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Determinants of change in self-rated health among older adults in Europe: a longitudinal perspective based on SHARE data

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Abstract

The present study aims at detecting factors which may predict a decline or an improvement in self-rated health (SRH) of older adults (persons aged 50 or higher) among socio-demographic characteristics, physical and mental health indicators and risky health behaviours. In the analysis, multinomial logistic regression models are applied to data from waves 1 and 2 of the Survey of Health Ageing and Retirement in Europe (carried out about 3 years apart); persons who report a decline or an improvement in SRH at wave 2 are compared to those who report no change while controlling for SRH at baseline and country of residence. The analysis was carried out for the whole sample and two subgroups, persons aged 50–64 and 65 or higher. The results indicate that female sex and higher educational attainment have a strong protective effect against decline in SRH. Worse health at baseline is an important predictor of subsequent decline but changes occurring between the waves have a more pronounced effect, implying that SRH is influenced more by recent developments. The findings also indicate that improvement in SRH is a more complex concept than decline and is strongly affected by factors other than health. Among behavioural risk factors, low levels of physical activity and a decrease in the levels of activity between the waves are significantly related to decline while frequent drinking seems associated with improvement. Differentiations by age are modest and probably suggest that advancing age is related to a milder view of one’s health.

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Authors and Affiliations

  1. Department of Statistics & Insurance Science, University of Piraeus, 80, Karaoli & Dimitriou Str, 185 34, Piraeus, Athens, Greece

    Georgia Verropoulou

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  1. Georgia Verropoulou
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Correspondence to Georgia Verropoulou.

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Responsible Editor: D. J. H. Deeg.

Appendix: Questions and items comprising the health indicators included in the analysis

Appendix: Questions and items comprising the health indicators included in the analysis

Self-Rated Health US version

Would you say your health is….

Excellent

Very good

Good

Fair

Poor

Self-Rated Health European version

Would you say your health is…

Very good

Good

Fair

Bad

Very bad

Mobility Difficulties

Because of a physical or health problem, do you have difficulty doing any of the activities on this card? Exclude any difficulties you expect to last less than three months.

Walking 100 meters

Sitting for about two hours

Getting up from a chair after sitting for long periods

Climbing several flights of stairs without resting

Climbing one flight of stairs without resting

Stooping, kneeling, or crouching

Reaching or extending your arms above shoulder level (either arm)

Pulling or pushing large objects like a living room chair

Lifting or carrying weights over 10 pounds, like a heavy bag of groceries

Picking up a 5p coin from a table

ADL (Activities of Daily Living)

Here are a few more everyday activities. Please tell me if you have any difficulty with these because of a physical, mental, emotional or memory problem. Again exclude any difficulties you expect to last less than three months.

Dressing, including putting on shoes and socks

Walking across a room

Bathing or showering

Eating, including cutting up your food

Getting in or out of bed

Using the toilet, including getting up or down

IADL (Instrumental Activities of Daily Living)

Using a map to figure out how to get around in a strange place

Preparing a hot meal

Shopping for groceries

Making telephone calls

Taking medications

Doing work around the house or garden

Managing money, such as paying bills and keeping track of expenses

Chronic Conditions

Has a doctor ever told you that you had any of the following conditions?

Heart attack including myocardial infarction or coronary thrombosis or any other heart problem including congestive heart failure

High blood pressure or hypertension

High blood cholesterol

A stroke or cerebral vascular disease

Diabetes or high blood sugar

Chronic lung disease such as chronic bronchitis or emphysema

Asthma

Arthritis, including osteoarthritis, or rheumatism

Osteoporosis

Cancer or malignant tumour, including leukaemia or lymphoma, excluding minor skin cancers

Stomach or duodenal ulcer, peptic ulcer

Parkinson disease

Cataracts

Hip fracture or femoral fracture

Other conditions, not yet mentioned

Somatic Symptoms

For the past six months at least, have you been bothered by any of the following health conditions?

Pain in your back, knees, hips or any other joint

Heart trouble or angina, chest pain during exercise

Breathlessness, difficulty breathing

Persistent cough

Swollen legs

Sleeping problems

Falling down

Fear of falling down

Dizziness, faints or blackouts

Stomach or intestine problems, including constipation, air, diarrhoea

Incontinence or involuntary loss of urine

Other symptoms, not yet mentioned

Depressive Symptoms comprising the EURO-D scale

Sadness—Depression

Pessimism

Suicidal tendency

Guilt

Trouble sleeping

Lack of Interest

Irritability

Loss of appetite

Fatigue

Lack of enjoyment

Tearfulness

Lack of concentration

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Verropoulou, G. Determinants of change in self-rated health among older adults in Europe: a longitudinal perspective based on SHARE data. Eur J Ageing 9, 305–318 (2012). https://doi.org/10.1007/s10433-012-0238-4

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