Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model
Abstract
Introduction: Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person’s general health status.
Objective: To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.
Materials and methods: We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: “What do you think is your current health status?” Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.
Results: A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).
Conclusions: A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.
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References
Sadana R. Comparative analyses of more than 50 household surveys on health status. Geneva: WHO; 2000.
Idler EL, Benyamini Y. Community studies reporting association between self-rated health and mortality. Res Aging. 1999;21: 392-401. http://dx.doi.org/10.1177/0164027599213002
Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav. 1997;38:21-37.
Phillips LJ, Hammock RL, Blanton JM. Predictors of selfrated health status among Texas residents. Prev Chronic Dis. 2005;2:A12.
Suija K, Kalda R, Maaroos HI. Patients with depressive disorder, their co-morbidity, visiting rate and disability in relation to self-evaluation of physical and mental health: A cross-sectional study in family practice. BMC Fam Pract. 2009;10:38. http://dx.doi.org/10.1186/1471-2296-10-38
Mossey JM, Shapiro E. Self-rated health: A predictor of mortality among the elderly. Am J Public Health. 1982;72:800-8.
Jylhä M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009;69:307-16. http://dx.doi.org/10.1016/j.socscimed.2009.05.013
Birch S, Eyles J, Newbold KB. Proxies for healthcare need among populations: Validation of alternatives--a study in Quebec. J Epidemiol Community Health. 1996;50:564-9.
DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med. 2006;21:267-75. http://dx.doi.org/10.1111/j.1525-1497.2005.00291.x
Friedsam H, Martin HW. A comparison of self and physicians’ health ratings in an older population. J Health Hum Behav.1963:179-83.
Maddox GL, Douglass EB. Self-assessment of health: A longitudinal study of elderly subjects. J Health Soc Behav.1973;4:87-93.
LaRue A, Bank L, Jarvik U, Hetland M. Health in old age: How do physicians’ ratings and self-ratings compare? J Gerontol. 1979;34:687-91. http://dx.doi.org/10.1093/geronj/34.5.687
Linn BS, Linn MW. Objective and self-assessed health in the old and very old. Soc Sci Med Med Psychol Med Sociol. 1980;14:311-5.
Linn MW, Hunter KI, Linn BS. Self-assessed health, impairment and disability in Anglo, Black and Cuban elderly. Med Care. 1980;18:282-8.
Pattussi MP, Peres KG, Boing AF, Peres MA, Da Costa JS. Self-rated oral health and associated factors in Brazilian elders. Community Dent Oral Epidemiol. 2010;38:348-59. http://dx.doi.org/10.1111/j.1600-0528.2010.00542.x
Moreno X, Huerta M, Albala C. Global self-rated health and mortality in older people. Gac Sanit. 2014;28:246-52. http://dx.doi.org/10.1016/j.gaceta.2013.07.006
Rennemark M, Hagberg B. What makes old people perceive symptoms of illness? The impact of psychological and social factors. Aging Ment Health. 1999;3:79-87. http://dx.doi.org/10.1080/13607869956460
Evans ME. Physical illness and depression. En: Copeland JR, Abou-Saleh MT, Blazer DG, editores. Principles and Practice of Geriatric Psychiatry. Second edition. Chichester, UK.: John Wiley & Sons, Ltd; 2002. p. 417-22. http://dx.doi.org/10.1002/0470846410.ch75a
Ratner PA, Johnson JL, Jeffery B. Examining emotional, physical, social, and spiritual health as determinants of selfrated health status. Am J Health Promot. 1998;12:275-82. http://dx.doi.org/10.4278/0890-1171-12.4.275
Paskulin L, Vianna L, Molzahn A. Factors associated with quality of life of Brazilian older adults. Int Nurs Rev. 2009;56:109-15. http://dx.doi.org/10.1111/j.1466-7657.2008.00671.x
Reynolds SL, Silverstein M. Observing the onset of disability in older adults. Soc Sci Med. 2003;57:1875-89. http://dx.doi.org/10.1016/S0277-9536(03)00053-4
Knäuper B, Turner PA. Measuring health: Improving the validity of health assessments. Qual Life Res. 2003;12:81-9.
Fýlkesnes K, Førde OH. Determinants and dimensions involved in self-evaluation of health. Soc Sci Med. 1992;35:271-9.
Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, et al. Age-and gender-specific prevalence of depression in latest-life – Systematic review and metaanalysis.J Affect Disord. 2012;136:212-21. http://dx.doi.org/10.1016/j.jad.2010.11.033
Gallegos-Carrillo K, García-Peña C, Durán-Muñoz C, Reyes H, Durán-Arenas L. Autopercepción del estado de salud: una aproximación a los ancianos en México. Rev Saúde Pública. 2006;40:792-801. http://dx.doi.org/10.1590/S0034-89102006000600008
Romero-Martínez M, Shamah-Levy T, Franco-Núñez A, Villalpando S, Cuevas-Nasu L, Gutiérrez JP, et al. Encuesta Nacional de Salud y Nutrición 2012: diseño y cobertura. Salud Pública Mex. 2013;55:S332-40.
Huang CQ, Dong BR, Lu ZC, Yue JR, Liu QX. Chronic diseases and risk for depression in old age: A meta-analysis of published literature. Ageing Res Rev. 2010;9:131-41. http://dx.doi.org/10.1016/j.arr.2009.05.005
Fernández-Niño JA, Manrique-Espinoza BS, Bojórquez-Chapela I, Salinas-Rodríguez A. Income inequality, socioeconomic deprivation and depressive symptoms among older adults in México. PLoS One. 2014;9:e108127. http://dx.doi.org/10.1371/journal.pone.0108127
Diederichs C, Berger K, Bartels DB. The measurement of multiple chronic diseases — A systematic review on existing multimorbidity indices. J Gerontol A-Biol. 2011;66:301-11. http://dx.doi.org/10.1093/gerona/glq208
Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: Toward a more uniform methodology. Ann Fam Med. 2012;10:142-51. http://dx.doi.org/10.1370/afm.1337
Katz S, Branch LG, Branson MH, Papsidero JA, Beck JC, Greer DS. Active life expectancy. New Engl J Med. 1983;309:1218-24. http://dx.doi.org/10.1056/NEJM198311173092005
Herrero J, Gracia E. Una medida breve de la sintomatología depresiva. Salud Mental. 2007;30:40-6.
Salinas-Rodríguez A, Manrique-Espinoza B, Acosta-Castillo GI, Franco-Núñez A, Rosas-Carrasco Ó, Gutiérrez-Robledo LM, et al. Validación de un punto de corte para la versión breve de la Escala de Depresión del Centro de Estudios Epidemiológicos en adultos mayores mexicanos. Salud Pública Mex. 2014;56:279-85.
Damian J, Pastor-Barriuso R, Valderrama-Gama E. Factors associated with self-rated health in older people living in institutions. BMC Geriatr. 2008;8:5. http://dx.doi.org/10.1186/1471-2318-8-5
Wilcox VL, Kasl SV, Idler EL. Self-rated health and physical disability in elderly survivors of a major medical event. J Gerontol B Psychol Sci Soc Sci. 1996;51:S96-104.
Han B. Depressive symptoms and self-rated health in community-dwelling older adults: A longitudinal study. J Am Geriatr Soc. 2002;50:1549-56. http://dx.doi.org/10.1046/j.1532-5415.2002.50411.x
Kondo N, Sembajwe G, Kawachi I, van Dam RM, Subramanian SV, Yamagata Z. Income inequality, mortality, and self rated health: Meta-analysis of multilevel studies. BMJ. 2009;339:b4471. http://dx.doi.org/10.1136/bmj.b4471
Gunasekara FI, Carter K, Blakely T. Change in income and change in self-rated health: Systematic review of studies using repeated measures to control for confounding bias. Soc Sci Med. 2011;72:193-201. http://dx.doi.org/10.1016/j.socscimed.2010.10.029.
Deeg DJ, Kriegsman DM. Concepts of self-rated health: Specifying the gender difference in mortality risk. Gerontologist. 2003;43:376-86. http://dx.doi.org/10.1093/geront/43.3.376
Shi L, Starfield B. Primary care, income inequality, and selfrated health in the United States: A mixed-level analysis. Int J Health Serv. 2000;30:541-55. http://dx.doi.org/10.2190/N4M8-303M-72UA-P1K1
Goldstein MS, Siegel JM, Boyer R. Predicting changes in perceived health status. Am J Public Health. 1984;74:611-4.
Brook RH, Ware JE, Davies-Avery A, Stewart AL, Donald CA, Rogers WH, et al. Overview of adult health status measures fielded in Rand’s Health Insurance Study. Med Care. 1979:17:i-131.
Nieminen T, Martelin T, Koskinen S, Aro H, Alanen E, Hyyppa MT. Social capital as a determinant of self-rated health and psychological well-being. Int J Public Health. 2010;55:531-42. http://dx.doi.org/10.1007/s00038-010-0138-3
Kim D, Kawachi I. A multilevel analysis of key forms of community- and individual-level social capital as predictors of self-rated health in the United States. J Urban Health. 2006;83:813-26. http://dx.doi.org/10.1007/s11524-006-9082-1
Fayers PM, Sprangers MA. Understanding self-rated health. Lancet. 2002;359:187-8. http://dx.doi.org/10.1016/s0140-6736(02)07466-4
Mohan R, Beydoun HA, Beydoun MA, Barnes-Eley M, Davis J, Lance R, et al. Self-rated health as a tool for estimating health-adjusted life expectancy among patients newly diagnosed with localized prostate cancer: A preliminary study. Qual Life Res. 2011;20:713-21. http://dx.doi.org/10.1007/s11136-010-9805-3
Lee Y, Shinkai S. A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea. Arch Gerontol Geriatr. 2003;37:63-76. http://dx.doi.org/10.1016/S0167-4943(03)00021-9
Verropoulou G. Key elements composing self-rated health in older adults: A comparative study of 11 European countries. Eur J Ageing. 2009;6:213-26. http://dx.doi.org/10.1007/s10433-009-0125-9
Bombak AE, Bruce SG. Self-rated health and ethnicity: Focus on indigenous populations. J Circumpolar Health. 2012;71:18538. http://dx.doi.org/10.3402/ijch.v71i0.18538
Nielsen AB, Siersma V, Waldemar G, Waldorff FB. Poor self-rated health did not increase risk of permanent nursing placement or mortality in people with mild Alzheimer’s disease. BMC Geriatr. 2016;16:1-8. http://dx.doi.org/10.1186/s12877-016-0262-x
Pinto JM, Fontaine AM, Neri AL. The influence of physical and mental health on life satisfaction is mediated by selfrated health: A study with Brazilian elderly. Arch Gerontol Geriatr. 2016;65:104-10. http://dx.doi.org/10.1016/j.archger.2016.03.009
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