Depressive Symptoms and Self‐Rated Health in Community‐Dwelling Older Adults: A Longitudinal Study

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Abstract
OBJECTIVES: To test whether baseline depressive symptoms in older adults increase the risk of subsequent decline in self‐rated health and decrease the likelihood of subsequent improvement in self‐rated health.DESIGN: A 2‐year prospective cohort study.SETTING: Six thousand seven hundred fourteen community‐dwelling older persons who completed the first and second wave of the Asset and Health Dynamics among the Oldest‐Old Survey in the United States.PARTICIPANTS: Community‐dwelling older people in the United States.MEASUREMENTS: Baseline depressive symptoms were measured using a short‐form of the Center for Epidemiological Studies Depression Scale. Self‐rated health was measured using a single item of global health rating.RESULTS: After adjustment for covariates, a high burden of depressive symptoms at baseline was predictive of greater decline in self‐rated health (odds ratio (OR) for decline in those with high burden of depressive symptoms vs those without = 1.47, 95% confidence interval (CI) = 1.26–1.70). Likewise, high burden of depressive symptoms at baseline predicted less improvement in self‐rated health (OR for improvement in those with high burden of depressive symptoms vs those without = 0.57, 95% CI = 0.50–0.65).CONCLUSIONS: Depressive symptomatology is an independent risk factor for subsequent changes in self‐rated health in older adults. Thus, early prevention and intervention of depressive symptoms in community‐dwelling older adults might be critical to promote and maintain their self‐rated health.