Značaj samoprocjene zdravlja za ocjenu mentalnog zdravlja i ...

9. SUMMARY
The aging of population increases the cost of health care and therefore an active and
healthy aging process is an important factor of social development.
The aim of this study was to investigate the importance of self-rated health on the
occurrence of depression and anxiety and the impact of modifying factors on health and the
use of health care by older persons in the following counties: Koprivnica-Krizevci, Istria and
Dubrovnik-Neretva county, along with proposing measures for preserving mental health and
an active and independent life at an elder age.
The study used data collected in a comparative cross-sectional study in the
international project TTB Second Decennial Survey of the Health Needs and Health Care for
Older People in Europe (Elderly study) conducted in Croatia in 2006. The study included
1496 respondents of both gender aged 70 years and over who lived alone or in the same
household with permanent residence in the study area. The socio-demographic data (age,
gender, "live alone") and data on the use of health care (visits to family physicians,
specialists and hospitalization in the last 12 months and data on the treatment of anxiety or
depression in the last 4 weeks) were collected. Self-rated health and level of anxiety and
depression were assessed with the SF-36 questionnaire and the HAD scale.
The results showed that there were significant differences in self-rated health,
prevalence of anxiety and depression and the use of health care at both primary and
secondary level between the three counties studied. Respondents in the Koprivnica-Krizevci
County rated their health the worst in all eight dimensions of health and most of them were
depressed and anxious, while respondents in the Dubrovnik-Neretva County assessed their
health the best and the least of them were depressed and anxious. Self-rated health and
prevalence of depression and anxiety in respondents of the Istria County were similar to
respondents in the Dubrovnik-Neretva County. The physical dimensions of health are
generally rated worse than the mental ones, while depression is generally more common
than anxiety in the elderly. Men rate their health significantly better than women in all eight
dimensions, and women are more anxious than men. Self-rated health deteriorates and
depression is more common, while the prevalence of anxiety decreases with older age.
Respondents who live alone do not differ in self-rated health, the prevalence of anxiety and
depression nor in the use of health care than those who do not live alone. Poor self-rated
health, particularly the dimensions of mental health, is associated with anxiety and especially
depression in the elderly. Older people in the Koprivnica-Krizevci County use health care
less often than their peers in the other two counties. Secondary (specialist) health care is
used most often in Istria, while primary health care by general practitioners/family physicians
is used most often in the Dubrovnik-Neretva County. Women significantly more often visit
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