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.


METHODS
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.


METHODS
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.


RESULTS
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.
Han
B
B
Special Populations Research Branch, Division of Programs for Special Populations, Bureau of Primary Health Care, Health Resources and Services Administration, Bethesda, MD 20814, USA. bhan@hrsa.gov
Small
B J
BJ
Haley
W E
WE
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D012111:Residence Characteristics; D012649:Self Concept; D020521:Stroke / Q000523:psychology; D014481:United States