Health appraisal models in multiple sclerosis.

This study used multi-group path analysis to test the hypothesis that disability's total effect on self-rated health differs for different-aged persons with multiple sclerosis (MS). Data (n=806) collected as part of a larger study examining quality of life for persons with MS were used to construct and compare models of health appraisal for three age groups, 18 to 45 (n=347), 46 to 60 (n=339), and 61 to 78 (n=120). The results suggest that while the same general model describes health appraisal in each age group, disability's total effect on self-rated health is less in the older and middle-aged groups than in the youngest group. Further, disability's direct effect, rather than the hypothesized indirect effects, accounts for the group differences. The findings support the other work in this area suggesting that age may moderate the effect of "objective" health status on self-rated health. The generally surprising finding was the "break point" for this effect -- contrary to other research that suggests older persons may differ from other-aged individuals, in this sample of persons with MS, the youngest group differed from the others. These results are discussed in terms of MS specifically and health appraisal more generally.