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Joint modeling of self-rated health and changes in physical functioning.
Tuesday,2012-11-06 12:19 America/Los_Angeles — eenright
| Title | Joint modeling of self-rated health and changes in physical functioning. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | Hubbard, RA, Inoue, LYT, Diehr, P |
| Journal | J Am Stat Assoc |
| Volume | 104 |
| Issue | 487 |
| Pagination | 912 |
| Date Published | 2009 Sep 01 |
| ISSN | 0162-1459 |
| Abstract | <p>Self-rated health is an important indicator of future morbidity and mortality. Past research has indicated that self-rated health is related to both levels of and changes in physical functioning. However, no previous study has jointly modeled longitudinal functional status and self-rated health trajectories. We propose a joint model for self-rated health and physical functioning that describes the relationship between perceptions of health and the rate of change of physical functioning or disability. Our joint model uses a non-homogeneous Markov process for discrete physical functioning states and connects this to a logistic regression model for "healthy" versus "unhealthy" self-rated health through parameters of the physical functioning model. We use simulation studies to establish finite sample properties of our estimators and show that this model is robust to misspecification of the functional form of the relationship between self-rated health and rate of change of physical functioning. We also show that our joint model performs better than an empirical model based on observed changes in functional status. We apply our joint model to data from the Cardiovascular Health Study (CHS), a large, multi-center, longitudinal study of older adults. Our analysis indicates that self-rated health is associated both with level of functioning as indicated by difficulty with activities of daily living (ADL) and instrumental activities of daily living (IADL), and the risk of increasing difficulty with ADLs and IADLs.</p> |
| DOI | 10.1198/jasa.2009.ap08423 |
| Alternate Journal | J Am Stat Assoc |
| PubMed ID | 20151036 |
| PubMed Central ID | PMC2819480 |
| Grant List | N01 HC085081 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States U01 HL080295-05 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |