Associated factors of depressive symptoms in the elderly: <i>Epi</i>Floripa study

Borges, Lucélia Justino; Benedetti, Tânia R Bertoldo; Xavier, André Junqueira; d'Orsi, Eleonora

doi:10.1590/S0034-8910.2013047003844

OBJECTIVE

To estimate the prevalence and associated factors of depressive symptoms in the elderly.

METHODS

Cross-sectional population based epidemiological study (The EpiFloripa Elderly survey) was carried out in two stage clusters, census tracts and households, with1.656 elderly individuals in Florianópolis, SC. The prevalence of depressive symptoms (outcome) was obtained using Geriatric Depression Scale (GDS-15) and its associations with socio-demographic, health, behavioral and social variables were assessed. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression.

RESULTS

Depressive symptoms were observed in 23.9% of the elderly individuals (95%CI 21.84;26.01). In the final model, depressive symptoms were associated with: 5 to 8 years of schooling (PR = 1.50, 95%CI 1.08;2.08); one to four years of schooling (PR = 1.62, 95%CI 1.18;2.23) and no schooling (PR = 2.11, 95%CI 1.46;3.05); being in a worse financial condition than at the age of 50 (PR = 1.33, 95%CI 1.02;1.74); cognitive impairment (PR = 1.45, 95%CI 1.21;1.75); perceiving their health to be regular (PR = 1.95, 95%CI 1.47;2.60) or poor (PR = 2.64, 95%CI 1.82;3.83); functional dependence (PR =1.83, 95%CI 1.43;2.33) and chronic pain (PR = 1.35, 95%CI 1.10;1.67). Factors with protective effects were: being in the 70 to 79 year old age group (PR = 0.77, 95%CI 0.64;0.93); physical activity in leisure time (PR = 0.75, 95%CI 0.59;0.94); participation in social or religious groups (PR = 0.80, 95%CI 0.64;0.99) and having sexual relations (PR = 0.70, 95%CI 0.53;0.94).

CONCLUSIONS

:Adverse clinical situations, being socioeconomically disadvantaged and low social and sexual activity were associated with depressive symptoms in the elderly.

Aged; Depression, epidemiology; Risk Factors; Socioeconomic Factors; Aging; Mental Health; Cross-Sectional Studies

[1] Correspondence
: Lucélia Justino Borges Centro de Desportos Universidade Federal de Santa Catarina Campus Universitário - Trindade 88040-900 Florianópolis, SC, Brasil E-mail: luceliajb@yahoo.com.br

Variable	Depressive symptoms				Raw analysis		p

	Total		Suspected depression
	n	%	n	% ^a	PR	95%CI

Sex	n = 1,656		n = 1,613				0.016
Male	598	36.1	116	19.8	1
Female	1,058	63.9	270	26.3	1.27	1.05;1.54
Age group (years)	n = 1,656		n = 1,613				0.004
60 to 69	846	51.1	176	21.3	1
70 to 79	596	36.0	138	23.7	1.09	0.84;1.42
80 and over	214	12.9	72	35.3	1.85	1.35;2.53
Marital status	n = 1,656		n = 1,613				< 0.001
Married	974	58.8	201	21.2	1
Single	95	5.7	23	25.0	1.64	1.07;2.50)
Divorced	130	7.9	36	28.4	1.44	1.03;2.03
Widowed	457	27.6	126	28.4	1.48	1.19;1.85
Self-reported skin color	n = 1,653		n = 1,613				0.188
White	1,410	85.3	311	22.6	1
Dark skinned	131	7.9	41	32.3	1.44	1.06;1.97
Black	84	5.1	23	27.7	1.27	0.83;1.95
Yellow	12	0.7	4	33.3	1.37	0.45;4.18
Indigenous	16	1.0	6	40.0	1.65	0.75;3.63
Schooling (years)	n = 1,656		n = 1,607				< 0.001
12 or more	386	23.4	41	10.9	1
9 to 11	231	14.0	34	15.0	1.37	0.89;2.10
5 to 8	315	19.1	75	24.1	2.13	1.51;3.01
1 to 4	568	34.5	173	31.4	2.85	2.05;3.95
0	148	9.0	61	42.7	3.94	2.72:5.70
Household income in quartiles	n = 1,656		n = 1,613				< 0.001
4 ^thquartile (> R$ 1,500.00)	410	24.8	63	15.7	1
3 ^rdquartile (> R$ 700.00 and ≤ R$ 1,500.00)	414	25.0	76	18.8	0.97	0.65;1.46
2 ^ndquartile (> R$ 327.50 and ≤ R$ 700.00)	418	25.2	134	32.6	2.10	1.49;2.95
1 ^stquartile (≤ R$ 327.50)	414	25.0	113	28.5	1.73	1.13;2.64
Economic situation compared with that at age 50	n = 1,654		n = 1,613				< 0.001
Better	775	46.9	174	23.0	1
Same	460	27.8	81	18.2	0.92	0.67;1.27
Worse	419	25.3	131	32.0	1.63	1.19;2.23

Variable	Depressive symptoms					Raw analysis	p

	Total		Suspected depression

	n	%	n	% ^a	PR	95%CI

Cognitive deficiency	n = 1,648		n = 1,613				< 0.001
No	877	53,2	160	18.5	1
Yes	771	46,8	224	30.2	1.76	1.44;2.15
Functional dependency	n = 1,656		n = 1,613				< 0.001
0 to 3 ADLs	1,165	70,4	161	14.1	1
4 or more ADLs	491	29,6	225	47.4	3.68	3.06;4.42
Falls in the last year	n = 1,656		n = 1,613				< 0.001
No	1,348	81,4	282	21.4	1
Yes	308	18,6	104	34.9	1.49	1.18;1.89
Taking medication	n = 1,656		n = 1,613				0.007
No	178	10,7	18	10.3	1
Yes	1,478	89,3	368	25.6	1.97	1.20;3.23
Taking anti-depressive	n = 1,656		n = 1,613				< 0.001
No	1,459	88,1	303	21.4	1
Yes	197	11,9	83	42.6	1.96	1.57;2.45
Perception of own health	n = 1,656		n = 1,613				< 0.001
Good/Very good	848	51,2	80	9.7	1
Regular	642	38,8	194	31.1	3.09	2.34;4.09
Bad/Very bad	165	10,0	112	69.6	6.86	4.97;9.46
Experiences pain most days	n = 1,656		n = 1,613				< 0.001
No	1,059	63,9	158	15.3	1
Yes	597	36,1	228	39.0	2.39	1.90;3.01
Self-reported morbidities
Back or spinal pain	n = 1,655		n = 1,613				< 0.001
No	826	49,9	142	17.6	1
Yes	829	50,1	244	30.2	1.56	1.24;1.98
Arthritis or rheumatism	n = 1,651		n = 1,608				< 0.001
No	1,089	66,0	208	19.7	1
Yes	562	34,0	175	31.8	1.67	1.35;2.05
Fibromyalgia	n = 1,652		n = 1,610				0.134
No	1,591	96,3	361	23.3	1
Yes	61	3,7	24	40.7	1.42	0.89;2.24
Cancer	n = 1,656		n = 1,613				0.067
No	1,506	90,9	345	23.5	1
Yes	150	9,1	41	28.7	1.32	0.98;1.78
Diabetes	n = 1,656		n = 1,613				< 0.001
No	1.290	77.9	256	20.4	1
Yes	366	22.1	130	36.2	1.70	1.39;2.07
Bronchitis or asthma	n = 1,656		n = 1,613				< 0.001
No	1.401	84.6	297	21.8	1
Yes	255	15.4	89	35.7	1.58	1.26;1.97
Hypertension	n = 1,656		n = 1,613				< 0.001
No	683	41.2	120	18.1	1
Yes	973	58.8	266	28.0	1.65	1.34;2.04
Cardiovascular disease	n = 1,656		n = 1,613				< 0.001
No	1.200	72.5	229	19.6	1
Yes	456	27.5	157	35.4	1.89	1.50;2.38
Stroke or cerebral ischemia	n = 1,656		n = 1,613				< 0.001
No	1,527	92.2	330	22.2	1
Yes	129	7.8	56	44.1	2.21	1.78;2.76

Variable	Depressive symptoms				Raw analysis		p

	Total		Suspected depression
	n	%	n	% ^a	RP	95%CI

Alcohol consumption	n = 1,656		n = 1,613				0.002
Never	1,061	64,1	291	28.2	1
Moderate	315	19,0	49	15.9	0.60	0.40;0.88
High	280	16,9	46	16.9	0.59	0.42;0.84
Smoking	n = 1,656		n = 1,613				0.815
Non-smoker	1,044	60,6	243	25.0	1
Ex-smoker	511	30,9	116	23.2	1.08	0.83;1.40
Smoker	141	8,5	27	19.4	0.98	0.57;1.68
Body Mass Index	n = 1,627		n = 1,613				0.315
Normal weight	628	38,6	130	21.2	1
Underweight	137	8,4	34	25.6	1.32	0.90;1.94
Overweight	862	53,0	206	24.6	1.16	0.86;1.55
Physical leisure activities	n = 1,656		n = 1,613				< 0.001
Insufficiently active	1,165	70,4	318	28.1	1
Active	491	29,6	68	14.1	0.48	0.38;0.62
Participating in social groups	n = 1,656		n = 1,613				0.005
No	941	56,8	246	26.9	1
Yes	715	43,2	140	20.1	0.71	0.56;0.90
Monthly contact with relatives	n = 1,653		n = 1,613				0.009
Yes	185	11,2	54	29.8	1
No	1,468	88,8	331	23.2	0.69	0.53;0.91
Monthly contact with friends	n = 1,649		n = 1,613				< 0.001
Yes	280	17,0	99	37.1	1
No	1,369	83,0	284	21.2	0.56		0.47;0.67
Sexual relations	n = 1,655		n = 1,613				< 0.001
No	925	55,9	278	31.0	1
Yes	730	44,1	108	15.1	0.43	0.31;0.59
Communicate using the internet	n = 1,656		n = 1,613				< 0.001
No	1,313	79,3	360	28.2	1
Yes	343	20,7	26	7.7	0.34	0.22;0.52

Variable		Adjusted analysis

	PR	95%CI	p

Gender (n = 1,613)
Man	1
Woman	0.85	0.71;1.01	0.065
Age group (years) (n = 1,613)
60 to 69	1
70 to 79	0.77	0.64;0.93	0.006
80 and over	0.90	0.68;1.18	0.426
Schooling (years) (n = 1,607)
12 or more	1
9 to 11	1.01	0.65;1.57	0.958
5 to 8	1.50	1.08;2.08	0.015
1 to 4	1.62	1.18;2.23	0.003
0	2.11	1.46;3.05	< 0.001
Economic situation compared to that at age 50 (n = 1,613)
Better	1
Same	0.94	0.76;1.16	0.582
Worse	1.33	1.02;1.74	0.036
Cognitive deficit (n = 1,613)
No	1
Yes	1.45	1.21;1.75	< 0.001
Perception of own health (n = 1,613)
Good	1
Regular	1.95	1.47;2.60	< 0.001
Bad	2.64	1.82;3.83	< 0.001
Functional dependency (n = 1,613)
0 to 3 AVDs	1
4 or more AVDs	1.83	1.43;2.33	< 0.001
Experience pain most days (n = 1,656)
No	1		0.004
Yes	1.35	1.10;1.67
Physical leisure activity (n = 1,613)
Insufficiently active	1		0.015
Active	0.75	0.59;0.94
Participating in social or religious groups (n = 1,656)
No	1		0.038
Yes	0.80	0.64:0.99
Sexual relations (n = 1,655)
No	1		0.018
Yes	0.70	0.53;0.94

Brasil

Brasil

Associated factors of depressive symptoms in the elderly: EpiFloripa study

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS