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The utility of self-rated health in older adults with schizophrenia

Published online by Cambridge University Press:  02 October 2019

Carl I. Cohen*
Affiliation:
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York
Aninditha Vengassery
Affiliation:
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York
Michael M. Reinhardt
Affiliation:
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York
*
Correspondence should be addressed to: Dr. Carl I. Cohen, Division of Geriatric Psychiatry, SUNY Downstate Medical Center, MSC1203, 450 Clarkson Avenue, Brooklyn, NY 11203-2098. Phone: 001-718 270 1750; Fax: 001-718-270-2619. Email: carl.cohen@downstate.edu.

Abstract

Objectives:

Self-rated health is one of the most widely used measures in gerontology, but it has not been evaluated systematically in older adults with schizophrenia (OAS). Therefore, the aim of this study was to determine the utility of self-rated health in OAS by examining its influencing factors and contrasting these findings with a community comparison (CC) group.

Method:

We compared 249 community-dwelling persons aged 55 years and older having a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnosis of schizophrenia arising before age 45 years with a demographically similar group of 113 older adults in the general community. Using a modified version of Ocampo’s model of self-rated health, we identified 12 predictor variables within 5 dimensions.

Results:

There were no significant differences in self-health ratings between the OAS and the CC groups. Six of the 12 variables in the model significantly correlated with self-rated health in both groups. In linear regression analysis, three variables were significantly associated with self-rated health in both groups: Center for Epidemiological Studies−Depression score, number of physical disorders, and perception of self-health versus others. Self-rated health assessment was not associated with positive or negative symptoms or lack of awareness of mental illness.

Conclusion:

There was a striking similarity in the factors influencing self-rated health in the two groups. The findings were consistent with results of previous gerontological studies that self-rated health reflects elements of psychiatric and physical well-being, as well as perceptions of their age peers. Our results support the use of self-rated health as a legitimate clinical and research measure in OAS.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2019

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References

Abdallah, C., Cohen, C.I., Sanchez-Almira, M., Reyes, P. and Ramirez, P. (2009). Community integration and associated factors among older adults with schizophrenia. Psychiatric Services, 60, 16421648.CrossRefGoogle ScholarPubMed
Abuladze, L., Kunder, N., Lang, K. and Vaask, S. (2017). Associations between self-rated health and health behaviour among older adults in Estonia: a cross-sectional analysis. BMJ Open, 7, e013257.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision. Arlington, VA: American Psychiatric Publishing, Inc.Google Scholar
Bankole, A.O., Cohen, C.I., Vahia, I., Diwan, S., Kehn, M. and Ramirez, P.M. (2007). Factors affecting quality of life in a multiracial sample of older persons with schizophrenia. The American Journal of Geriatric Psychiatry, 15, 10151023.CrossRefGoogle Scholar
Blazer, D.G. (2008). How do you feel about…? Health outcomes in late life and self-perceptions of health and well-being. Gerontologist, 48, 415422.CrossRefGoogle Scholar
Clogg, C.C., Petkova, E. and Haritou, A. (1995). Statistical methods for comparing regression coefficients between models. American Journal of Sociology, 100, 12611293.CrossRefGoogle Scholar
Coblentz, J.M., Mattis, S., Zingesser, L.H. and Peck, A. (1973). Presenile dementia. Clinical aspects and evaluation of cerebrospinal fluid dynamics. Archives of Neurology, 29, 299308.CrossRefGoogle ScholarPubMed
Cohen, C.I., Freeman, K., Ghoneim, D., Vengassery, A., Ghezelaiagh, B. and Reinhardt, M.M. (2018). Advances in the conceptualization and study of schizophrenia in later life. Psychiatric Clinics of North America, 41, 3953.CrossRefGoogle ScholarPubMed
Cohen, C.I., Mani, A. and Ghezelaiagh, B. (2019). A longitudinal study of illness awareness in older adults with schizophrenia. The American Journal of Geriatric Psychiatry, 27, 200209.CrossRefGoogle ScholarPubMed
Cohen, J. (1976). Statistical Power Analysis for the Behavioral Sciences, 2nd Edition [Book]. Orlando: Academic Press.Google Scholar
Depp, C.A., Davis, C.E., Mittal, D., Patterson, T.L. and Jeste, D.V. (2006). Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder. Journal of Clinical Psychiatry, 67, 215221.CrossRefGoogle ScholarPubMed
Diwan, S., Cohen, C.I., Bankole, A.O., Vahia, I., Kehn, M. and Ramirez, P.M. (2007). Depression in older adults with schizophrenia spectrum disorders: prevalence and associated factors. The American Journal of Geriatric Psychiatry, 15, 991998.CrossRefGoogle ScholarPubMed
Goldman, N., Glei, D.A. and Chang, M.C. (2004). The role of clinical risk factors in understanding self-rated health. Annals of Epidemiology, 14, 4957.CrossRefGoogle ScholarPubMed
Hambleton, I.R., Clarke, K., Broome, H.L., Fraser, H.S., Brathwaite, F. and Hennis, A.J. (2005). Historical and current predictors of self-reported health status among elderly persons in Barbados. Revista Panamericana de Salud Pública, 17, 342352.CrossRefGoogle ScholarPubMed
Han, B.(2002). Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. Journal of the American Geriatrics Society 50, 15491556.CrossRefGoogle ScholarPubMed
Jeste, D.V., Symonds, L.L., Harris, M.J., Paulsen, J.S., Palmer, B.W. and Heaton, R.K. (1997). Nondementia nonpraecox dementia praecox? Late-onset schizophrenia. The American Journal of Geriatric Psychiatry, 5, 302317.CrossRefGoogle ScholarPubMed
Kahn, R., Goldfarb, A., Pollack, M. and Peck, A. (1960). Brief objective measures for the determination of mental status in the aged. American Journal of Psychiatry, 117, 326328.CrossRefGoogle ScholarPubMed
Kay, S.R., Opler, L.A. and Fiszbein, A. (1992). Positive and Negative Syndrome Scale. Manual. North Tonawanda, NY: Multi-Health Systems, Inc.Google Scholar
Lawton, M., Moss, M., Fulcomer, M. and Kleban, M. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 9199.CrossRefGoogle ScholarPubMed
Mulsant, B.H., Ganguli, M. and Seaberg, E.C. (1997). The relationship between self health and depressive symptoms in an epidemiological sample of community-swelling older adults. Journal of the American Geriatrics Society, 45, 954958.CrossRefGoogle Scholar
Ocampo, J.M. (2010). Self-rated health: importance of use in elderly adults. Colombia Médica, 41, 275289.Google Scholar
Olawa, B.D., Adebayo, S.O., Mokuolu, B.O., Umeh, C.S. and Omolayo, B.O. (2018). Physical health burdens and emotional distress in later life: the mediating effects of self-rated health. Aging & Mental Health, 18, 17. doi: 10.1007/s11292-018-9344-4 [Epub ahead of print]. PMID: 30449143Google Scholar
Radloff, J.S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Journal Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Robinson-Whelen, S. and Kiecolt-Glaser, J. (1997). The importance of social versus temporal comparison apprisals among older adults. Journal of Applied Social Psychology, 27, 959966.CrossRefGoogle Scholar
Sciolla, A., Patterson, T.L., Wetherell, J.L., McAdams, L.A. and Jeste, D.V. (2003). Functioning and well-being of middle-aged and older patients with schizophrenia: measurement with the 36-item short-form (SF-36) health survey. The American Journal of Geriatric Psychiatry, 11, 629637.Google ScholarPubMed
Vahia, I.V. et al. (2008). Adequacy of medical treatment among older persons with schizophrenia. Psychiatric Services, 59, 853859.CrossRefGoogle ScholarPubMed