OBJECTIVE: To confirm the association between
depression and self-rated general health, independent of
demographics, functional disability, physical illness
burden, and health services utilization.
DESIGN:
Logistic regression analyses of data obtained in a
cross-sectional epidemiological survey.
SETTING:
The mid-Monongahela Valley, a rural, nonfarm, low SES
community.
PARTICIPANTS: Random sample of 880
subjects aged 65 and older.
MEASUREMENTS: The
dependent variable was self-rated overall health,
categorized as excellent, good, fair, or poor. The
independent variables were demographics (age, gender,
education), number of depressive symptoms, number of
impaired instrumental activities of daily living (IADLs),
measures of physical illness burden (individual medical
conditions, number of affected organ systems or disease
processes, and number of prescription medications), and
measures of health services utilization (number of visits
to physicians, and acute hospitalization).
RESULTS:
Univariate analyses indicated that poorer self-rated
health was associated with lesser education, higher
numbers of depressive symptoms, impaired IADLs,
prescription medications, physician visits,
hospitalizations, and affected organ systems, and with the
presence of several specific conditions. However, multiple
logistic regression analyses revealed that only the
following variables were associated independently with
poorer self-rated health: age less than 75 years,
education less than high school graduation, greater
numbers of depressive symptoms, impaired IADLs,
prescription medications, and physician visits.
CONCLUSIONS: Even when controlling for physical
illness and functional disability, subjective rating of
overall health remains strongly and independently
associated with depressive symptoms.