Depression in the elderly of a rural region in Southern Brazil

Corrêa, Mariana Lima; Carpena, Marina Xavier; Meucci, Rodrigo Dalke; Neiva-Silva, Lucas

doi:10.1590/1413-81232020256.18392018

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ARTICLE • Ciênc. saúde coletiva 25 (6) • June 2020 • https://doi.org/10.1590/1413-81232020256.18392018 copy

Depression in the elderly of a rural region in Southern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this study is to estimate the prevalence of depression and its associated factors in elderly residents of the rural area of Rio Grande/RS. In this cross-sectional population-based study performed with 994 elderly (≥ 60 years), whose sampling was based on the 2010 Demographic Census, the Patient Health Questionnaire 9 (PHQ-9) was used for Major Depressive Episode (EDM) screening. Descriptive, bivariate and multivariate analyses were performed using logistic regression. The overall prevalence for Major Depressive Episode screening was 8.1%. The variables independently associated with depression were: female gender, continuous use of medications, chronic diseases, body mass index and worse health perception. The creation of programs target at the elderly in the rural area, aimed at screening, early diagnosis of depression and maintenance of treatment, encompassing several factors related to health, are important actions that must be fostered by the health system.

Key words
Depression; Elderly; Rural

Variable		Depression
Variable	N (%)	No N (%)	Yes N (%)	p ^a a Chi square test.
	994 (100)	913 (91,9)	81 (8,1)
Gender				0.02
Female	442 (44.5)	396 (89.6)	46 (10.4)
Male	552 (55.5)	517 (93.7)	35 (6.3)
Age				0.48
60-69 years	521 (52.5)	474 (91.0)	47 (9.0)
70-79 years	315 (31.7)	294 (93.3)	21 (6.7)
80 or more	157 (15.8)	144 (91.7)	13 (8.3)
Marital Status				0.60
Companion	628 (63.2)	579 (92.2)	49 (7.8)
No companion	366 (36.8)	334 (91.3)	38 (8.7)
Schooling (years) Median (IQI^ Interquartile interval. )				0.58^b b Wilcoxon's (Mann-Whitney) test.
	3 (1-5)	3 (1 -5)	3 (1 - 5)
Economic class (ABEP)				0.14² 2 Chi square test for linear trend.
D-E	394 (40.1)	358 (90.9)	36 (9.1)
C	510 (51.9)	470 (92.2)	40 (7.8)
A-B	79 (8.0)	76 (96.2)	3 (3.8)
Alcohol use				0.13
Yes	170 (17.1)	161 (94.7)	9 (5.3)
No	824 (82.9)	752 (91.3)	72 (8.7)
Tobacco use				< 0.01
Smoker	132 (13.3)	117 (88.6)	15 (11.4)
Ex smokers	338 (34.0)	317 (93.8)	21 (6.2)
Non-smoker	523 (52.7)	478 (91.4)	45 (8.6)
Health Perception				< 0.01² 2 Chi square test for linear trend.
Very good/good	575 (58.0)	558 (97.0)	17 (3.0)
Regular	345 (34.8)	307 (89.0)	38 (11.0)
Poor/very poor	71 (7.2)	46 (64.8)	25 (35.2)
Continuous medication use				< 0.01
Yes	751 (75.6)	674 (89.7)	77 (10.3)
No	242 (24.4)	238 (98.3)	4 (1.7)
Sedentary behavior (h/day)				0.78
< 7 hours	872 (87.9)	800 (91.7)	72 (8.3)
8 hours or more	120 (12.1)	111 (92.5)	9 (7.5)
Chronicdiseases¹ 1 Hypertension, diabetes, cancer, arthritis/arthrosis, osteoporosis, respiratory disease and kidney disease. 0 1 2 or more	272 (27,6) 328 (33,3) 385 (39,1)	259 (95,2) 311 (94,8) 335 (87,0)	13 (4,8) 17 (5,2) 50 (13,0)	< 0.01
Body Mass Index^c c Variable with the highest missing value, N= 950. - Mean (SD)	26.5 (±4.7)	26.5 (±4.6)	26.2 (±5.0)	0.04^* * T test.

Variable	Crude Analisys		Adjusted Analisys ¹ 1 Hosmer-Lemeshow's test: p= 0,0980. ² 2 R² final logistic regression model = 20,4%.
Variable	OR (CI95%)	p	OR (CI95%)	p
Gender		0.021		0.034
Female	1.71 (1.08 - 2.71)		1.65 (1.04 - 2.62)
Male	1		1
Age		0.485		0.362
60 a 69 years	1		1
70 a 79 years	0.72 (0.42 - 1.23)		0.72 (0.42 - 1.23)
80 anos or more	0.91 (0.48 - 1.73)		0.69 (0.35 - 1.38)
Marital Status		0.601		0.984
Companion	0.88 (0.55 - 1.41)		1.00 (0.61 - 1.65)
No companion	1		1
ABEP		0.14^* * p value for linear trend.		0.126^* * p value for linear trend.
D-E	1		1
C	0.85 (0.53 - 1.35)		0.83 (0.52 - 1.33)
A-B	0.39 (0.12 - 1.31)		0.38 (0.11 - 1.28)
Schooling	0.98 (0.92 - 1.05)	0.568	1.00 (0.93 - 1.08)	0.989
Tobacco use		0.166		0.178
Smoker	1.36 (0.73 - 2.53)		1.75 (0.90 - 3.38)
Ex smoker	0.70 (0.41 – 1.20)		0.96 (0.53 – 1.73)
Non-smoker	1		1
Alcohol use		0.139		0.401
No	1		1
Yes	0.58 (0.29 – 1.19)		0.73 (0.35 – 1.53)
Sedentary behaviour (h/day)		0.777		0.815
< 7 hours	1		1
8 hours or more	0.90 (0.44 - 1.85)		1.09 (0.52 - 2.29)
Medication use		< 0.01		< 0.01
No	1		1
Yes	6.80 (2.46 - 18.77)		5.16 (1.74 - 15.33)
Chronic diseases		< 0.01^* * p value for linear trend.		< 0.01^* * p value for linear trend.
0	1		1
1	1.09 (0.52 - 2.28)		0.90 (0.38 - 2.09)
2 or more	2.97 (1.58 - 5.59)		2.40 (1.11 - 5.19)
Body Mass Index Percepção de saúde	0.95 (0.80 – 0.95)	0.08 <0.01^* * p value for linear trend.	0.94 (0.89 - 0.99)	0.04 <0.01^* * p value for linear trend.
Very good/good	1		1
Regular	4.06 (2.25 - 7.32)		33.12 (1.60- 5.12)
Poor/ Very poor	18.84 (8.98 - 35.41)		19.59 (8.65 - 44.32)

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[1] Collaborations

ML Corrêa participated in the conception and project, data collection, analysis and interpretation of results and writing of the article. MX Carpena contributed to data analysis and writing of the article. RD Meucci worked as general coordinator of the research and in the relevant critical review of the article. L Neiva-Silva collaborated in the guidance and relevant critical review of all stages, from conception to the preparation of the article.