Abstract
ObjectiveDepression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico.MethodsCross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model.ResultsSocioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not.ConclusionsThe results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.
Highlights
The study of depression in older adults (OA) has acquired critical importance in that it ranks as the second most common mental disorder worldwide, surpassed only by dementia [1]
Context variables: As principal exposure variables, we considered income inequality and socioeconomic deprivation in the localities, municipalities and states where OA resided
Of the 8,874 OA who participated in ENSANUT 2012, we excluded those who were unable to respond to the interview personally
Summary
The study of depression in older adults (OA) has acquired critical importance in that it ranks as the second most common mental disorder worldwide, surpassed only by dementia [1]. In 2005, prevalence of clinical depression in Mexico was estimated at 5% and 9.5% among men and women, respectively [3]. Have drawn considerable attention from public health initiatives. While they share a number of probable etiological explanations with clinical depression [5,6] and have been directly associated with mortality and suicide in this age group [6,7], it is estimated that their prevalence may eventually affect four times as many individuals as clinical depression [8]. In the case of Mexico, the prevalence of subclinical depression in OA over 65 years, using the Geriatric Examination for Computer Assisted Taxonomy (GMS– AGECA), was estimated at 31.9% and 32.2% in urban and rural areas, respectively, which is more than twice that the estimated prevalence using DSM-IV or ICD-10 criteria [9]
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