Depression in later life: A closer look at the gender gap (original) (raw)
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Gender differences in depressive symptoms among older adults: a cross-national comparison
Social Psychiatry and Psychiatric Epidemiology, 2007
Objectives To assess country-specific gender differences in depressive symptoms and to explore if exposures and vulnerabilities vary by gender among older men and women from four European countries and Israel. Methods Data on 4,449 subjects between 75 and 84 years old were derived from CLESA (“Cross-national determinants of quality of life and health services for the elderly”. A ratio score of depressive symptoms derived form the CESD and GDS scales was regressed on education, marital status, living arrangements, comorbidity and disability and all interactions of these factors with gender and country. Results The prevalence of depressive symptoms is higher in women than in men in every country, except Sweden. Women are more likely to be exposed to socio-structural risks, and have poorer health and more disability than men in most of the countries. However, women are not more vulnerable to these risk factors. Conclusions Findings indicate that the female excess in depressive symptoms remains after taking into account the higher prevalence of socio-structural and health-related risk factors and that older women are not more vulnerable than older men to these known risk factors, suggesting the existence of additional pathways linked to gender and/or biological sex.
Sex differences in late-life depression
Acta Psychiatrica Scandinavica, 2000
The primary aim of this study was to assess sex differences in depression in later life. In a random, age and sex-stratified community sample of 3056 older Dutch people (55 85 years) the prevalence, symptom-reporting and risk factors associated with depression in later life were studied. Depression was measured with the Center for Epidemiologic Studies Depression scale (CES-D). Bivariate, multivariate and factor analyses were used. Prevalence of depression in women was almost twice as high as in men. Controlling for age and competing risk factors reduced the relative risk for females with more than half. Symptom-patterns in men and women were very much alike. Sex differences in associations with risk factors were small, but exposure to these risk factors was considerably higher in females. Very little evidence for a typical 'female depression' was found. Female preponderance in depression was related to a greater exposure to risk factors.
Prevalence and Gender Differences in Late-Life Depression: A Population-Based Study
The American Journal of Geriatric Psychiatry, 2014
Objective: The worldwide phenomenon of an aging population combined with the increasing prevalence of depression in late life are issues that need to be addressed. This study aims to estimate the frequency of depression and subthreshold depression occurring in a sample of cognitively well-functioning, community-dwelling, older Italian adults and to investigate sociodemographic and clinical correlates of depression, exploring gender differences. Methods: We used a cross-sectional analyses of survivors in a population-based study (the Faenza Project) that included 359 subjects aged 74 years and older (49.3% women). A modified version of Cambridge Examination for Mental Disorders of Elderly Persons-Revised was administered to all participants. Prevalence rates of depression and 95% confidence intervals (CIs) were estimated according to International Classification of Diseases, Tenth Revision criteria. Statistical analyses were implemented to describe sociodemographic and clinical features associated with depression. Odds ratios were estimated by multivariate logistic regression, and the dependant variable was any type of depression. Results: Overall prevalence of depression was 25.1% (95% CI: 20.6e29.6), with no evidence of gender difference. Prevalence of mild, moderate, and severe depression was 16.4% (95% CI: 12.6e20.2), 7.5% (95% CI: 4.8e10.2), and 1.1 (95% CI: e0.4e2.6), respectively. A rate of 5.6% of the population complained of subthreshold depressive symptoms. After age 81, depression occurrence decreased as age increased. The association between depression and functional measures, such as primary activity, mobility, and disability in performing household chores, were stronger in men than in women. Similarly, severely disabling conditions like stroke were more strongly associated with depression in men than in women. Conclusion: Our data suggest a disparity between men and women regarding the impact of depression on everyday life. Specific gender differences need to be taken into account for the evaluation of the depression-related burden in late life.
Aging, Health, and Depressive Symptoms: Are Women and Men Different?
Journal of Women's Health, 2002
Objective: This study investigated whether age and self-reported health status comparisons affected reports of depressive symptoms differently for older women and men. Methods: Cross-sectional survey design conducted in a large health maintenance organization (HMO) that provides comprehensive, prepaid benefits to its members. Study subjects were enrollees who were 65 years of age or older. The dependent measure was their reports of depressive symptoms as measured using the Center for Epidemiologic Studies-Depression Scale (CES-D). The explanatory variables were patients' gender, age, self-reported health status comparisons, living status, and physical impairments. Results: The difference in the proportion of females reporting high depressive symptoms (CES-D$16) was 3.8% between the 75-84 year age group and the youngest female group (26.9% vs. 23.1%, respectively). The difference for males was 13.7% (26.5% vs. 12.8%, respectively) (OR50.44, 95% CI50.27, 0.73). Similar findings occurred among females and males who selfreported that they were in poor health (OR50.20, 95% CI50.06, 0.72). Aging and self-reported comparisons affected females and males similarly when high depressive symptoms were examined using a higher cut point (CES-D$21), although females were more than 50% more likely to report symptoms than males. Conclusions: As females aged and self-reported health status comparisons declined, their depressive symptoms increased steadily, but at a lower rate than males' depressive symptoms. Older persons in fair or poor self-reported health should especially be screened for increasing depressive symptoms. Although females generally report greater risk of high depressive symptoms, it is still a concern for males as they age and their health declines.
Geriatrics & Gerontology International, 2011
The main objective of this study was to identify determinants of poor self-rated health. We hypothesized that poor self-rated health reflects not only health, but also physical, functional, psychological and social factors. Methods: We conducted a cross-sectional analysis of a representative Spanish population sample of 600 subjects aged 65 years and older. Self-rated health status was measured and dichotomized into good (excellent and good) and poor (fair and poor). Univariate and multiple logistic regression analyses were used to determine these independent variables modifying poor self-rated health. Results: Of the participants, 43.9% perceived their health as poor. Depressive symptoms were a factor that showed the strongest relation to poor self-rated health (odds ration [OR] 5.06), even when distributed by sex (women, OR 4.70 and men, OR 5.19), followed by the need for caregiver support 24 h a day in both the total population (OR 3.67) and women (OR 3.53), but having a connective tissue disease was the second strongest factor in men (OR 2.07). When depressive symptoms and the need for caregiver support were present, the likelihood for poor self-rated health was 91.5% in the total population and 94.4% in women. In men, the likelihood reached 78.4% in the presence of depressive symptoms and connective tissue disease. Conclusions: Self-rated health is a multidimensional construct, which includes physical, psychological, functional and social variables. To recognize and intervene on the different factors involved, especially depressive symptoms, caregiver support and connective tissue disease, may contribute to improving self-rated health and ultimately the welfare for this group.
PloS one, 2016
To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression. International cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions. Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were...
Sex and depression in the national comorbidity survey. II: Cohort effects
Journal of Affective Disorders, 1994
Data from a nationally representative sample of the general population are used to study cohort differences in the prevalence of DSM-III-R Major Depressive Episode (MDE). We document increasing lifetime prevalence of MDE among both men and women in more recent cohorts, but no major change in the sex ratio over the 40-year period retrospectively covered in the survey. We find a cohort difference in 12-month MDE, with older women much more likely than older men to have recurrent episodes. This sex difference in recurrence plays an important part in the elevated 12-month prevalence of depression among women compared to men in the 45-54 age range.
Gender differences in depression
The British Journal of Psychiatry, 2000
s Abstract Background While there is ample evidence that the prevalence rates for major depressive disorder (MDD) in the general population are higher in women than in men, there is little data on gender differences as regard to symptoms, causal attribution, help-seeking, coping, or the consequences of depression. Method The large DEPRES Study dataset covering representative population samples of six European countries (wave I: 38,434 men and 40,024 women; wave II: 563 men and 1321 women treated for depression) was analyzed for gender differences. Results In wave I marked gender differences were found in the six-month prevalence rate for major depression but less so for minor depression; the gender differences for major depression persisted across all age groups. Even after stratification by clinically significant impairment and paid employment status, men reported fewer symptoms than women; as a consequence, men reached the diagnostic threshold less often. In wave II there were clear gender differences in causal attribution and in coping. Men coped by increasing their sports activity and consumption of alcohol and women through emotional release and religion. Women felt the effects of depression in their quality of sleep and general health, whereas men felt it more in their ability to work. Limitations The second wave of the study comprises treated depressives only and may be less representative than the first wave. s