Depression among the rural elderly. A study of prevalence and correlates.

A large sample (N = 3159) of noninstitutionalized older adults (aged 65 to 105 years) residing in two rural Iowa counties participated in an assessment of a wide range of health-related factors, including depression. Prevalences of significant depressive symptomatology (9.0%; based on a modified version of the Center for Epidemiological Studies Depression Scale [CES-D]) and clinical depression (2.9%; based on self-report of Research Diagnostic Criteria [RDC]-like criteria) were low. The relationships between several demographic measures and the depression indices were examined. While expected sex differences were obtained for the CES-D, they were not found for the depression RDC. Subjects who lived alone and subjects with lower incomes were more at risk for depression. There was also evidence that being married and having a higher educational level were associated with lower risk for depression as measured by the CES-D (but not the RDC). The role of social support in rural communities was discussed as a factor contributing to the low rate of depression found in this study. The importance of sex, social support, and economic resources in accounting for depression among the elderly was also discussed.