Abstract
BackgroundLittle is known about depression in middle-aged and older Canadians and how it is affected by health determinants, particularly immigrant status. This study examined depression and socio-economic, health, immigration and nutrition-related factors in older adults.MethodsUsing weighted comprehensive cohort data from the baseline Canadian Longitudinal Study on Aging (n = 27,162) of adults aged 45–85, gender-specific binary logistic regression was conducted with the cross-sectional data using the following variables: 1) Depression (outcome) measured using the Center for Epidemiologic Studies Short Depression (CESD-10) rating scale; 2) Immigration status: native-born, recent and mid-term (< 20 years), and long-term immigrants (≥20 years); and 3) covariates: socioeconomic status, physical health (e.g., multi-morbidity), health behavior (e.g., substance use), over-nutrition (e.g., anthropometrics), under-nutrition (e.g., nutrition risk), and dietary intake.ResultsThe sample respondents were mainly Canadian-born (82.6%), women (50.6%), 56–65 years (58.9%), earning between C$50,000–99,999 (33.2%), and in a relationship (69.4%). When compared to Canadian-born residents, recent, mid-term (< 20 years), and longer-term (≥ 20 years) immigrant women were more likely to report depression and this relationship was robust to adjustments for 32 covariates (adjusted ORs = 1.19, 2.54, respectively, p < 0.001). For women, not completing secondary school (OR = 1.23, p < 0.05), stage 1 hypertension (OR = 1.31, p < 0.001), chronic pain (OR = 1.79, p < 0.001), low fruit/vegetable intakes (OR = 1.33, p < 0.05), and fruit juice (OR = 1.80, p < 0.001), chocolate (ORs = 1.15–1.66, p’s < 0.05), or salty snack (OR = 1.19, p < 0.05) consumption were associated with depression. For all participants, lower grip strength (OR = 1.25, p < 0.001) and high nutritional risk (OR = 2.24, p < 0.001) were associated with depression. For men, being in a relationship (OR = 0.62, p < 0.001), completing post-secondary education (OR = 0.82, p < 0.05), higher fat (ORs = 0.67–83, p’s < 0.05) and omega-3 egg intake (OR = 0.86, p < 0.05) as well as moderate intakes of fruits/vegetables and calcium/high vitamin D sources (ORs = 0.71–0.743, p’s < 0.05) predicted a lower likelihood of depression. For men, chronic conditions (ORs = 1.36–3.65, p’s < 0.001), chronic pain (OR = 1.86, p < 0.001), smoking (OR = 1.17, p < 0.001), or chocolate consumption (ORs = 1.14–1.72, p’s < 0.05) predicted a higher likelihood of depression.ConclusionsThe odds of developing depression were highest among immigrant women. Depression in middle-aged and older adults is also associated with socioeconomic, physical, and nutritional factors and the relationships differ by sex. These results provide insights for mental health interventions specific to adults aged 45–85.
Highlights
Little is known about depression in middle-aged and older Canadians and how it is affected by health determinants, immigrant status
Depression in middleaged and older adults is associated with socioeconomic, physical, and nutritional factors and the relationships differ by sex
All body composition measures indicated that the majority tended to have excess weight based on Body mass index (BMI) measures (n = 18,893, 69.7%), high visceral adiposity based on Waistto-hip ratio (WHR) (n = 17,898, 65.9%), high body fat percent (n = 16,752, 61.7%), and elevated disease risk based on BMI and WHR measures (n = 19,198, 70.8%)
Summary
Little is known about depression in middle-aged and older Canadians and how it is affected by health determinants, immigrant status. This study examined depression and socio-economic, health, immigration and nutrition-related factors in older adults. Theoretical and empirical evidence indicates that various social determinants are associated with depression. Higher prevalence or incidence of major depression tends to occur in women [7] as well as older adults, those who are not married, and those with lower incomes [8]. The association between depression and education level seems to interact with working status. Higher risk of major depression was found among those with a higher level of education [9]
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