Psychological distress in older adults linked to immigrant status, dietary intake, and physical health conditions in the Canadian Longitudinal Study on Aging (CLSA)

Background: Psychological distress increases mortality risk; there is little knowledge about its prevelance and contributory factors in older populations. Methods: Canadian Longitudinal Study on Aging baseline data (2010-2015) were analyzed to examine the relationship between Kessler's Psychological Distress Scale-K10 and immigrant status (recent/mid-term, <20 years; long-term,>= 20 years; Canadian-born). Covariates included socioeconomic and health-related variables. Stratified by sex, two series of multinomial logistic regression were used to calculate the likelihood of having mild distress (20 < K10 score <= 24) and moderate/severe distress (K10 score >24). Results: Respondents (n = 25,700) were mainly Canadian-born (82.8%), 45-65 years (59.3%), earning <C$100,000/year (58.2%) and had a post-secondary education (78.4%). For women, psychological distress was associated with being a recent/mid-term immigrant(OR =1.76, 99% CI 1.09-2.83), marital status (widowed/divorced/separated, OR =1.62, 99% CI 1.19-2.20), lower education level ( secondary school; OR = 1.95, 99% CI 1.32-2.88), lower intake of fruit and vegetable (<= 2/day; OR =1.50, 99% CI 1.05-2.14), higher waist-to-height ratio (>cut-off; OR =1.32, 99% CI 1.02-1.70), and higher nutritional risk (ORs = 2.16-3.31, p's <0.001). For men, psychological distress was associated with under-nutrition (grip strength < cut-off, OR =1.57, 99% CI 1.14-2.16). For men and women, psychological distress was associated with age ( >56 years, ORs =0.19-0.79, p's <0.01), lower income (<= C$149,000, ORs = 1.68-7.79, p's <0.01),multi-morbidities (ORs = 1.67-4.70, pis <0.01), chronic pain (ORs = 1.67-3.09, p's <0.001) and higher intakeof chocolate (>= 0.6 bar/week, ORs = 1.61-2.23, p's <0.001). Limitations: Cross-sectional design prohibits causal inferences. Conclusions: Nutritional factors, immigration status, social, and health-related problems are strongly associated with psychological distress among midlife and older adults.