Epidemiological Determinants and Health-Related Predictors of Self-Perceived Health among Community-Dwelling Older...

Self-perceived health, defined as an individual's subjective evaluation of their overall health status, is a widely recognized indicator of health among older adults and is strongly associated with objective health outcomes. Identifying epidemiological and health-related determinants of poor self-perceived health among older individuals is essential to improve targeted interventions and resource allocation.

This community-based cross-sectional study included 10,321 older adults aged 65 years and over. The data were obtained from the 2023 Turkey Elderly Profile Survey conducted between 23 October and 18 December 2023. The survey was carried out by the Turkish Statistical Institute (TUIK) in collaboration with the Ministry of Family and Social Services to inform aging-related policies. Data were collected on sociodemographic characteristics, lifestyle behaviors, clinical conditions, depressive symptoms, and self-perceived health. Univariable and multivariable logistic regression analyses were undertaken to identify factors associated with poor self-perceived health.

The mean age of the study population was 72.8 ± 6.4 years (range: 65-115 years); 45.5% (n = 4,698) of participants were male and 54.5% (n = 5,623) were female. The prevalence of participants rating their health status as "bad" was 77.2%. In the multivariable analysis, age ≥ 75 years (aOR = 1.25, 95% CI: 1.09-1.42, p = 0.001), female gender (aOR = 1.19, 95% CI: 1.06-1.34, p = 0.004), the presence of chronic disease (aOR = 8.31, 95% CI: 7.42-9.30, p < 0.001), hearing impairment (aOR = 1.88, 95% CI: 1.46-2.43, p < 0.001), visual impairment (aOR = 1.80, 95% CI: 1.39-2.33, p < 0.001), and not having a spouse (aOR = 1.15, 95% CI: 1.01-1.31, p = 0.036) were associated with increased odds of poor self-perceived health. Mild and severe depression (aOR = 2.08, 95% CI: 1.84-2.36, p < 0.001; aOR = 5.89, 95% CI: 4.41-7.88, p < 0.001, respectively) were also significantly associated with increased odds of poor self-perceived health. Conversely, having a medium (aOR = 0.77, 95% CI: 0.64-0.92, p = 0.004) or high education level (aOR = 0.62, 95% CI: 0.52-0.74, p < 0.001), and engaging in physical activity (aOR = 0.67, 95% CI: 0.60-0.75, p < 0.001) were associated with decreased odds of poor self-perceived health.

Poor self-perceived health among community-dwelling older adults is highly prevalent and strongly influenced by demographic, lifestyle, clinical, and psychosocial factors. Public health strategies aimed at improving subjective health perceptions should address modifiable determinants, including chronic disease management, physical activity promotion, and mental health interventions.