HYPERTENSION AND HEART DISEASE IN LATER LIFE: THE ROLE OF DEPRESSION, SUBJECTIVE AGE, AND PREVENTATIVE HEALTH BEHAVIORS

Subjective age and depressive symptoms are different indicators of mental health that
have implications for physical health. Subjective age has multiple meanings and is measured
in a variety of ways. This dissertation investigated subjective age as the age an individual
feels. The relationship between subjective age and health behaviors is not fully understood,
and thus, requires more scholarly research. This dissertation uses the Health and Retirement
Study to investigate the relationships between subjective age and depressive symptoms, the
health behaviors of physical activity and diet, and cardiovascular health outcomes. The
dissertation is composed of three studies.
Study 1 explores the relationships between subjective age and physical health and
diet, and the moderating effect of chronological age. Results indicate that feeling younger is
related to exercising more frequently, and to engaging in a healthier diet, supporting my
hypotheses. There is no moderating effect of chronological age; this hypothesis is not
supported.
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Study 2 investigates the relationship between depressive symptoms, physical activity,
diet, and hypertension. Depressive symptoms and physical activity are observed in 2012, diet
in 2013, and hypertension in 2014. Two measures of diet are used, the Mediterranean Diet
Score (MedDiet) and the Mediterranean-DASH Diet Intervention for Neurocognitive Delay
(MIND diet). In terms of hypertension, while direct and indirect (mediating) effects are
found for physical activity, only direct effects are found for the MedDiet. These results
partially support my hypotheses. The MIND diet is not statistically related to hypertension;
thus, my hypothesis about this relationship is not supported. Further, older adults with more
depressive symptoms engage in less physical activity, have a less healthy diet, and are more
likely to have hypertension at the following wave. This supports my hypothesis.
Study 3 analyzes the relationship between depressive symptoms, hypertension and
heart disease. Depressive symptoms and hypertension are observed in 2014 and heart disease
is observed in 2016. Further, this study investigates the moderating roles of gender and raceethnic status. Direct relationships are found for all key variables, but no indirect effect was
found. These results partially supported my hypotheses. Gender did not moderate any of the
relationships; this hypothesis was not supported. Race-ethnic status moderates all
relationships. Hispanic older adults are more likely to develop hypertension and heart disease
when they report more depressive symptoms, compared to non-Hispanic White older adults.
Both non-Hispanic Black and Hispanic respondents are more likely to develop heart disease
if they have hypertension than are non-Hispanic White respondents. These results provide
partial support for my hypotheses.
Results from these three studies add to the current scholarly literature by highlighting
the importance of mental health and health behaviors for cardiovascular health outcomes
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among older adults in the United States. Public health programs should focus on improving
mental health education and resources, especially for historically marginalized communities.