Self-rated health and depressive symptoms in patients with end-stage renal disease and their spouses: a longitudinal dyadic analysis of late-life marriages.

Limited research has examined the ways in which changes in self-rated health experienced by aging spouses affect depressive symptoms of both members of the dyad. Longitudinal data from 315 older couples in which one partner had end-stage renal disease were analyzed using multilevel modeling. Results indicate that for both patients and spouses, own mean self-rated health was associated with own depressive symptoms, and change in self-rated health had a significant negative association with change in own depressive symptoms. Both mean self-rated health of the patient and change in patient's self-rated health had negative relationships with spouse depressive symptoms, with changes in patient's self-rated health having a stronger impact on spouse depressive symptoms than changes in spouse's own self-rated health. Results suggest the importance of understanding physical and mental health in the context of the marital dyad.