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The structure of self-rated health among community-dwelling older adults with stroke
1Special 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
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.
Data Sources And Study Setting:
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.
Study Design:
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.
Principle Findings:
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.
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