Chronic physical conditions and aging: Is mental health a potential protective factor?

Abstract

Research has shown that risk of chronic disease increases with age. Mental disorders and chronic disease are highly comorbid, with studies showing reciprocal causal relations. However, research focuses exclusively on combinations of, or a specific, mental illness. This study investigates the hypothesis that complete mental health is a protective factor against, while mental illness is a risk factor for, chronic (physical) conditions with age. Mental health is conceived of as a syndrome of subjective well-being consisting of symptoms of hedonia (positive feelings toward life) and eudaimonia (positive functioning in life). A categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, are described and applied to data from the MIDUS study of 3,032 adults, 25-74 years old. Data were also collected regarding 12-month prevalence of major depressive episode (MDE), and complete mental health is the absence of any of MDE and the presence of flourishing. Descriptive findings revealed a strong association of the complete mental health diagnostic categories with 23 of the 27 self-reported chronic conditions. In multivariate regression, quantity of chronic disease increased with age and was higher among moderately mentally healthy and adults with MDE, compared with the completely mentally healthy. Chronic conditions increased exponentially with age among adults with pure languishing and adults with languishing and a MDE. At all ages, completely mentally healthy adults reported the fewest chronic conditions, suggesting it may act as a protective factor in aging.