Do discrepancies between subjective and objective health shift over time in later life? A markov transition model

Dados Bibliográficos

ID4883429
AutoresBill Calvey (0000-0002-4095-4082, National University of Ireland, Maynooth), Justin M Power (0000-0002-7387-3107, National University of Ireland, Maynooth), Roma Maguire (0000-0002-0368-4626, National University of Ireland, Maynooth), Rafael De Andrade Moral (0000-0002-0875-3563, National University of Ireland, Maynooth), Idemauro Antonio Rodrigues De Lara (0000-0002-1172-9855, Universidade de São Paulo)
Ano2024
Volume362
Páginas117441
Data de publicação2024-12-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSocial Science & Medicine (JOURNAL)
Identificadores do periódicoISSN: 0277-9536 • E-ISSN: 1873-5347
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2024.117441
PMID39488954
OpenAlexW4403907314
IdiomaEN
Referências citadas86

Subjective health (SH) deteriorates less rapidly than objective health (OH) in older adults. However, scant evidence exists regarding if discrepancies between SH and OH shift in the same individuals over time. We explore whether such discrepancies change over time in a sample of older adults living in England, through a prospective, observational cohort study design. Using data from the English Longitudinal Study of Ageing, we followed a sample of 6803 older adults, aged 60+ years at baseline, over three waves of data collection (2002-2007), yielding two wave transitions. A 'health asymmetry' metric classified older adults into four categories at each wave, based on the level of agreement between their SH and OH scores ('health pessimist', 'health optimist', 'good health realist' and 'poor health realist'). First-order Markov transition and generalised logit models yielded estimated transition probabilities and odds ratios for health asymmetry transitions over time. At baseline, 36.84% of the sample were 'good health realists', 33% were 'poor health realists', 14.54% were 'health optimists', and 15.62% were 'health pessimists'. Good and poor health realists were likely to remain health realistic over time. Good health realists who did transition however, were likely to become health optimists. Subsequently, the proportion of health optimists in the sample increased over time. Health pessimists had a high probability of being lost to study attrition. In conclusion, health optimism (i.e. where SH is rated better than OH) becomes more prevalent over time, in later life. Future research should investigate if promoting positive SH appraisals among health pessimists and poor health realists can optimise health and survival outcomes

Markov chain · Markov model · Public health · Sociology · Statistics · Transition (genetics · Demography · Global Health Care Issues · Health disparities and outcomes · Mathematics · Medicine · Psychology · Retirement, Disability, and Employment · Gerontology