Distinguishing between-person and within-person relationships in longitudinal health research: Arthritis and quality of life

Background Many health measures (e.g., blood pressure, quality of life) have meaningful fluctuation over time around a relatively stable mean level for each person. Purpose This didactic paper describes two closely related statistical models for examining between-person and withinperson relationships between two or more sets of measures collected over time: the latent intercept model with correlated residuals (LI) in structural equation modeling framework and the multivariate multilevel model (MVML) in multilevel modeling framework. Results We illustrated that the basic LI model and the MVML model are equivalent. We presented an illustrative example using a national arthritis data resource to examine between-person and within-person relationships of symptom status, functional health, and quality of life in arthritis patients. Discussion Additional design and modeling issues for the treatment of missing data are considered.We discuss contexts in which one of the two models may be preferred. Mplus and SAS syntax are available.