Rural‐Urban differences in the prevalence of depression and anxiety among middle‐aged and older Indians

Abstract

AbstractBackgroundDepression and anxiety have a considerably adverse impact on physical, mental and cognitive abilities. Since rural communities generally have more difficult living circumstances than urban communities, it is likely that prevalence of depression and anxiety could be higher in the rural population. Socio‐demographic factors, such as gender and age could also significantly influence the prevalence of these conditions. This study aims to examine the above potential differences.MethodThis was a cross‐sectional study which included participant’s ≥45 years, of both genders, who were recruited as part of two ongoing, prospective, aging cohort studies – Srinivaspura Aging, Neuro Senescence and COGnition (SANSCOG) in rural India and Tata Longitudinal Study of Aging (TLSA) in urban India. Baseline clinical data of SANSCOG (rural) and TLSA (urban) participants was utilized. Geriatric Depression Scale (GDS‐30) and Generalized Anxiety Disorder scale (GAD‐7) were used to estimate the prevalence of depression and anxiety, respectively. Statistical analysis was performed using Binomial test to determine differences in prevalence of depression and anxiety between the two populations as well as gender and age group‐wise differences.ResultOverall prevalence of depression was significantly higher among rural (16.13%) than urban population (8.2%, p<0.001). Similar trend was seen for prevalence of anxiety (rural = 5.27%, urban = 2.42%, p = 0.002). Also, prevalence of depression was significantly higher among females than males in both rural (20% vs. 12%, p = <0.001) and urban participants (11% vs. 5%, p = 0.0003). Prevalence of anxiety was also significantly higher among females than males in rural (6% vs. 4%, p = 0.01) but not significantly different in urban population (3% vs. 2%, p = 0.36). There was no significant difference between the two age groups in either of the populations for depression (rural: <65 = 15% vs. ≥65 = 18%, p = 0.92 and urban: <65 = 9% vs. ≥65 = 7%, p = 0.18) or anxiety (rural: <65 = 6% vs. ≥65 = 4%, p = 0.12 and urban: <65 = 2% vs. ≥65 = 3%, p = 0.81).ConclusionRural Indians had significantly higher prevalence of depression and anxiety than their urban counterparts. Women in both these populations had significantly higher burden than men. However, no age group‐wise differences were observed. Public health initiatives to address the high burden of depression in rural Indian women are urgently needed.