Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model

• Published in: Biomédica Vol. 37; pp. 92 - 103
• Main Authors: Bustos-Vázquez, Eduardo, Fernández-Niño, Julián Alfredo, Astudillo-Garcia, Claudia Iveth
• Format: Journal Article
• Language: English
• Published: Colombia 01.04.2017
• Subjects: Cross-Sectional Studies; Depression - epidemiology; Health Status; Humans; Mexico - epidemiology; Multimorbidity; Self Report; health status; social determinants of health; comorbidity; México; Self-assessment; aging; depression
• ISSN: 0120-4157
• DOI: 10.7705/biomedica.v37i3.3070

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. 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. 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. 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). A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.