Depressive symptoms in the elderly.: Prevalence and associated factors

Objectives: To estimate the prevalence of depressive symptoms in people older than 64 and to analyze their association with sociodemographic factors, frailty markers, and disabling diseases. Methods: A survey-based, cross-sectional descriptive study was carried out. The sample was composed of 417 elderly people living in Guadalajara (Spain), selected on the basis of health cards. Depressive symptoms were assessed using Yesavage's test (cut-off: 6 or more items). The questionnaire contained sociodemographic and clinical items and evaluation scales for cognitive impairment, disability, and social risk. The frailty markers studied were age over 80 years old, female sex, cognitive impairment, disability, polypharmacy, comorbidity, and social risk. Results: The prevalence of depressive symptoms was 19.7% (95% Cl, 15.9-23.4) and clinical depression was diagnosed in 5% (95% Cl, 2.3-7.7). Depressive symptoms were more frequent in elderly individuals living in rural environments than in those living in urban areas (p < 0.05). These symptoms increased with age (p linear trend < 0.001) and were associated with social risk (p < 0.001), comorbidity (p < 0.001), cognitive impairment (p < 0.01), and disability (p < 0.05). When a multivariate statistical analysis was applied using logistic regression models, only comorbidity (odds ratio [OR] = 2.38; 95% Cl, 1.35-4.20) and social risk (OR = 2.69; 95% Cl, 1.50-4.83) were significantly associated. Conclusions: The prevalence of depressive symptoms is very high in the elderly, four times higher than a diagnosis of clinical depression. Social risk and comorbidity are strongly associated with depressive symptoms.