Impact of depression and perceived stress on self-rated health in individuals aged 55 years and older considering cardiovascular diseases

Abstract

Aim. To study the associations of depression and perceived stress with self-rated health (SRH) in men and women aged ≥55 years, considering cardiovascular diseases (CVD), and to estimate the population attributable risk (PAR) of these factors regarding poor SRH. Material and methods . We analyzed data from the cross-sectional stage of the Stress, Aging and Health in Russia (SAHR) study, which included 1876 individuals aged ≥55 years (898 men, 978 women). Stress was assessed using the Perceived Stress Scale-10 (PSS-10), and depression was evaluated using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). SRH was determined based on a total score of a 4-item questionnaire, with poor SRH corresponding to the 5th quintile. Associations were analyzed using logistic regression adjusted for age, with the additional inclusion of CVD in the model. PAR was also calculated. Results . Significant associations between depression, stress, and SRH were identified, which persisted regardless of CVD. We found that somatic depression increased the odds of poor SRH by 2,6 times in men and 3,4 times in women. Affective depression was also associated with increased odds of poor SRH. Notably, significant associations between CVD and poor SRH were found only in women. The greatest contributors to the prevalence of poor SRH were somatic depression in men (PAR 27,8%) and CVD in women (PAR 45,1%). Conclusion . The study results demonstrate the significant role of depression and stress in the subjective assessment of health. Gender differences in the population contribution of these factors were identified. Somatic depression in men and CVD in women were the primary contributors to poor SRH, while the associations of depression and stress with SRH remained independent of CVD in both sexes. The findings underscore the importance of a differentiated approach to assessing the health of the elderly, taking into account sex, mental status, and cardiovascular pathology.