Abstract
BACKGROUND: A growing body of evidence has identified that people's physical health could influence self-rated health and quality of life (QoL). However, only focusing on physical health is not adequate for the well-being of older adults. Studies focusing on the impact of psychological well-being on self-rated health and QoL are still rare. OBJECTIVE: This study aimed to identify the mediating effect of depression on the association between psychological well-being and self-rated health and QoL to comprehensively understand the relationship between them. METHODS: We used a cross-sectional study design and secondary data analysis from the Chinese Longitudinal Healthy Longevity Survey of 2017 to 2018. Path analysis was applied to examine the research questions. RESULTS: A large sample of 8839 older adults was included. Among them, more positive affect was found among those who were younger and had more years of schooling, higher household income, greater social security and social insurance, lower depression levels, and higher self-rated health levels. Depression had a partial mediation effect of psychological well-being on self-rated health and QoL, which explained 36% of the total variance (R2=0.36). In addition, psychological well-being had a statistically significant direct effect on self-rated health and QoL (β=0.290; P<.001). CONCLUSIONS: Our results indicate that psychological well-being had both direct and indirect effects on self-rated health and QoL. Depression was an important mediator that regulated the effect pathway in older adults.