National Institute of Public Health, Wako, Japan.
Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
PLoS One. 2021 Jan 28;16(1):e0245489. doi: 10.1371/journal.pone.0245489. eCollection 2021.
Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.
低客观社会经济地位（SES）与老年人的身心健康不良有关。一些研究表明，主观 SES 对于确保老年人身心健康也很重要。然而，关于客观 SES 和主观 SES 对老年人心理健康的影响的研究甚少。本研究探讨了在缅甸，客观 SES 和主观 SES 是否与老年人的抑郁症状有关。这是一项横断面研究，于 2018 年 9 月至 12 月进行，采用多阶段抽样方法从缅甸的两个地区招募参与者进行面对面访谈。使用老年抑郁量表（GDS）评估抑郁症状。将参与者分为无抑郁症状（GDS 评分<5）和有抑郁症状（GDS 评分≥5）。使用财富指数评估客观 SES，通过向参与者提出关于当前财务状况的多项选择问题评估主观 SES。使用多变量逻辑回归分析检查客观/主观 SES 与抑郁症状之间的关系。1186 名 60 岁及以上参与者的平均年龄为 69.7（标准差：7.3），其中 706 名（59.5%）为女性。其中，265 名（22.3%）有抑郁症状。在调整客观 SES 和其他协变量后，只有低主观 SES 与抑郁症状呈正相关（调整后的优势比，AOR：4.18，95%置信区间，CI：2.98-5.87）。这种关联在农村地区的参与者中更强（城市地区，AOR：2.10，95%CI：1.08-4.05；农村地区，AOR：5.65，95%CI：3.69-8.64）。在缅甸的两个地区的老年人中，主观 SES 与抑郁症状的关联强于客观 SES，尤其是在农村地区。针对老年人的抑郁症干预措施应考虑到主观 SES 的区域差异，减少社区之间的社会经济差距。
