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Open AccessArticle

Associations between Polypharmacy, Self-Rated Health, and Depression in African American Older Adults; Mediators and Moderators

1
Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA
2
Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
3
Center for Research on Ethnicity, Culture, and Health, University of Michigan, Ann Arbor, MI 48109, USA
4
Wayne State University, Detroit, MI 48202, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(9), 1574; https://doi.org/10.3390/ijerph16091574
Received: 8 March 2019 / Revised: 23 April 2019 / Accepted: 2 May 2019 / Published: 6 May 2019
(This article belongs to the Special Issue Mental Health and Emotional Wellbeing)
Background. Despite the prevalence of multimorbidity among African American (AA) older adults, little information exists on correlates of polypharmacy (using 5+ medications) in AA older adults. There is more information available regarding the link between polypharmacy and physical aspects of health than subjective ones. Aims. In a local sample of AA older adults in Los Angeles, this study investigated the association of polypharmacy with self-rated health (SRH) and depression. We also explored gender differences in these links. Methods. This community-based study was conducted in south Los Angeles. A total number of 708 AA older adults (age ≥ 55 years) were entered into this study. From this number, 253 were AA men and 455 were AA women. Polypharmacy was the independent variable. Self-rated health (SRH) and depression were the dependent variables. Age, educational attainment, financial difficulty (difficulty paying bills, etc.), and marital status were covariates. Gender was the moderator. Multimorbidity, measured as the number of chronic diseases (CDs), was the mediator. Logistic regressions were applied for data analysis. Results. Polypharmacy was associated with worse SRH and depression. Multimorbidity fully mediated the association between polypharmacy and depressive symptoms. Multimorbidity only partially mediated the association between polypharmacy and poor SRH. Gender moderated the association between polypharmacy and SRH, as polypharmacy was associated with poor SRH in women but not men. Gender did not alter the association between polypharmacy and depression. Conclusions. AA older women with polypharmacy experience worse SRH and depression, an association which is partially due to the underlying multimorbidity. There is a need for preventing inappropriate polypharmacy in AA older adults, particularly when addressing poor SRH and depression in AA older women with multimorbidity. View Full-Text
Keywords: African Americans; Black; older adults; polypharmacy; self-rated health; depression; depressive symptoms African Americans; Black; older adults; polypharmacy; self-rated health; depression; depressive symptoms
MDPI and ACS Style

Bazargan, M.; Smith, J.; Saqib, M.; Helmi, H.; Assari, S. Associations between Polypharmacy, Self-Rated Health, and Depression in African American Older Adults; Mediators and Moderators. Int. J. Environ. Res. Public Health 2019, 16, 1574.

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