The Mediating Role of Proxy Respondents on the Relationship Between Cognitive Function and Self-Rated Health.

IF 4.6 2区医学 Q1 GERONTOLOGY Gerontologist Pub Date : 2024-06-01 DOI:10.1093/geront/gnad163

Andrew G Alberth, Edward Alan Miller, Nina M Silverstein, Jeffrey Stokes, Yan-Jhu Su

{"title":"The Mediating Role of Proxy Respondents on the Relationship Between Cognitive Function and Self-Rated Health.","authors":"Andrew G Alberth, Edward Alan Miller, Nina M Silverstein, Jeffrey Stokes, Yan-Jhu Su","doi":"10.1093/geront/gnad163","DOIUrl":null,"url":null,"abstract":"Background and objectives: Proxy respondents are an important tool in survey research, especially among people with cognitive impairment. However, proxy respondents may be unable to accurately answer subjective survey instruments for cognitively impaired persons. This study investigates the mediating effect of proxy status on the relationship between cognitive impairment and subjectively rated health.Research design and methods: Respondents from the 2018 wave of the Health and Retirement Study (N = 17,146) were included, and the Baron and Kenny method assessed the potential mediating role of having a proxy on subjectively rated health. Subjectively rated health and proxy status were dichotomously coded, and relationships between cognitive impairment, proxy status, and subjectively rated health were assessed using logistic regression.Results: Findings indicate that cognitive impairment is inversely associated with subjectively rated health, and it is directly associated with having a proxy. They also indicate that having a proxy is inversely related to subjectively rated health. When including proxy status and cognitive impairment in the same model, cognitive impairment no longer predicted subjectively rated health. This indicates that proxy status perfectly mediated the relationship between cognitive impairment and subjectively rated health.Discussion and implications: Measuring the experiences of people with cognitive impairment is challenging in survey research due to the limiting features of cognitive impairment. Although having a proxy respondent helps address attrition-related measurement challenges in survey research, findings indicate that proxies report worse subjectively rated health for people with cognitive impairment compared to individuals with comparable levels of cognitive impairment without a proxy. Future research may benefit from exploring optimal proxy-respondent characteristics.","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519039/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gerontologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geront/gnad163","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objectives: Proxy respondents are an important tool in survey research, especially among people with cognitive impairment. However, proxy respondents may be unable to accurately answer subjective survey instruments for cognitively impaired persons. This study investigates the mediating effect of proxy status on the relationship between cognitive impairment and subjectively rated health.

Research design and methods: Respondents from the 2018 wave of the Health and Retirement Study (N = 17,146) were included, and the Baron and Kenny method assessed the potential mediating role of having a proxy on subjectively rated health. Subjectively rated health and proxy status were dichotomously coded, and relationships between cognitive impairment, proxy status, and subjectively rated health were assessed using logistic regression.

Results: Findings indicate that cognitive impairment is inversely associated with subjectively rated health, and it is directly associated with having a proxy. They also indicate that having a proxy is inversely related to subjectively rated health. When including proxy status and cognitive impairment in the same model, cognitive impairment no longer predicted subjectively rated health. This indicates that proxy status perfectly mediated the relationship between cognitive impairment and subjectively rated health.

Discussion and implications: Measuring the experiences of people with cognitive impairment is challenging in survey research due to the limiting features of cognitive impairment. Although having a proxy respondent helps address attrition-related measurement challenges in survey research, findings indicate that proxies report worse subjectively rated health for people with cognitive impairment compared to individuals with comparable levels of cognitive impairment without a proxy. Future research may benefit from exploring optimal proxy-respondent characteristics.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

代理受访者对认知功能与自评健康之间关系的中介作用。

背景和目的：代理受访者是调查研究的重要工具，尤其是在认知障碍人群中。然而，代理受访者可能无法准确回答认知障碍患者的主观调查问卷。本研究调查了代理身份对认知障碍与主观评定健康之间关系的中介效应：研究纳入了2018年健康与退休研究（Health and Retirement Study）的受访者（N=17146），并采用巴伦和肯尼法（Baron and Kenny method）评估了拥有代理人对主观评定健康状况的潜在中介作用。主观评定的健康状况和代理状态被二分编码，认知障碍、代理状态和主观评定的健康状况之间的关系使用逻辑回归进行评估：结果：研究结果表明，认知障碍与主观评定的健康状况成反比，与是否有代理人直接相关。结果：研究结果表明，认知障碍与主观评定的健康状况成反比，并且与是否有代理人直接相关，还表明是否有代理人与主观评定的健康状况成反比。如果将代理状态和认知障碍纳入同一模型，认知障碍不再预测主观评定的健康状况。这表明，代理状态完美地调解了认知障碍与主观健康评分之间的关系：由于认知障碍的局限性，在调查研究中测量认知障碍患者的经历具有挑战性。虽然代理受访者有助于解决调查研究中与自然减员相关的测量难题，但研究结果表明，与认知障碍程度相当但没有代理受访者的个体相比，认知障碍患者的代理受访者报告的主观评定健康状况更差。未来的研究可能会受益于探索最佳的代理受访者特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Gerontologist GERONTOLOGY-

CiteScore

11.00

自引率

8.80%

发文量

171

期刊介绍： The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.