADLs) and Basic Activities of Daily Living (Araújo, Teixeira, Ribeiro, & Paúl, 2018). An issue with such measures, however, is that health is more complex than just disease and functional status.…”

Income Inequality and Self-Reported Health Among Older Adults in Brazil

“…Although self-rated health among older adults has been associated with the presence of chronic noncommunicable diseases and their complications (Confortin et al, 2015), recent studies have indicated that health self-perception in very-old older adults may be related to aspects beyond the presence of chronic diseases and the functional disability, such as the perception of successful aging, psychological resilience, and life satisfaction (Araújo et al, 2018; Carstensen et al, 2011). Thus, the direct relationship between physical function and health perception observed in younger-old older adults is not usually linear among the very-old older adults, suggesting that the factors that influence the health of the younger age group, paradoxically, do not have the same impact for older adults over 80 years old (Gondo, 2012).…”