title: Estimates of prospective change in self-rated health in older people were biased owing to potential recalibration response shift.
abstract: OBJECTIVE
  Evidence shows that self-rated health (SRH) remains remarkably stable during aging. Individuals may change their conceptualization of health or revise their standard of good health when facing health decline. Although this "response shift" phenomenon is potentially beneficial to the individual, it also challenges comparison of SRH assessments over time. The present study investigates this response shift.
  
  
  METHODS
  Data come from two waves (T1 and T2) of the Longitudinal Aging Study Amsterdam (N: 1,274; age: 55-89 years; mean follow-up: 3.6 years). Linear regression models were used for predicting SRH at T1 and T2. To capture changes in individual health standards, we administered a then-test at T2, asking respondents to retrospectively rate their health at T1 again.
  
  
  RESULTS
  No support was found for a changed conceptualization of SRH after health decline: predictive models for SRH at T1 and T2 were not significantly different. In the subgroup that reported identical SRH at T1 and T2, participants who experienced incident diseases were three times more likely to retrospectively overrate health at T1 with the then-test, suggesting that they had a lowered health standard.
  
  
  CONCLUSIONS
  Older people's concept of health remains stable when they encounter significant health problems, but they potentially lower their standard of good health over time.
authors: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. h.galenkamp@vumc.nl
authors: Henrike
authors: H
authors: Galenkamp
authors: Martijn
authors: M
authors: Huisman
authors: Arjan W
authors: AW
authors: Braam
authors: Dorly J H
authors: DJ
authors: Deeg
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012044:Regression Analysis