Multimorbidity, disability, and mental health conditions in a nationally representative sample of middle-aged and older Canadians

Abstract

• Prevalence of major depression, generalized anxiety disorder, suicide ideation, and poor self-rated mental health were 11.9%, 10.2%, 9.1%, and 7.7%, respectively. • Multimorbidity and disability were negatively associated with depression, generalized anxiety disorder, and poor self-rated mental health. • Covariates such as family and personal history of mental health disorder, stressful life experiences, and low general life satisfaction negatively predicted all the conditions. • Higher household income and smoking status were protective factors. We aimed to estimate the prevalence of four mental health conditions as well as explore the association of multimorbidity, disability, and these problems among middle-aged and older Canadians. We used a subsample ( N = 13,096) of the 2012 cross-sectional Canadian Community Health Survey-Mental Health Component. This data was used because it remains the most recent national survey that provided a comprehensive assessment of the major mental health conditions. Both ordinal and binary logistic regression models were fitted. Univariate and multivariate models assessed the association of multimorbidity, disability, and four mental health conditions. Descriptive statistics, prevalence estimates, and adjusted odds ratios, and 95% confidence intervals were reported. The prevalence of major depression, generalized anxiety disorder, suicide ideation, and poor self-rated mental health were 11.9%, 10.2%, 9.1%, and 7.7%, respectively. Multimorbidity and disability were significantly negatively associated with all the response variables except for disability and suicide ideation. We also found that (1) family history of mental health disorder, (2) personal history of mental health disorder, (3) stressful life experiences, and (4) low general life satisfaction negatively predicted all the conditions while higher household income and smoking status were protective factors. The cross-sectional nature of this study means that causality between predictor variables and outcomes cannot be inferred. Secondly, the use of self-reported data to derive the multimorbidity variable is subject to recall bias. This study highlights the need to create an integrated mental and physical healthcare support approach for middle-aged and older Canadians while taking into consideration age, sex, and racial differences.