The structure of self-rated health among community-dwelling older adults with stroke.

OBJECTIVE

To examine whether depressive symptomatology is a third fundamental component of the structure of self-rated health, in addition to two other components (physical disease and functional disability) among community-dwelling older adults with stroke.

DATA SOURCES AND STUDY SETTING

A total of 591 community-dwelling older adults with stroke were identified from the 1993 Asset and Health Dynamics among the Oldest-Old (AHEAD) national survey of community-dwelling older adults.

STUDY DESIGN

A cross-sectional study. Structural equation modeling was applied to compare a widely used two-factor model of self-rated health with a model adding depression as a third possible factor.

PRINCIPLE FINDINGS

The hypothesized three-factor model explained additional 21% more variance of self-rated health of older adults with stroke (R2 = 79%, NNFI = 0.95, CFI = 0.96, RMSEA = 0.04) as compared with the two-factor biomedical model (R2 = 58%, NNFI = 0.95, CFI = 0.98, RMSEA = 0.05). The three-factor model was statistically different from the two-factor model.

CONCLUSIONS

Greater attention should be given to the theoretical structure of self-rated health of older adults with stroke, particularly, the significant impact of depression on their self-rated health.