title: Assessing mental health and its association with income and resource utilization in old-old Chinese in Hong Kong.
abstract: OBJECTIVE
  The authors assessed mental health status and its association with income and resource utilization in old-old Chinese citizens in Hong Kong.
  
  
  METHODS
  Stratified disproportional random sampling in 1991-92 assembled a cohort of 1,696 elderly community-dwelling subjects who were age 70 or above, measuring the age and education adjusted mean level of cognitive functioning and geriatric depression, by income groups and further investigating the association between mental health and income by incorporating deficiencies in activities of daily living (ADL) and the presence of major chronic conditions in the multivariate regressions. The association between mental health and resource utilization, including physician visits and use of medication, was examined by multivariate regression analyses.
  
  
  RESULTS
  Better cognitive functioning was associated with higher income across groups. Lower geriatric depression was associated with higher income. Cognitive impairment was associated with the ADL deficiencies, and geriatric depression was associated with a number of major chronic conditions and higher resource utilization, including physician visits and medication use.
  
  
  CONCLUSIONS
  Income was significantly associated with cognitive functioning and geriatric depression in elderly persons in Hong Kong. Mental health, ADL deficiency, major chronic conditions, and resource utilization are interrelated. The fact that aging in the population is associated with increasing cognitive impairment and geriatric depression presents new challenges in financing and delivering efficient and equitable health care in the region.
authors.affiliation: Section of General Internal Medicine, Dept. of Medicine, The University of Chicago, 5841 S. Maryland Avenue (MC 2007), Chicago, IL 60637, USA. xzhang@medicine.bsd.uchicago.edu
authors.forename: James X
authors.initials: JX
authors.lastname: Zhang
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Ho
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000191:economics / Q000523:psychology; D003863:Depression / Q000191:economics; D006304:Health Status; D006723:Hong Kong; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008603:Mental Health; D012044:Regression Analysis; D011795:Surveys and Questionnaires