Background The extent to which older adults take their age into consideration when rating their health is not well understood.
Objective The aim of this study is to determine if older adults change their self-rated health (SRH) when instructed to compare with others their own age and, if so, what factors are associated with older adults changing their SRH.
Methods We used data from the first wave of the 2nd Longitudinal Study on Aging (n = 9,447), a population-based face-to-face interview of non-institutionalized US residents over age 70 in 1995. The subjects were asked (1) to rate their health and (2) to rate their health compared to others their own age. Response choices were “excellent,” “very good,” “good,” “fair,” or “poor.” We used ANOVA and chi-squared analyses to examine potential correlates of changing SRH, including sociodemographic and health characteristics. We constructed a logistic regression model to identify characteristics independently correlated with changing SRH.
Results 43% of older persons did not change their SRH when asked to compare with others their own age. Increasing one's SRH was associated with older age, being a high school graduate, and having fewer medical conditions, fewer difficulties with activities of daily living (ADLs), and fewer days spent in bed (p < .01 for all). In multivariate analysis, increasing SRH when comparing with others was positively associated with older age (OR, 1.02; 95% CI, 1.01 to 1.03), higher education (OR, 1.01; 95% CI, 1.01 to 1.06), poor health ratings (OR, 5.2; 95% CI, 4.6. to 5.90) were all independently associated with and inversely associated with greater number of bed days (OR, 0.99; 95% CI, 0.98 to 0.99), medical conditions (OR, 0.80; 95% CI, 0.78 to 0.83), and ADL difficulties (OR, 0.96; 95% CI, 0.93 to 0.99).
Conclusions Almost half of older adults do not change their self-rating of health when comparing with others, demonstrating that implicit age adjustment is common among seniors.
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