Effect of Multimorbidity on Depression of Indonesian Older Persons: An Application of the Utility Function

Authors

  • Farma Mangunsong Universitas Indonesia
  • Theerathorn Yoongthong Mahidol University
  • Rina Gustiana Ministry of Population and Family Development (BKKBN)

DOI:

https://doi.org/10.37385/d1hg7t62

Keywords:

IFLS, panel, mental health, health insurance

Abstract

Previous studies have found adverse relationships between physical deterioration and depression among older persons. Relied on the utility function, this study assumed that living in good health condition and at an older age contribute to higher utility. To assess the causal relationship, it used longitudinal panel data of older adults withdrawn from three waves of the Indonesian Family Life Survey (IFLS) waves 3, 4, and 5. Good health status and higher utility were represented by fewer morbidities and lower depression, respectively. By applying the Robust Hausman test (p-value 0.3903), the Random Effect (RE) Model is more appropriate than the Fixed Effect (FE) Model. The RE Model suggests that more morbidities and being older cause higher depression. Meanwhile, older persons living in urban areas tend to have lower depression than those in rural areas. Promotion of mental health services for Indonesian older persons and utilization of the national health insurance are important for older persons to mitigate the adverse effects of multimorbidity.

References

Adair, T. (2019). Morbidity. Beginning Population Studies. https://demography.cass.anu.edu.au/files/docs/2025/5/bps_morbidity_adair_01_05_2019.pdf

Altman, B. M. (2014, 2014/01/01/). Definitions, concepts, and measures of disability. Annals of Epidemiology, 24(1), 2-7. https://doi.org/https://doi.org/10.1016/j.annepidem.2013.05.018

Barnagar College. Indifference curve analysis. https://barnagarcollege.ac.in/upload/e_resource/1657204656.pdf

BOLPUR COLLEGE. Properties of Indifference Curve. https://bolpurcollege.edu.in/uploads/1706091693_ECONOMICSSemICC -IIndifferencecurveproperties.pdf

Gutterman, A. S. (2023). Definitions and Models of Disability. SSRN. https://doi.org/https://dx.doi.org/10.2139/ssrn.4500074

Hamza, E., Albareeq, J. M., & Al Kuwari, K. M. (2019). Morbidity and Mortality Evaluation Could Be an Educational Tool to Improve Healthcare Service Delivery. Bahrain Medical Bulletin, 41, No. 4. https://www.bahrainmedicalbulletin.com/DEC_2019/DEC2019_MM.pdf

Hardiani, H., Junaidi, J., & Suri, P. S. (2025). What shapes older adults’ multidimensional well-being in Jambi Province, Indonesia? Integrating capability–ecological frameworks. Jurnal Perspektif dan Pembiayaan Pembangunan Daerah, 13 No. 3. file:///C:/Users/Public/Documents/FEB/Jurnal%20IJEDR/Literatur/Hardiani_what%20shapes%20older%20adults%20multidimensional%20well-being%20in%20Jambi%20province%20Indonesia.pdf

Hwang, S., Nam, J. Y., Ahn, J. H., & Park, S. (2022). Gender differences in the association between multimorbidity and depression in older Korean adults: an analysis of data from the National Survey of Older Koreans (2011-2017). Epidemiol Health, 44, e2022049. https://doi.org/10.4178/epih.e2022049

Ishida, M., Hulse, E. S. G., Mahar, R. K., Gunn, J., Atun, R., McPake, B., Tenneti, N., Anindya, K., Armstrong, G., Mulcahy, P., Carman, W., & Lee, J. T. (2020). The Joint Effect of Physical Multimorbidity and Mental Health Conditions Among Adults in Australia. Preventing Chronic Disease, 17, E157. https://doi.org/10.5888/pcd17.200155

Jauhari, A. F., Suprapto, Y., & Mauludiyanto, A. (2019). Data Panel Modelling with Fixed Effect Model (FEM) Approach to Analyze the Influencing Factors of DHF in Pasuruan Regency. the 2nd International Conference on Applied Science, Engineering and Social Sciences (ICASESS 2019),

Komalasari, D. R., Jalayondeja, C., Jalayondeja, W., & Romadon, Y. A. (2025). Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health. Journal of Preventive Medicine and Public Health, 58(2), 199-207. https://doi.org/https://doi.org/10.3961/jpmph.24.423

Mahwati, Y., & Hasibuan, S. R. (2025, Dec). Mental Health Service Utilization among Older Adults in Indonesia: Nationwide Retrospective Cohort Study Using the National Health Insurance Claims Data, 2015-2023. Ann Geriatr Med Res, 29(4), 525-533. https://doi.org/10.4235/agmr.25.0108

Palmese, F., Remelli, F., Dekhtyar, S., Grande, G., Marengoni, A., Calderón-Larrañaga, A., Domenicali, M., Volpato, S., Vetrano, D. L., & Triolo, F. (2025, 2025/12/05). Multimorbidity patterns and mental health in late life: a systematic review of longitudinal studies. European Geriatric Medicine. https://doi.org/10.1007/s41999-025-01370-1

Segel-Karpas, D., Palgi, Y., & Shrira, A. (2017, Sep). The reciprocal relationship between depression and physical morbidity: The role of subjective age. Health Psychol, 36(9), 848-851. https://doi.org/10.1037/hea0000542

Shi, P., Yang, A., Zhao, Q., Chen, Z., Ren, X., & Dai, Q. (2021, 2021-October-25). A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males [Review]. Frontiers in Psychiatry, Volume 12 - 2021. https://doi.org/10.3389/fpsyt.2021.589687

Sinaga, I. O. Y., Barliana, M. I., Pradipta, I. S., Iskandarsyah, A., Abdulah, R., & Alfian, S. D. (2022). Depression is Associated with the Increase Risk of Multimorbidity Among the General Population in Indonesia. J Multidiscip Healthc, 15, 1863-1870. https://doi.org/10.2147/jmdh.S372712

Singh, S., Shri, N., & Dwivedi, L. K. (2022, 2022/09/15). An association between multi-morbidity and depressive symptoms among Indian adults based on propensity score matching. Scientific Reports, 12(1), 15518. https://doi.org/10.1038/s41598-022-18525-w

Triolo, F., Harber-Aschan, L., Belvederi Murri, M., Calderón-Larrañaga, A., Vetrano, D. L., Sjöberg, L., Marengoni, A., & Dekhtyar, S. (2020, 2020/12/01/). The complex interplay between depression and multimorbidity in late life: risks and pathways. Mechanisms of Ageing and Development, 192, 111383. https://doi.org/https://doi.org/10.1016/j.mad.2020.111383

Widagdo, T. M. M., Pudjohartono, M. F., Meilina, M., Mete, A. R., Primagupita, A., & Sudarsana, K. D. A. P. (2022). Comparing well-being among rural and urban Indonesian older people: a quantitative analysis of the related factors. International Journal of Public Health Science (IJPHS), 11 No. 4, 1552-1560. https://ijphs.iaescore.com/index.php/IJPHS/article/viewFile/21752/13730

Zhang, F., Huang, Z., Jiang, C., Xie, Y., & Tao, Q. (2024). Depression among older adults with multimorbidity: A scope review on the prevalence and intervention. Aging Research, 2(2), 9340029. https://doi.org/10.26599/AGR.2024.9340029

Zhang, L., Shooshtari, S., St John, P., & Menec, V. H. (2022). Multimorbidity and depressive symptoms in older adults and the role of social support: Evidence using Canadian Longitudinal Study on Aging (CLSA) data. PLOS ONE, 17(11), e0276279. https://doi.org/10.1371/journal.pone.0276279

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Published

2026-06-21

How to Cite

Effect of Multimorbidity on Depression of Indonesian Older Persons: An Application of the Utility Function. (2026). International Journal of Economics Development Research (IJEDR), 7(2), 140-155. https://doi.org/10.37385/d1hg7t62