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Self-Rated Health, Depression, and One-Year Health Outcomes in Older Primary Care Patients

Received November 12, 2002; revised March 17, 2003; accepted April 4, 2003. From the Program in Geriatrics and Neuropsychiatry, Department of Psychiatry (JML,DAK,YC,PRD,SMS,EDC) and the Department of Biostatistics (SE), University of Rochester Medical Center, Rochester, NY. Send correspondence to Jeffrey M. Lyness, M.D., Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642. e-mail: Jeffrey_Lyness{at}urmc.rochester.edu

Objective: The authors tested the hypothesis that poorer self-rated health is associated with poorer health outcomes. Method: They prospectively examined the association of self-rated health to 1-year outcomes in 247 older subjects from primary care settings. Results: Poorer self-rated health was independently associated with 1-year functional disability, after covarying initial clinical and functional measures, but was not independently associated with 1-year depression diagnosis. Results were mixed regarding associations with 1-year medical burden or mortality. Conclusions: Clinicians should be vigilant for functional decline in patients who perceive their health negatively. Future research should test potential mechanisms that might underlie this association.

Key Words: Depression • Primary Care • Medical Comorbidity

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