title: A five-year study of older adults' health incongruence: consistency, functional changes and subsequent survival.
abstract: In later life, optimistic health appraisals promote well-being and survival, whereas pessimistic appraisals can be harmful. This study contrasted subjective health (SH) appraisals 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) with incongruent ratings. Health congruence and functional well-being of 757 older adults were assessed via two interviews conducted 5 years apart. We examined consistency in health congruence, and among those with persistent OH, we examined 5-year functional well-being changes that corresponded with SH shifts and determined whether SH shifts predicted 30-month survival. Most realists remained realists; health optimists and pessimists tended to become realists. Increased health optimism corresponded with enhanced functioning; increased pessimism corresponded with decreased functioning. Among realists, increasingly positive SH predicted survival. Findings have implications for quality and length of life among older adults with chronic health conditions.
authors.affiliation: Department of Psychology, University of North Dakota, 319 Harvard Street Stop #8380, Grand Forks, North Dakota 58202, USA. joelle.ruthig@und.edu
authors.forename: Joelle C
authors.initials: JC
authors.lastname: Ruthig
authors.forename: Judith G
authors.initials: JG
authors.lastname: Chipperfield
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Payne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba; D012650:Self Disclosure; D016019:Survival Analysis