Patterns of longitudinal change in older adults’ self-rated health: The effect of the point of reference.

OBJECTIVE: This study investigated the effect of the reference point of self-rated health (SRH) items on the trajectory of older adults' subjective health. DESIGN: Seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004) were used to determine change in SRH in a large sample (N = 2,081; 49% men) of older adults (65+ years). MAIN OUTCOME MEASURES: Three SRH measures with different points of reference (global vs. age-comparative and self-comparative) were used. RESULTS: Ordinal latent growth models revealed unique patterns of change. Global ratings became more negative in a linear fashion. Self-comparative ratings initially declined; however, the rate of change was found to decelerate over time. Age-comparative ratings showed a gender by age interaction, revealing that women's ratings remained relatively stable, whereas men's ratings were more likely to become more negative with age. CONCLUSION: Findings suggest that the reference point significantly influences how older adults evaluate their health over time. This has implications regarding the use of SRH items and indicates that the reference point is an important consideration in the subjective health assessment of older adults.