Affect and self-rated health: a dynamic approach with older adults

Self-rated health (SRH) predicts mortality above and beyond objective health risks and, as such, comprises an important aspect of health. Established contributors to SRH include affect, age, and disease, but neither their dynamic nor their synergistic contributions to SRH have been comprehensively tested.

The present study employed older adults (N = 150; Mage = 75 years) and a longitudinal design with 6-month waves over a period up to 5 years. Positive (PA) and negative affect (NA), chronic disease, and SRH were assessed at each wave.

In multilevel models with single predictors, older age, more chronic disease, and higher NA predicted worse SRH, whereas higher PA predicted better SRH. Affect predicted SRH both between and within people. In multilevel models with interactions between affect and age or disease, individual differences in NA predicted worse SRH primarily in older people. Within people, changes in NA were associated with changes in SRH, but more so in younger than in older people. Within people, changes in PA were associated with changes in SRH, but only when health was better than usual.

There were both dynamic and synergistic relationships between affect and SRH that could only emerge in a multilevel, multivariable design. In the case of NA, between-person, trait NA had the opposite relationship to SRH and age compared to within-person, state NA. Which component of this relationship predicts mortality is an important question for future research.