Depressive Symptoms Among Older Adults in Mexico City

BACKGROUND  Ageing and depression are associated with disability and have significant consequences for health systems in many other developing countries. Depression prevalence figures among the elderly are scarce in developing countries. OBJECTIVE  To estimate the prevalence of depressive symptoms and their cross-sectional association with selected covariates in a community sample of Mexico City older adults affiliated to the main healthcare provider. DESIGN  Cross-sectional, multistage community survey. PARTICIPANTS  A total of 7,449 persons aged 60 years and older. MEASUREMENTS  Depression was assessed using the 30-item Geriatric Depression Scale (GDS); cognitive impairment, using the Mini-Mental State Examination; and health-related quality of life with the SF-36 questionnaire. MAIN RESULTS  The prevalence of significant depressive symptoms was estimated to be 21.7%, and 25.3% in those aged 80 and older. After correcting for GDS sensitivity and specificity, major depression prevalence was estimated at 13.2%. Comparisons that follow are adjusted for age, sex, education and stressful life events. The prevalence of cognitive impairment was estimated to be 18.9% in depressed elderly and 13.7% in non-depressed. SF-36 overall scores were 48.0 in depressed participants and 68.2 in non-depressed (adjusted mean difference = −20.2, 95% CI = −21.3, −19.1). Compared to non-depressed elderly, the odds of healthcare utilization were higher among those depressed, both for any health problem (aOR 1.4, 95% CI = 1.1, 1.7) and for emotional problems (aOR 2.7, 95% CI = 2.2, 3.2). CONCLUSIONS  According to GDS estimates, one of every eight Mexican older adults had major depressive symptoms. Detection and management of older patients with depression should be a high priority in developing countries.