Date of Award

5-7-2026

Degree Type

Thesis

Degree Name

Master of Arts (MA)

Department

Gerontology

First Advisor

Dr. Julie Blaskewicz Boron

Second Advisor

Dr. Lindsay Wilkinson

Third Advisor

Dr. Richard Stacy

Abstract

Population aging is accompanied by a rising incidence of chronic disease, highlighting the need to identify early indicators of disease risk to support prevention and delay onset. Mental health has gained attention as a potential predictor of health outcomes. Self-rated mental health (SRMH) has emerged as a validated measure capturing resilience, social support, and overall outlook. Few studies in older adults have examined the relationship between SRMH and incident chronic disease. Although mental health is associated with behavioral and psychosocial factors such as physical activity and happiness, these pathways have rarely been examined as mediators. Self-rated physical health (SRPH) is a well-established predictor of health outcomes, yet its potential moderating role is unclear. This study focuses on older women, a population historically underrepresented in aging research despite distinct biological and psychosocial influences.

This study examined associations between baseline SRMH and five-year incidence of heart conditions, cancer (excluding skin), and dementia including mild cognitive impairment (MCI), while also evaluating moderation by SRPH and mediation by physical activity frequency (PAF) and happiness. The sample included 867 older women (mean age = 70.9) from Waves 2 and 3 of the National Social Life, Health, and Aging Project, free of disease at baseline. Path models estimated direct, moderation, and mediation effects. Results indicated that higher SRMH was associated with lower risk of incident dementia/MCI but higher risk of heart conditions. The positive heart condition pattern likely reflects adjustment or suppression effects and is interpreted cautiously. SRPH did not moderate the SRMH–disease relationships. Mediation analyses suggested a small indirect association through PAF for cancer, with no significant mediation by happiness. SRPH emerged as an independent predictor of cancer.

Overall, findings suggest that a single-item SRMH measure may serve as a low-cost screening indicator for identifying older women at elevated risk of cognitive decline. Further longitudinal research is needed to clarify behavioral pathways and the unexpected association with heart conditions.

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