Rationale: Self-reports of health and well-being are central for population monitoring, so it is paramount that they are measured accurately. The goal of this study was to examine the impact of age on the use of the comparison standards or frames of reference (FoRs) in self-reports of health, life-satisfaction, fatigue, and pain, and to determine if the age-health outcome associations were affected by age differences in FoRs.
Methods: Respondents (n = 2000) selected from the U.S. general population self-rated their life-satisfaction and health outcomes. Following this, they were asked to indicate if they used any comparisons (FoRs) when making their rating and the direction of these comparisons (upward, lateral or downward). Analyses examined (a) whether age groups differed in the type and direction of FoRs, and (b) whether age patterns in health, life-satisfaction, fatigue, and pain were altered when FoRs were statistically controlled.
Results: Compared to middle-aged and older people, younger respondents were more likely to compare themselves with other people when self-rating their health and life-satisfaction. They were also more likely to use a hypothetical situation when evaluating their pain and fatigue. Younger participants used lateral comparisons less often and downward comparisons more often than middle-aged and older participants. When these age differences in FoRs were statistically controlled, the observed age patterns in self-reported health outcomes were somewhat reduced.
Conclusions: The results show that people of different ages use different FoRs when self-reporting their life-satisfaction and health outcomes.
Keywords: Age; Fatigue; Frames of reference; Health; Life-satisfaction; Pain; Self-reports.