Understanding depression in older Indians using diathesis-stress framework: The role of neighborhood safety and physical and functional health.

OBJECTIVES

The interplay between an individual's vulnerability and related stressors, effectively termed as diathesis, is an important contributor towards depressive symptoms. Utilizing the diathesis-stress model, the present study examines the role of perceived neighborhood safety along with specific indicators of health such as activities of daily living (ADL) and self-rated health (SRH), and their associations with depressive symptoms among older Indian adults.

STUDY DESIGN

A cross-sectional study has been conducted.

METHODS

Data were drawn from the Longitudinal Aging Study in India wave 1 that was collected during 2017-18. The present study is conducted on respondents aged 60 years and above and the sample included 31,464 older adults. Depressive symptoms were assessed using the Short Form Composite International Diagnostic Interview (CIDI-SF).

RESULTS

In this study, approximately 14.3% of the older participants reported perceiving their neighborhood as unsafe. A total of 23.77% and 24.21% of older adults reported at least one difficulty in ADL and poor SRH, respectively. Older adults who had perceived their neighborhood as unsafe had higher odds of reporting depressive symptoms [AOR: 1.758, CI: 1.497-2.066] than those with the perception of a safe neighborhood. Those with a perceived unsafe neighborhood and low ADL functioning had approximately 3.3 times higher odds of reporting depressive symptoms [AOR: 3.298, CI: 2.553-4.261] than those with a safe perceived neighborhood and high ADL functioning. Further, older adults with unsafe perceived neighborhood, low ADL functioning and poor SRH had much greater odds of reporting depressive symptoms [AOR: 7.725, CI: 5.443-10.960] than those with a safe perceived neighborhood, high ADL functioning and good SRH. Additionally, depressive symptoms were pronounced among older women and those who resided in rural areas with unsafe perceived neighborhood, low ADL functioning and poor SRH than their male peers.

CONCLUSIONS

The findings suggest that older women and rural-dwelling older adults are more prone to have higher prevalence of depressive symptoms than their male and urban-dwelling peers, especially when they have an unsafe neighborhood and poor functional and physical health, and thus, they should be given focused care and attention by healthcare practitioners.