Health incongruence in later life: implications for subsequent well-being and health care.
OBJECTIVE
The premise that pessimistic health appraisals compromise well-being whereas optimistic appraisals are compensatory was examined in a longitudinal study of 232 community-dwelling older adults (ages 79-98 years).


METHODS
Subjective health (SH) appraisals were contrasted with objective health (OH) to identify realists, whose ratings were congruent (SH = OH), distinguishing them from health pessimists (SH < OH) and health optimists (SH > OH), whose ratings were incongruent. Analyses of covariance were used to examine group differences 2 years later on well-being and health care.


METHODS
Outcome measures were psychological well-being (life satisfaction, positive and negative emotions), functional well-being (objective and perceived physical activity, activity restriction), and health care (health care management, hospital admissions, length of hospital stays).


RESULTS
Compared with realists, pessimists had significantly poorer outcomes and optimists had better outcomes. Because perceived control (PC) was weaker among pessimists and stronger among optimists, supplemental analysis determined whether PC differences explained these findings. When accounting for PC, many pessimism and optimism effects became nonsignificant, yet effects on functional well-being remained unchanged.


CONCLUSIONS
Findings have implications for older adults at risk of functional decline.
Ruthig
Joelle C
JC
Department of Psychology, University of North Dakota, 319 Harvard Street, Grand Forks, ND 58202, USA. joelle.ruthig@und.nodak.edu
Chipperfield
Judith G
JG
D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001294:Attitude to Health; D015444:Exercise; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba; D010551:Personality