THE STRUCTURE OF HEALTH-STATUS AMONG OLDER ADULTS - DISEASE, DISABILITY, FUNCTIONAL LIMITATION, AND PERCEIVED HEALTH

This article builds on earlier conceptualizations of the structure of health status to propose a more complex, multiequation model that exam ines the interrelationships among its various dimensions. As such, the focus is not merely on the identification of the direct effects of a variety of factors on perceived health status, but on how the construc ts of disease, functional limitation, and self-rated health interrelat e. In so doing, we expose the inherent problems of several complex and contaminated items routinely included in applications of established functional health status measures. The source of these problems lies i n the lack of specificity or conceptual clarity for the individual ite ms in these established measures. Potential biases are discussed, and several methods and strategies for addressing these problems are explo red. Alternative scales are constructed and their psychometric propert ies are presented. Researchers who rely on public use data bases conta ining these scales should be aware of the potential biases and either modify the scales or use other appropriate methodologies to control fo r the measurement contamination.