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There is evidence that subjective health is an important variable in general health outcomes. It can be an indicator of the individual's overall health status, creating a reliable and valid estimate about health. Quality of life (QoL) assessment can be associated with the individuals' subjective assessment of their own health status. The aim of the present study was to investigate variables associated with subjective perception of health in older inpatients. Ninety elderly inpatients over 60 years old were interviewed. The perception of health assessment (healthy/unhealthy) allocated elders in either of two groups. All the elders answered sociodemographic questions, the WHOQOL-100 and the Beck Depression Inventory (BDI). Comparing the group that considered themselves unhealthy to the other group, the former showed a tendency of worse QoL assessments in five out of six domains investigated. Significant differences were found for the physical and level of independence domains, as well as overall QoL. There was a significant association between health perception and lower intensity of depressive symptoms, as well as better QoL perception in the level of independence domain. This study shows the existence of an association between depressive symptoms and health assessment. It also suggests that the independence dimension is important in the elders' perception of their health status. These findings can help identify cause-effect relations between variables in aging studies involving health indicators and bring new intervention proposals for the elderly.

Purpose: The impact of major depression on quality of life (QOL) and aging experiences in older adults has been reported. Studies have demonstrated that the clinical diagnosis of major depression is the strongest predictor for QOL. We postulate that some findings are biased because of the use of inadequate instruments. Although subsyndromal depression is more prevalent than major depression, there are no reports on its impact on QOL or attitudes toward aging. In the present study we aim at assessing the association of major and subsyndromal depression on QOL and attitudes toward aging in a large international sample., Design and Methods: Our cross-sectional study assessed 4,316 respondents in 20 countries from five continents. The study used the World Health Organization Quality of Life (WHOQOL) Assessment for Older Adults, known as the WHOQOL-OLD; the brief version of the WHOQOL instrument, known as the WHOQOL-BREF; and the Attitudes to Ageing Questionnaire. Statistical analyses involved hierarchical multiple regression, as well as comparison of means., Results: Even relatively minor levels of depression are associated with a significant decrease in all QOL domains and with a pattern of negative attitudes toward aging (overall WHOQOL-OLD R(2) change =.421). QOL and attitudes toward aging scores are lower as depression intensity is increased, even in subsyndromal levels (overall WHOQOL-OLD mean scores of 95.7 vs 86.4, p <.001). This phenomenon happens not only for clinically depressed individuals but also for subsyndromic individuals., Implications: Present findings suggest that classifying a respondent as nondepressed is not sufficient and is still not informative about his or her QOL and attitudes toward aging status.

Background: Aging has determined a demographic shift in the world, which is considered a major societal achievement, and a challenge. Aging is primarily a subjective experience, shaped by factors such as gender and culture. There is a lack of instruments to assess attitudes to aging adequately. In addition, there is no instrument developed or validated in developing region contexts, so that the particularities of ageing in these areas are not included in the measures available. This paper aims to develop and validate a reliable attitude to aging instrument by combining classical psychometric approach and Rasch analysis., Methods: Pilot study and field trial are described in details. Statistical analysis included classic psychometric theory (EFA and CFA) and Rasch measurement model. The latter was applied to examine unidimensionality, response scale and item fit., Results: Sample was composed of 424 Brazilian old adults, which was compared to an international sample (n = 5238). The final instrument shows excellent psychometric performance (discriminant validity, confirmatory factor analysis and Rasch fit statistics). Rasch analysis indicated that modifications in the response scale and item deletions improved the initial solution derived from the classic approach., Conclusion: The combination of classic and modern psychometric theories in a complementary way is fruitful for development and validation of instruments. The construction of a reliable Brazilian Attitudes to Aging Questionnaire is important for assessing cultural specificities of aging in a transcultural perspective and can be applied in international cross-cultural investigations running less risk of cultural bias.