Department of Family & Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India.
Institute of Rural Management, Anand, Gujarat, India.
BMJ Open. 2022 Jun 1;12(6):e054730. doi: 10.1136/bmjopen-2021-054730.
To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression.
A cross-sectional study was conducted using large representative survey data.
Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017-2018. The effective sample size was 30 888 older adults aged 60 years and above.
The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff's decomposition were used to fulfil the objectives of the study.
There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was -0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults.
Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.
了解老年人的社会经济和健康状况与抑郁之间的关系，并探讨导致老年后期抑郁的社会经济和健康相关不平等的因素。
使用大型代表性调查数据进行横断面研究。
本研究的数据来自于 2017-2018 年期间进行的印度纵向老龄化研究的基线波。有效样本量为 30888 名 60 岁及以上的老年人。
本研究的结局变量为老年人的抑郁情况。进行描述性统计和双变量分析以报告初步结果。采用多变量二元逻辑回归分析和 Wagstaff 分解来实现研究目标。
来自贫困（11.2%）和非贫困（6.8%）类别的老年人的抑郁发生率存在显著差异（4.3%；p<0.05）。集中指数的值为-0.179，这也证实了主要抑郁更多地集中在贫困老年人中。大约 38.4%的社会经济和健康相关不平等可以用老年人的财富五分位数来解释。此外，约 26.6%的主要抑郁不平等可以用心理困扰来解释。自评健康（SRH）、日常生活活动（ADL）困难和工具性日常生活活动（IADL）分别对不平等造成 8.7%、3.3%和 4.8%的影响。此外，区域对老年人的主要抑郁不平等解释了约 23.1%，其次是生活满意度（11.2%）和工作状况（9.8%）。
研究结果表明，老年人的抑郁存在较大的社会经济和健康相关不平等，尤其是在家庭经济贫困、丧偶、SRH 差、ADL 和 IADL 困难以及心理困扰的情况下更为明显。在制定预防计划时，应高度重视对有抑郁症状的老年人的检测和管理，尤其是对那些更脆弱的老年人。
