Depressive and subthreshold depressive symptomatology among older adults in a socioeconomically deprived area in Brazil. (3rd December 2021)

• Record Type: Journal Article
• Authors: Nakamura, Carina Akemi; Scazufca, Marcia; Peters, Tim J.; Fajersztajn, Lais; Van de Ven, Pepijn; Hollingworth, William; Araya, Ricardo; Moreno‐Agostino, Darío
• Is Part Of: International journal of geriatric psychiatry. Volume 37:Number 2(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-03
• Subjects: depression -- low‐ and middle‐income country -- older adult -- primary healthcare -- subthreshold depression; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5665
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Depressive and subthreshold depressive symptomatology are common but often neglected in older adults. Objective: This study aimed to assess rates of depressive and subthreshold depressive symptomatology, and the characteristics associated, among older adults living in a socioeconomically deprived area of Brazil. Methods: This study is part of the PROACTIVE cluster randomised controlled trial. 3356 adults aged 60+ years and registered in 20 primary health clinics were screened for depressive symptomatology with the Patient Health Questionnaire‐9 (PHQ‐9). Depressive status was classified according to the total PHQ‐9 score and the presence of core depressive symptoms (depressed mood and anhedonia) as follows: no depressive symptomatology (PHQ‐9 score 0–4, or 5–9 but with no core depressive symptom); subthreshold depressive symptomatology (PHQ‐9 score 5–9 and at least one core depressive symptom); and depressive symptomatology (PHQ‐9 score ≥ 10). Sociodemographic information and self‐reported chronic conditions were collected. Relative risk ratios and 95% CIs were obtained using a multinomial regression model. Results: Depressive and subthreshold depressive symptomatology were present in 30% and 14% of the screened sample. Depressive symptomatology was associated with female gender, low socioeconomic conditions and presence of chronic conditions, whereas subthreshold depressive symptomatology was only associated with female gender and having hypertension. Conclusions: Depressive and subthreshold depressive symptomatology is highly prevalent in this population registered with primary care clinics. Strategies managed by primary care non‐mental health specialists can be a first step for improving this alarming and neglected situation among older adults. Key points: This is the first study to assess subthreshold depressive symptomatology in a large sample of older adults in Brazil. Individuals registered in primary care clinics and living in socioeconomically deprived areas were assessed for depressive and subthreshold depressive symptomatology. Depressive and subthreshold depressive symptomatology rates were high among this population. Higher levels of depressive symptomatology were associated with female gender, worse socioeconomic conditions and the presence of other chronic health conditions.