title: Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany.
abstract: BACKGROUND
  With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients.
  
  
  METHODS
  Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses.
  
  
  RESULTS
  Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson's disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors.
  
  
  CONCLUSIONS
  In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH.
authors.affiliation: Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany. anna.nuetzel@lrz.tu-muenchen.de.
authors.forename: Anna
authors.initials: A
authors.lastname: Nützel
authors.forename: Anne
authors.initials: A
authors.lastname: Dahlhaus
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.forename: Jochen
authors.initials: J
authors.lastname: Gensichen
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Steffi
authors.initials: S
authors.lastname: Riedel-Heller
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Ingmar
authors.initials: I
authors.lastname: Schäfer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schön
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.forename: Hendrik
authors.initials: H
authors.lastname: van den Bussche
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D058006:General Practice; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D011320:Primary Health Care; D012737:Sex Factors