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Biomédica
versión impresa ISSN 0120-4157
Resumen
BUSTOS-VAZQUEZ, Eduardo; FERNANDEZ-NINO, Julián Alfredo y ASTUDILLO-GARCIA, Claudia Iveth. Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model. Biomédica [online]. 2017, vol.37, suppl.1, pp.92-103. ISSN 0120-4157. https://doi.org/10.7705/biomedica.v37i3.3070.
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.
Palabras clave : Self-assessment; health status; comorbidity; depression; aging; social determinants of health; México.