Tracking Divergence of Objective and Subjective Health Across Age and Historical Time

Influential work in the gerontological literature in the 1990s has demonstrated that the discrepancy between objective and subjective evaluations of health increases with age. It is an open question though whether the direction and size of the age gradient in the discrepancies has changed over historical time. In this study, we examine cohort differences in age-related divergences in health evaluations using two markers of objective health (illnesses/functioning) and two markers of subjective health (overall/compared to others) obtained from cross-sectional samples of older adults in the Berlin Aging Studies in 1990–1993 ( n = 516, aged 70–103) and 2018–2020 ( n = 625, aged 68–94). We use both person-oriented and variable-oriented methodological frameworks that specifically facilitate study of aging as a process that propels individuals through a multidimensional health space: permutational multivariate analysis of variance (PERMANOVA) and structural equation modeling (SEM). The person-oriented PERMANOVA results revealed that divergence across markers of health increased with age, but did not evidence any cohort differences. Complementary results from variable-oriented SEMs corroborated that the four-dimensional variance-covariance structure did not differ across cohorts and that the age pattern was consistent across cohorts. Results suggest that objective and subjective indicators of health are increasingly discrepant after age 70, but reveal no evidence that age gradient of the divergences has changed across historical time.