Date of Award

5-2023

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Jeffrey A. Burr

Second Advisor

Elizabeth Dugan

Third Advisor

Tongjian You

Abstract

Subjective age and depressive symptoms are different indicators of mental health that have implications for physical health. Subjective age has multiple meanings and is measured in a variety of ways. This dissertation investigated subjective age as the age an individual feels. The relationship between subjective age and health behaviors is not fully understood, and thus, requires more scholarly research. This dissertation uses the Health and Retirement Study to investigate the relationships between subjective age and depressive symptoms, the health behaviors of physical activity and diet, and cardiovascular health outcomes. The dissertation is composed of three studies. Study 1 explores the relationships between subjective age and physical health and diet, and the moderating effect of chronological age. Results indicate that feeling younger is related to exercising more frequently, and to engaging in a healthier diet, supporting my hypotheses. There is no moderating effect of chronological age; this hypothesis is not supported. Study 2 investigates the relationship between depressive symptoms, physical activity, diet, and hypertension. Depressive symptoms and physical activity are observed in 2012, diet in 2013, and hypertension in 2014. Two measures of diet are used, the Mediterranean Diet Score (MedDiet) and the Mediterranean-DASH Diet Intervention for Neurocognitive Delay (MIND diet). In terms of hypertension, while direct and indirect (mediating) effects are found for physical activity, only direct effects are found for the MedDiet. These results partially support my hypotheses. The MIND diet is not statistically related to hypertension; thus, my hypothesis about this relationship is not supported. Further, older adults with more depressive symptoms engage in less physical activity, have a less healthy diet, and are more likely to have hypertension at the following wave. This supports my hypothesis. Study 3 analyzes the relationship between depressive symptoms, hypertension and heart disease. Depressive symptoms and hypertension are observed in 2014 and heart disease is observed in 2016. Further, this study investigates the moderating roles of gender and race-ethnic status. Direct relationships are found for all key variables, but no indirect effect was found. These results partially supported my hypotheses. Gender did not moderate any of the relationships; this hypothesis was not supported. Race-ethnic status moderates all relationships. Hispanic older adults are more likely to develop hypertension and heart disease when they report more depressive symptoms, compared to non-Hispanic White older adults. Both non-Hispanic Black and Hispanic respondents are more likely to develop heart disease if they have hypertension than are non-Hispanic White respondents. These results provide partial support for my hypotheses. Results from these three studies add to the current scholarly literature by highlighting the importance of mental health and health behaviors for cardiovascular health outcomes among older adults in the United States. Public health programs should focus on improving mental health education and resources, especially for historically marginalized communities.

Comments

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