Does a rural residence predict the
development of depressive symptoms
in older adults?
Can J Rural Med 2009; 14 (4)
Philip D. St. John, MD
Audrey A. Blandford, BA
Laurel A. Strain, PhD
Full article: http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/cjrm/vol-14/issue-4/pdf/pg150.pdf
Objective: We sought to determine whether adults aged 65 years or older living in
rural areas who are without depressive symptoms have a lower risk of developing
depressive symptoms over 5 years than their urban counterparts, and to determine the
factors that predict the development of depressive symptoms in older adults in rural
and urban areas.
Methods: We conducted a secondary analysis of an existing data set, the Manitoba
Study of Health and Aging (MSHA.) We studied a population-based random sample
of 807 people without depressive symptoms or cognitive impairment who were residing
in Manitoba communities in 1991/92 and 5 years later in 1996/97. We defined
“rural” as a census subdivision with a population of less than 20 000, and “urban” as a
popu lation of 20 000 or greater. The MSHA investigators measured depressive symptoms
using the Center for Epidemiologic Studies Depression scale, using the standard
cut-point of 16 or more. Participants reported their age, sex, education, self-rated
health, and functional status at the time of their first interview.
Results: Of adults aged 65 years or older living in urban areas, 13.3% developed
depressive symptoms, versus 8.9% of those living in rural regions (p = 0.047). In multivariate
analyses, a rural residence was not associated with the development of depressive
symptoms. In rural areas, factors predicting depressive symptoms were female sex
and poor self-rated health at the time of the first interview.
Conclusion: A rural residence is only weakly protective for the development of
depressive symptoms over 5 years, and this association was not seen after we accounted
for potential confounding variables. As well, these results underscore the strong
association between poor health and depressive symptoms.
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