Does Self-Rated Health Foretell Loss of Dual Functionality?

Although there is a rich literature examining whether self-rated health predicts a variety of single measures of health, it is unknown whether it also predicts a global measure of health defined by a combination of physical and cognitive functions: dual functionality. We used data from the Health and Retirement Study from 2004 to 2020 (N = 12,439) to prospectively study the relationship between three specifications of self-rated health and loss of dual functionality using Weibull accelerated failure-time models. Among respondents with dual functionality at baseline, each higher level of self-rated health was significant in fully adjusted models to later loss of dual functionality. Specifying self-rated health as a time-varying covariate, however, revealed a more pronounced relationship with dual functionality than with baseline self-rated health. Self-rated health is a valuable upstream predictor of dual functionality, but using baseline self-rated health only will likely underestimate its influence on health outcomes.