Background Self-rated health (SRH) is a widely used global indicator of physical, psychological, and social well-being. In older adults, SRH predicts mortality, morbidity, and functional decline. Although SRH has been linked to psychological, functional, and lifestyle factors, these domains are often examined separately, limiting our understanding of their combined influence. This study examined the multidimensional structure of SRH by assessing mental health, physical function, and activity-related factors among Japanese community-dwelling older adults. Methods This cross-sectional study analyzed data from 1,821 older adults (aged ≥ 65 years) in Ayase City, Japan. SRH was assessed using a four-point scale and categorized into high (very/somewhat healthy) and low (not very/unhealthy) groups. Independent variables included age, gender, education, diagnosed conditions, depressive symptoms (Geriatric Depression Scale, GDS), physical fitness (Motor Fitness Scale, MFS), functional capacity (Tokyo Metropolitan Institute of Gerontology Index of Competence for Instrumental Activities of Daily Living, TMIG-IC IADL), and activity frequency. Logistic regression was performed to identify factors associated with SRH. Results Participants with higher SRH were younger (median age: 74 vs. 77 years, p < .001), had fewer diagnosed conditions (p < .001), lower GDS scores (median: 0 vs. 2, p < .001), and higher motor fitness scores, including mobility, strength, and balance (p < .001 for all), compared to those with lower SRH. Logistic regression showed that younger age (OR = 0.95, 95% CI: 0.93 to 0.97, p < .001), female sex (OR = 1.68, 95% CI: 1.22 to 2.31, p = .001), and fewer diagnosed conditions (OR = 1.74, 95% CI: 1.56 to 1.93, p < .001) were significant predictors of better SRH. Higher motor fitness scores for mobility, strength, and balance, and lower GDS scores were also significant predictors. Education, TMIG-IC IADL scores, and activity frequency were not significant. Conclusions SRH in Japanese older adults is shaped by physical fitness, mental health, and demographic factors. These findings emphasize the importance of holistic health promotion strategies targeting physical activity and mental health. Culturally sensitive interventions and further longitudinal research are warranted to better understand SRH determinants.

Mental and physical factors influencing self-rated health in Japanese older adults

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2026年1月31日

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Hirotomo Shibahashi,
Kanta Ohno,
Shinpei Ikeda

摘要

Background

Self-rated health (SRH) is a widely used global indicator of physical, psychological, and social well-being. In older adults, SRH predicts mortality, morbidity, and functional decline. Although SRH has been linked to psychological, functional, and lifestyle factors, these domains are often examined separately, limiting our understanding of their combined influence. This study examined the multidimensional structure of SRH by assessing mental health, physical function, and activity-related factors among Japanese community-dwelling older adults.

Methods

This cross-sectional study analyzed data from 1,821 older adults (aged ≥ 65 years) in Ayase City, Japan. SRH was assessed using a four-point scale and categorized into high (very/somewhat healthy) and low (not very/unhealthy) groups. Independent variables included age, gender, education, diagnosed conditions, depressive symptoms (Geriatric Depression Scale, GDS), physical fitness (Motor Fitness Scale, MFS), functional capacity (Tokyo Metropolitan Institute of Gerontology Index of Competence for Instrumental Activities of Daily Living, TMIG-IC IADL), and activity frequency. Logistic regression was performed to identify factors associated with SRH.

Results

Participants with higher SRH were younger (median age: 74 vs. 77 years, p < .001), had fewer diagnosed conditions (p < .001), lower GDS scores (median: 0 vs. 2, p < .001), and higher motor fitness scores, including mobility, strength, and balance (p < .001 for all), compared to those with lower SRH. Logistic regression showed that younger age (OR = 0.95, 95% CI: 0.93 to 0.97, p < .001), female sex (OR = 1.68, 95% CI: 1.22 to 2.31, p = .001), and fewer diagnosed conditions (OR = 1.74, 95% CI: 1.56 to 1.93, p < .001) were significant predictors of better SRH. Higher motor fitness scores for mobility, strength, and balance, and lower GDS scores were also significant predictors. Education, TMIG-IC IADL scores, and activity frequency were not significant.

Conclusions

SRH in Japanese older adults is shaped by physical fitness, mental health, and demographic factors. These findings emphasize the importance of holistic health promotion strategies targeting physical activity and mental health. Culturally sensitive interventions and further longitudinal research are warranted to better understand SRH determinants.