How does self-assessed health change with age? A study of older adults in Japan.

OBJECTIVE This research examines how the trajectories of self-rated health evolve among elderly Japanese individuals and how socioeconomic status (SES), social relations, and baseline health differentiate these trajectories. METHODS Data came from a five-wave panel study of a national sample of 2,200 Japanese old adults between 1987 and 1999. Hierarchical linear models and cluster analysis were employed to depict major patterns of temporal changes in self-rated health. RESULT Overall perceived health becomes worse, but only slightly, between ages 60 and 85, whereas it appears to improve a little bit after age 85. Underlying the observed age norm are four subtrajectories including constant good health, early onset of perceived health decline, late onset of perceived health decline, and a course of recovery from poor self-assessed health. DISCUSSION Diverse subjective health trajectories exist in old age, extending well into the 90s. Prior observations of the effects of SES, social relations, and baseline health on health states and transitions can now be extended to trajectories of subjective health. Our analysis of Japanese data provides important benchmarks for comparisons with observations made in other developed nations.

[1]  Erika Kobayashi,et al.  Changes in functional status among older adults in Japan: successful and usual aging. , 2003, Psychology and aging.

[2]  J. Bennett,et al.  Gender differences in old age mortality: roles of health behavior and baseline health status. , 2003, Journal of clinical epidemiology.

[3]  E. Feskens,et al.  Age, time, and cohort effects on functional status and self-rated health in elderly men. , 1997, American journal of public health.

[4]  G. Fillenbaum,et al.  Comparison of Two Brief Tests of Organic Brain Impairment, the MSQ and the Short Portable MSQ , 1980, Journal of the American Geriatrics Society.

[5]  J M Lepkowski,et al.  The social stratification of aging and health. , 1994, Journal of health and social behavior.

[6]  David Rogosa,et al.  Myths about longitudinal research. , 1988 .

[7]  J. Mcardle,et al.  Two – Latent Variable Growth Models for Research on Aging , 1990 .

[8]  Y. Benyamini,et al.  Self-rated health and mortality: a review of twenty-seven community studies. , 1997, Journal of health and social behavior.

[9]  Erika Kobayashi,et al.  Old age mortality in Japan: does the socioeconomic gradient interact with gender and age? , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[10]  L. George,et al.  Race differences in depressive symptoms: a dynamic perspective on stress exposure and vulnerability. , 2003, Journal of health and social behavior.

[11]  Robert Crosnoe,et al.  Successful adaptation in the later years: A life course approach to aging , 2002 .

[12]  E. Idler Age differences in self-assessments of health: age changes, cohort differences, or survivorship? , 1993, Journal of gerontology.

[13]  Shawna V. Hudson,et al.  The Meanings of Self-Ratings of Health , 1999 .

[14]  D. Dannefer,et al.  Aged heterogeneity: fact or fiction? The fate of diversity in gerontological research. , 1992, The Gerontologist.

[15]  C. Ross,et al.  Education, age, and the cumulative advantage in health. , 1996, Journal of health and social behavior.

[16]  J. Potter,et al.  Essentials of Clinical Geriatrics , 2002 .

[17]  Eva Kahana,et al.  The meaning of older adults' health appraisals: congruence with health status and determinant of mortality. , 1996, The journals of gerontology. Series B, Psychological sciences and social sciences.

[18]  H. Sudak Handbook of Aging and Mental Health: An Integrative Approach , 2000 .

[19]  J. Rowe,et al.  Human aging: usual and successful. , 1987, Science.

[20]  L. Berkman,et al.  Two Shorter Forms of the CES-D Depression Symptoms Index , 1993 .

[21]  K F Ferraro,et al.  Self-ratings of health among the old and the old-old. , 1980, Journal of health and social behavior.

[22]  J. House,et al.  Social relationships and health. , 1988, Science.

[23]  L. Radloff The CES-D Scale , 1977 .

[24]  B. Singer,et al.  Resilience in adulthood and later life: Defining features and dynamic processes. , 1998 .

[25]  M. Farmer,et al.  Utility of Health data from Social Surveys: Is There a Gold Standard for Measuring Morbidity? , 1999, American Sociological Review.

[26]  Correlates of subjective health in older adults: a meta-analysis. , 2001 .

[27]  S. Fiske,et al.  The Handbook of Social Psychology , 1935 .

[28]  J. Rowe,et al.  Successful aging. , 1998, Aging.

[29]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[30]  M. Pinquart,et al.  Correlates of subjective health in older adults: a meta-analysis. , 2001, Psychology and aging.

[31]  Bridget Martin,et al.  Countries , 2019, Survival or Extinction?.

[32]  P. Berglund,et al.  Histories of poverty and self-rated health trajectories. , 2003, Journal of health and social behavior.

[33]  E. Clipp,et al.  Trajectories of health: In concept and empirical pattern. , 1992 .

[34]  R. Nisbett,et al.  The cultural matrix of social psychology , 1998 .

[35]  G. Maddox,et al.  Self-assessment of health: a longitudinal study of elderly subjects. , 1973, Journal of health and social behavior.

[36]  K. Schaie,et al.  Methodological issues in aging research , 1990 .

[37]  E. Pfeiffer A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients † , 1975, Journal of the American Geriatrics Society.

[38]  G. Jay,et al.  Patterns of nonresponse in a national survey of elderly Japanese. , 1993, Journal of gerontology.

[39]  Joseph L Schafer,et al.  Analysis of Incomplete Multivariate Data , 1997 .

[40]  K. Ferraro,et al.  Self and Age Differences in Defining Health Situations , 1996 .