Hamilton Institute, Maynooth University, Co. Kildare, Ireland.
Department of Psychology, Maynooth University, Co. Kildare, Ireland.
Br J Health Psychol. 2022 Sep;27(3):971-989. doi: 10.1111/bjhp.12585. Epub 2022 Feb 11.
Ageing populations have the propensity to rate their health status more inaccurately than their younger counterparts. As a result, we (1) devised a metric which categorized older adults into groups based on the discrepancy between their self-rated health (SRH) and Frailty Index (FI) scores, and (2) investigated which factors predict group membership.
A cross-sectional design was employed using data from The Irish Longitudinal Study of Ageing (TILDA).
A health asymmetry metric was derived: this categorized 6907 participants (aged 50+ years) into three groups: 'health pessimistic' where participants underestimated their healthiness, 'health realistic' where participants accurately assessed their health, and 'health optimistic' where participants overestimated their healthiness. A multinomial logistic regression modelled the ability of a set of sociodemographic, psychosocial, and health behaviour variables in predicting membership of these categories.
A significant proportion of the study population were categorized as 'health realistic' (~69%). The prevalence rates of health optimistic individuals increased in older age groups, and conversely, health pessimistic rates decreased in older age groups. Most notably, psychosocial factors significantly predicted being health pessimistic: such as anxiety (OR = 1.03), loneliness (OR = 1.04), and decreased social connectedness (OR = 0.87). However, less clear sociodemographic, psychosocial, and health behaviour associations were found for being health optimistic.
Health asymmetry is a useful method of identifying at-risk individuals for inaccurate SRH. The ability of this metric to predict clinical mental health outcomes should be investigated.
老年人群体往往比年轻人群体更不准确地评估自己的健康状况。因此，我们（1）设计了一种基于自我报告健康状况（SRH）和脆弱指数（FI）评分之间差异的指标，将老年人分为不同组别；（2）研究了哪些因素可以预测分组。
采用横断面设计，使用爱尔兰老龄化纵向研究（TILDA）的数据。
得出了一个健康不对称指标：该指标将 6907 名（年龄在 50 岁及以上）参与者分为三组：“健康悲观组”，即低估自己健康状况的参与者；“健康现实组”，即准确评估自己健康状况的参与者；“健康乐观组”，即高估自己健康状况的参与者。采用多项逻辑回归模型，研究了一组社会人口统计学、心理社会和健康行为变量对这些组别的预测能力。
研究人群中相当一部分被归类为“健康现实组”（约 69%）。随着年龄的增长，健康乐观个体的比例增加，而健康悲观个体的比例则下降。最值得注意的是，心理社会因素显著预测了健康悲观：如焦虑（OR=1.03）、孤独（OR=1.04）和社交联系减少（OR=0.87）。然而，对于健康乐观，社会人口统计学、心理社会和健康行为因素的关联不太明确。
健康不对称是一种识别自我报告健康状况不准确的高危个体的有用方法。应研究该指标预测临床心理健康结果的能力。
