A path analysis model of self-rated health among older people.

The aim of this study was to examine the structure of self-rated health among 75-year-old men and women. The study was part of the Evergreen project, comprising all the 75-year-old residents (N = 382) of Jyväskylä, in central Finland, in 1989. The data were collected by interviews, questionnaires and laboratory examinations, focusing on different domains of health and functional capacity. Of the target group, 91.6% (119 men and 231 women) participated in the interview, and 77.2% (104 men and 191 women) took part in the clinical and laboratory examinations. Path analysis models (LISREL 8) were used to examine the structure of self-rated health. About half the participants self-rated their health as good or unusually good. In both genders, a smaller number of difficulties in performing the physical activities of daily living (PADL), fewer chronic diseases, and better maximal working capacity were associated with better self-rated health. In addition, among the women a smaller number of depressive symptoms, and among the men better cognitive capacity had a positive effect on self-rated health. Physical activity and muscle strength had a positive indirect effect on self-rated health among both men and women. The explanatory power of the path analysis model for self-rated health was 44% for the men, and 42% for the women. The ability to perform the physical activities of daily living independently is an important associate of good self-rated health among older people. The path analysis models suggest that the factors underlying the physical activities of daily living also directly modify self-ratings of health among the elderly. The models of self-rated health for the men and the women were not exactly alike.