Effort-reward imbalance at work is predicted by temporal and energetic characteristics of behavior: A population-based study

Objective

Personality dispositions may influence perceptions of work stress. The paper examines the relationship between temperament in terms of Strelau’s Regulative Theory of Temperament and the effort-reward imbalance and its components.

Material and Methods

There were 890 participants (360 men) aged 37.9 years on average. Temperament traits of briskness and perseveration (temporal characteristics of behavior), sensory sensitivity, emotional reactivity, endurance and activity (energetic characteristics of behavior) were measured by Strelau & Zawadzki’s Formal Characteristics of Behavior-Temperament Inventory (FCB-TI) in 1997 and 2001. Effort and reward at work were assessed with the original effort-reward imbalance (ERI) questionnaire of 2007.

Results

Higher ERI at work was predicted by higher emotional reactivity, higher perseveration, lower briskness, and lower endurance. Higher effort and lower rewards at work were predicted by higher perseveration and lower endurance. The FCB-TI temperament characteristics accounted for 5.2%, 4.8% and 6.5% of the variance in the ERI, effort and reward, respectively. Lower emotional reactivity, lower perseveration, higher briskness and higher endurance predicted higher esteem at work, job promotion and job security.

Conclusions

Individual differences in arousability, reflected in temporal and energetic characteristics of behavior, may predispose to or to protect from an effort-reward imbalance at work. Individual differences should be acknowledged in work stress prevention and developing interventions.     

Auswirkungen von Overcommitment auf den subjektiven Gesundheitszustand bei Bankmitarbeitern

Background

The health outcome of stress and strains in the work setting has been the subject of many studies over the last decades. Siegrist’s model of effort-reward imbalance is one of the most valid instruments for studying this relationship. Overcommitment is especially said to have a strong impact on health and well-being. However, no analyses of bank employees exist.

Methods

In three banks, the effects of overcommitment on health were investigated using the overcommitment scale of the effort-reward imbalance model as well as the SF-36 health survey scale.

Results

The effects of overcommitment on general health, physical roles, and social functionality were significant.

Conclusion

The results are in line with former studies of the model of effort–reward imbalance. Still, a representative study in banks should be undertaken in order to generalize the results presented.     

Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction

Purpose

Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of ‘bianzhi’ nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals.

Methods

This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics.

Principal Results

Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than ‘bianzhi’ nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P?<?0.05).

Conclusions

Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and ‘bianzhi’ nurses may adversely affect both nurse and patient satisfaction in hospitals. Our study provides empirical support for the ‘equal pay for equal work’ policy emphasized by the China Ministry of Health’s recent regulations, and calls for efforts in Chinese hospitals to eliminate the disparities between ‘bianzhi’ and contract-based nurses.     

Prevalence and associated factors of depressive symptoms among Chinese male correctional officers

Objectives

Chinese correctional officers (COs) consist of frontline COs in direct contact with the prisoners and non-frontline COs (including administrative staff and professionals). Male COs compose the majority of Chinese COs, especially for frontline COs. Although they are quite susceptible to depressive symptoms due to highly risky and stressful working environment, few studies focus on this issue. This study aimed to evaluate the prevalence of depressive symptoms and to explore its associated factors among Chinese male frontline and non-frontline COs.

Methods

This cross-sectional study was performed during the period of March/April 2011. The study population comprised of 1,900 male COs in four male prisons in a province of northeast China. A questionnaire including the Center for Epidemiological Studies Depression Scale, demographic factors, work conditions, effort–reward imbalance questionnaire was distributed to these COs. A total of 1,494 effective respondents became our subjects (981 frontline COs and 513 non-frontline COs). Frontline and non-frontline COs were analyzed separately.

Results

Approximately 61.4 % of Chinese male COs had depressive symptoms (63.5 % in frontline COs and 57.3 % in non-frontline COs). Multivariate logistic analyses showed that effort–reward ratio, overcommitment, chronic disease, and threat perception were associated with depressive symptoms in frontline and non-frontline COs, whereas weekly work time had an effect only in frontline COs.

Conclusions

Chinese male COs, especially frontline COs, might have high-level prevalence of depressive symptoms. Moreover, this study had identified important risk factors that might be important in planning strategies for prevention and intervention of depressive symptoms for Chinese male COs.     

The mediating role of disability and social support in the association between low vision and depressive symptoms in older adults

Purpose

Vision loss is highly prevalent in old age and has a substantial impact on different aspects of quality of life including depressive symptoms. Our objective was to examine the mediating role of disability and social support in the association between low vision and depressive symptoms.

Methods

Differences in disability, social support, and depressive symptoms between 148 persons with low vision and a reference population (N = 4,792) all ≥57 years were compared. The association between low vision and depressive symptoms and the mediating role of disability and social support was examined by the means of regression.

Results

A significant effect of low vision on depressive symptoms was identified even after the adjustment for disability and social support (standardized beta 0.053, P < 0.001). The association between low vision and symptoms of depression was partially mediated by disability, while social support was identified as a suppressor variable. Low vision, disability, and social support showed unique contributions to depressive symptoms.

Conclusions

Prevention of disability and the increase in social support may help to reduce symptoms of depression in older adults with low vision. By taking such information into account in their intervention work, health professionals working in this area may improve their care quality.     

Depressive symptoms and carotid artery intima-media thickness in police officers

Purpose

Police work is a stressful occupation. Depressive symptoms, which may occur as a result of exposure to stressors in police work, have been known to be associated with an increased risk of cardiovascular disease. This cross-sectional study investigated the association between depressive symptoms and carotid artery intima-media thickness (CIMT) among police officers.

Methods

CIMT was measured with B-mode carotid ultrasonography. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Analyses of variance and covariance were utilized to examine the mean values of common CIMT (CCA IMT) and maximum CIMT (MMXIMT) across quintiles of depressive symptoms.

Results

Participants included 412 officers (mean age = 41 years). Hypertension status significantly modified the association between CES-D score and CIMT. The association between CES-D score and CCA IMT was statistically significant (adjusted P = 0.030) but only among officers without hypertension. The associations between CES-D score and MMXIMT were not significant among officers with or without hypertension. Our results also showed that among officers who reported poor sleep quality, mean levels of CCA IMT, and MMXIMT tended to increase as depressive symptoms increased.

Conclusions

Depressive symptoms may be therefore be independently associated with CIMT, yet masked by hypertension. Even though sleep quality did not significantly modify the main association, our results also suggest that poor sleep quality may act synergistically with depressive symptoms to increase CIMT. Future prospective work would help to clarify these associations.     

Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium

Background

Effort-reward imbalance (ERI) is an established conceptualisation of work stress. Although a validated effort-reward questionnaire is available for public use, many epidemiological studies adopt shortened scales and proxy measures. To examine the agreement between different abbreviated measures and the original instrument, we compared different versions of the effort-reward scales available in 15 European cohort studies participating in the IPD-Work (Individual-participant-data meta-analysis in working populations) consortium.

Methods

Five of the 15 studies provide information on the original (‘complete’) scales measuring ‘effort’ and ‘reward’, whereas the 10 remaining studies used ‘partial’ scales. To compare different versions of the ERI scales, we analyse individual-level data from 31,790 participants from the five studies with complete scales.

Results

Pearson’s correlation between partial and complete scales was very high in case of ‘effort’ (where 2 out of 3 items were used) and very high or high in case of ‘reward’, if at least 4 items (out of 7) were included. Reward scales composed of 3 items revealed good to satisfactory agreement, and in one case, a reward scale consisting of 2 items only demonstrated a modest, but still acceptable degree of agreement. Sensitivity and specificity of a composite measure, the ratio of effort and reward, comparing partial versus complete scales ranged between 59–93 and 85–99 %, respectively. Complete and partial scales were strongly associated with poor self-rated health.

Conclusion

Our results support the notion that short proxy measures or partial versions of the original scales can be used to assess effort-reward imbalance.     

Walk on the sunny side of life — Epidemiology of hypovitaminosis D and mental health in elderly nursing home residents

Objectives

Old age is a well-known risk factor for both depression and hypovitaminosis D, and an association between both conditions has been postulated. We document the prevalence of vitamin D deficiency in nursing home residents, and we examine the link with self-reported depressive symptoms and pharmacotherapy for depression.

Design

Cross- sectional. Setting: nursing homes in Antwerp, Belgium.

Participants

Healthy elderly (n=589), with a mean age of 84 years.

Measurements

We detected depressive symptoms by means of SF-36, a validated quality of life assessment; we registered the use of antidepressants and anxiolytics, and we measured serum 25(OH)D concentrations in all participants.

Results

Almost our entire study population appeared to be vit D deficient. Comparison of the most severely and least deficient subgroups showed a consistent tendency towards more depressive symptoms and more use of antidepressants in the group with the lowest vit D level.

Conclusion

Nursing home residents are particularly vulnerable to preventable vit D deficiency. The relevance of the association with depressive symptoms and the possibilities for treatment are critically reviewed in the discussion.     

The oncology nurse coordinator: role perceptions of staff members and nurse coordinators

Background

There is extensive evidence that the role of nurse coordinators is beneficial for patients. Nurse coordinators are more available to patients compared to general registered nurses, know better to control symptoms and work as team players with multiple care providers. Despite its significance, there is a dearth of literature on the subject in Israel and a lack of clarity regarding the definitions of the role in terms of responsibilities and authorities. The aim of the study is to: To examine how the role of nurse oncology coordinator is implemented in various fields of oncology and to describe the actual performance of different kinds of oncology nurse coordinators and staff perceptions regarding this role in one tertiary hospital in Jerusalem.

Methods

A phenomenological approach was used to explore the participants’ experiences and views of nurse coordinators’ performance. We conducted a qualitative study using in-depth semi-structured interviews. Interviewees included 30 employees from different levels of the hospitals, and leading figures associated with oncology medicine outside of the hospital: Nurses and physicians of the Sharett Oncology Institute of Hadassah Ein Kerem Hospital in Jerusalem, the administrative staff of Hadassah Ein Kerem Hospital, head nurses of the Israel Cancer Association, the chairperson of the Non-Profit Organization of Oncology Nurses, nurse directors at the Ministry of Health Nursing Division, and seven nurse coordinators at Hadassah Ein Kerem Hospital in diverse fields of oncology.

Results

The nurse coordinator is perceived as an important staff member providing care to cancer patients. Several key elements were found to be common features in the work of all nurse coordinators: emotional support, guidance to patients, and coordination of patients’ care.

Conclusions

The nurse coordinator plays a noteworthy role in the health care system. In view of the variety of roles that the nurse coordinator assumes in different units, performance standards must be adapted to the performance areas for each unit, as well as nurses’ professional development requirements. Changes in a service organization and careful attention to the continuum of care highlight the need to develop and to strengthen the role of a nurse who coordinates treatment over the entire continuum of care, both in the hospital and in the community.

     

Job demands, job resources, and work engagement of Japanese employees: a prospective cohort study

Purpose

Research on the prospective association of job demands and job resources with work engagement is still limited in Asian countries, such as Japan. The purpose of the present study was to investigate the prospective association of job demands (i.e., psychological demands and extrinsic effort) and job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward), based on the job demands-control (JD-C) [or demand-control-support (DCS)] model and the effort-reward imbalance (ERI) model, with work engagement among Japanese employees.

Methods

The participants included 423 males and 672 females from five branches of a manufacturing company in Japan. Self-administered questionnaires, including the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance Questionnaire (ERIQ), the nine-item Utrecht Work Engagement Scale (UWES-9), and demographic characteristics, were administered at baseline (August 2009). At one-year follow-up (August 2010), the UWES-9 was used again to assess work engagement. Hierarchical multiple regression analyses were conducted.

Results

After adjusting for demographic characteristics and work engagement at baseline, higher psychological demands and decision latitude were positively and significantly associated with greater work engagement at follow-up (β = 0.054, p = 0.020 for psychological demands and β = 0.061, p = 0.020 for decision latitude).

Conclusions

Having higher psychological demands and decision latitude may enhance work engagement among Japanese employees.     

Mediterranean diet and depressive symptoms among older adults over time

Objective

To examine whether adherence to a Mediterranean-based dietary pattern is predictive of depressive symptoms among older adults.

Design

Generalized estimating equation models were used to test the association between a Mediterranean-based dietary pattern and depressive symptoms over time. Models were adjusted for age, sex, race, education, income, widowhood, antidepressant use, total calorie intake, body mass index, smoking, alcohol consumption, number of self-reported medical conditions, cognitive function, and physical disability.

Setting

Chicago, Illinois.

Participants

Community-dwelling participants (n=3502) of the Chicago Health and Aging Project aged 65+ years (59% African American) who had no evidence of depression at the baseline.

Measurements

Adherence to a Mediterranean-based dietary pattern was assessed by the MedDietScore. Dietary evaluation was performed with a food frequency questionnaire at baseline and related to incident depression as measured by the presence of four or more depressive symptoms from the 10-item version of the Center for Epidemiologic Studies Depression scale.

Results

Over an average follow-up of 7.2 years, greater adherence to a Mediterranean-based diet was associated with a reduced number of newly occurring depressive symptoms (parameter estimate = ?0.002, standard error = 0.001; p = 0.04). The annual rate of developing depressive symptoms was 98.6% lower among persons in the highest tertile of a Mediterranean-based dietary pattern compared with persons in the lowest tertile group.

Conclusion

Our results support the hypothesis that adherence to a diet comprised of vegetables, fruits, whole grains, fish, and legumes may protect against the development of depressive symptoms in older age.     

Relation of work family conflict and role quality on depressive symptoms in mothers

Aim

The purpose of this study was to further investigate the relationship between perceived role quality (of the mother, partner, work and homemaker role), work family conflict (WFC) and maternal depression. We assume that role quality moderates the relation between WFC and depressive symptoms in working mothers.

Method

Data for the cross-sectional study were obtained from mothers (N?=?148) with children up to 10?years of age. In order to analyze the relationship between role quality, WFC and depressive symptoms in mothers, we conducted moderated regression analyses.

Results

The central findings are (1) that positive role quality of the mother (p?<?.001), partner (p?<?.001) and work role (p?<?.01) is negatively related to depressive symptoms; (2) that the frequently in recent literature discussed relation between high levels of WFC and the development of depressive symptoms, is moderated by role quality. Positive role quality buffers the detrimental influence of WFC on depressive symptoms.

Conclusion

Results indicated that in order to better understand possible influence combining work and family roles on depressive symptoms for mothers, focus should be on the quality of the occupied roles and not solely on possible conflict between roles. Roles provide important resources that help to cope with possible conflicts between roles thus protecting from the development of depressive symptoms in mothers.     

The mediating effects of depressive symptoms on nutritional status of older adults in long-term care facilities

Objective

To test whether depressive symptoms mediate the effects of activities of daily living (ADLs) on nutritional status of older adults living in long-term care (LTC) facilities in Taiwan.

Design

A cross-sectional study.

Setting

Seventy-three community-based LTC facilities in northern Taiwan.

Participants

This study sampled 306 adults ranging in age from 65 to 97 years who were free of acute infection or disease and who were able to communicate.

Measurements

Nutritional status was assessed by the Mini-Nutritional Assessment (MNA) scale and depressive symptoms were assessed by the short form of the Geriatric Depressive Scale (GDSSF).

Results

MNA scores revealed that 65% of the subjects were at risk for malnutrition (17 to 23.5 points). In addition, depressive symptoms partially mediated the relationship between ADLs and nutritional status, with 10.7% of the effect of depressive symptoms on nutritional status going through the mediator.

Conclusion

Interventions to reduce depressive symptoms among institutionalized older adults should focus on improving nutritional status rather than promoting ADLs, which are believed to be difficult to change.     

Migration and depressive symptoms in migrant-sending areas: findings from the survey of internal migration and health in China

Objectives

China has experienced large-scale internal migration and growing mental health disorders. Limited research has examined the relationship between the two processes. We examined the association between labor out-migration and depressive symptoms of family members left behind in migrant-sending areas.

Methods

We conducted a multistage probability sample survey of Chinese adults in 2008 (“Internal Migration and Health in China”), including 787 people in rural migrant-sending areas. To study whether adults in out-migrant households were more likely to experience depressive symptoms (CES-D) than were adults in non-migrant households, we used multivariate regressions and adjusted for a wide range of confounding factors and for the complex sampling design.

Results

Adults in households with labor out-migrants were more likely to report depressive symptoms than those in households without out-migrants, presumably a result of the absence of family members. However, monetary remittances from labor migrants buffered the mental health costs of out-migration.

Conclusions

Labor out-migration has important consequences for the mental health in migrant-sending communities. There is an urgent need to address the psychological costs of migration and to promote regular remittances.     

Präsentismus vermeiden – Arbeitsbereitschaft fördern. Ein Zielkonflikt der Pandemieplanung?

Introduction

Employees are recommended to stay at home when they show symptoms of an acute respiratory infection. Yet, in case of an influenza pandemic another challenge is to promote the employees’ high willingness to report to work. For pandemic planning this raises the question, whether there is a conflict between these two goals.

Method

Employee survey at the urban administration of Dortmund, Germany, about presenteeism with symptoms of an acute respiratory infection and the willingness to report to work during an influenza pandemic.

Results

Results of multivariate linear regression indicated: There is only little association between propensity for presenteeism with symptoms of an acute respiratory infection and willingness to report to work during an influenza pandemic (R²?=?0,024).

Conclusion

Results did not support the aforementioned conflict of goals between reducing presenteeism with symptoms of an acute respiratory infection and promoting willingness to report to work during an influenza pandemic. Further research should investigate interventions, which will support both goals alike, in order to support pandemic planning.     

Association of depressive symptoms with recurrent falls: A cross-sectional elderly population based study and a systematic review

Background

Screening of depressive symptoms is recommended in recurrent fallers. Compared to the 30-item and 15-item Geriatric Depression Scales (GDS), the 4-item GDS is easier to administer and quicker to perform. The association between abnormal 4-item GDS score and recurrent falls has not yet been examined, hi addition, while depressive symptoms-related gait instability is well known, the association with recurrent falls has been few studied.

Objective

1) To examine the association between abnormal 4-item GDS score and recurrent falls in community-dwelling older adults using original data from health examination centers (HEC) of French health insurance of Lyon, and 2) to perform a systematic review of studies that examined the association of depressive symptoms with recurrent falls among older adults.

Methods

Firstly, based on a cross-sectional design, 2,594 community-dwellers (mean age 72.1±54years; 49.8% women) were recruited in HEC of Lyon, France. The 4-item GDS score (abnormal if score>l) and recurrent falls (i.e., 2 or more falls in the past year) were used as main outcomes. Secondly, a systematic English and French Medline literature search was conducted on May 28, 2012 with no limit of date using the following Medical Subject Heading (MeSH) terms “Aged OR aged, 80 and over”, “Accidental falls”, “Depressive disorder” and “Reccurence”. The search also included the reference lists of the retrieved articles.

Results

A total of 19.0% (n=494) participants were recurrent fallers in the cross-sectional study. Abnormal 4-item GDS score was more prevalent among recurrent fallers compared to non-recurrent fallers (44.7% versus 25.0%, with P<0.001), and was significantly associated with recurrent falls (Odd ratio (OR)=1.82 with P<0.001 for full model; OR=1.86 with P<0.001 for stepwise backward model). In addition to the current study, the systematic review found only four other studies on this topic, three of them examining the association of depressive symptoms with recurrent falls using 30-item or 15-item GDS. All studies showed a significant association of depressive symptoms with recurrent falls.

Conclusions

The current cross-sectional study shows an association between abnormal 4-item GDS score and recurrent falls. This association of depressive symptoms with recurrent falls was confirmed by the systematic review. Based on these results, we suggest that recurrent falls risk assessment should involve a systematic screening of depressive symptoms using the 4-item GDS.     

Hospital Use of Agency‐Employed Supplemental Nurses and Patient Mortality and Failure to Rescue

Objective

To determine the association between the use of agency-employed supplemental registered nurses (SRNs) to staff hospitals and patient mortality and failure to rescue (FTR).

Data Sources

Primary survey data from 40,356 registered nurses in 665 hospitals in four states in 2006 were linked with American Hospital Association and inpatient mortality data from state agencies for approximately 1.3 million patients.

Study Design

Logistic regression models were used to examine the association between SRN use and 30-day in-hospital mortality and FTR, controlling for patient and hospital characteristics, nurse staffing, the proportion of nurses with bachelor''s degrees, and quality of the work environment.

Principal Findings

Before controlling for multiple nurse characteristics of hospitals, higher proportions of agency-employed SRNs in hospitals appeared to be associated with higher mortality (OR = 1.06) and FTR (OR = 1.05). Hospitals with higher proportions of SRNs have poorer work environments, however, and the significant relationships between SRNs and mortality outcomes were rendered insignificant when work environments were taken into account.

Conclusions

Higher use of SRNs does not appear to have deleterious consequences for patient mortality and may alleviate nurse staffing problems that could produce higher mortality.     

Depressive symptoms,health-related quality of life,and cardiac event-free survival in patients with heart failure: a mediation analysis

Purpose

Health-related quality of life (HRQOL) and depressive symptoms both are associated with an adverse prognosis in heart failure (HF), although their associations with outcomes have been examined only in isolation. Therefore, it is unknown how HRQOL and depressive symptoms might interact in their associations with outcomes. The present study was conducted to determine whether the association between HRQOL and cardiac event-free survival is mediated by depressive symptoms in HF patients given that depressive symptoms are associated strongly with HRQOL.

Methods

A total of 209 HF patients (61 ± 11 years, 24 % female, 49 % NYHA III/IV) participated. The Minnesota Living with HF Questionnaire and the Patient Health Questionnaire-9 were used to measure HRQOL and depressive symptoms, respectively. Patients were followed for a median of 357 days to determine cardiac event-free survival.

Results

In Cox regression analysis, HRQOL [hazard ratio (HR) 1.013; 95 % confidence interval (CI) 1.001–1.026] and depressive symptoms (HR 1.075; 95 % CI 1.025–1.127) predicted cardiac event-free survival separately, controlling for demographic and clinical variables. HRQOL independently explained 38.7 % of the variance in depressive symptoms (p < 0.05; standardized β = 0.695) in a multiple regression. When HRQOL and depressive symptoms were entered in the model simultaneously, only depressive symptoms independently predicted cardiac event-free survival (HR 1.068; 95 % CI 1.001–1.139), demonstrating a mediation effect of depressive symptoms.

Conclusions

Depressive symptoms mediated the relationship between HRQOL and cardiac event-free survival. Interventions targeting HRQOL to enhance patient outcomes must also address patient depressive symptoms to be fully efficacious.     

Urban environment, physical inactivity and unhealthy dietary habits correlate to depression among elderly living in eastern Mediterranean islands: The MEDIS (MEDiterranean ISlands elderly) study

Aims

To evaluate factors associated with depression in elderly.

Methods

During 2005–2007, 553 men and 637 women (aged 65 to 100 yrs) living in various Greek islands and in Cyprus participated in the study. The sampling was random and multistage (according to age-sex distribution of the referent population). Depressive symptoms were evaluated using the Geriatric Depression Scale (GDS).

Results

Twenty five per cent of men and 35% of women were classified in the highest GDS category (i.e. GDS score > 10), indicating intense depressive symptoms, while 54% of men and 70% of women scored above the depression cut-off (i.e. GDS score > 5) indicating mild-to-severe depressive symptoms. Among the investigated characteristics, living in urban environment, physical inactivity and history of hypertension were correlated with the presence of depressive symptoms (p<0.05), after adjusting for various confounders. Moreover, the consumption of fish, vegetables and cereals is more prevalent among people with low or moderate depression (p<0.05).

Conclusions

The prevalence of depression is quite high between elderly people living in Greek islands and Cyprus. Urban environment that may also interact with sedentarism and unhealthy dietary habits seems to promote depression in the studied population. Efforts to lower the prevalence of depression in the elderly should target on the aforementioned factors that employ functional impairment, social environment and dietary habits.