Prevalence of depressive symptoms among rural elderly: Examining the need for mental health services.

Abstract

In a statewide, regionally representative, random sample consisting of 1,724 older adults living independently in North Dakota, the prevalence of depression was found to be relatively low. Controlling for potential alcohol abuse, cognitive impairment, and medical problems, 5% of older adults reported current depressive symptomatology. When using a cutoff score that is likely to correspond to a diagnosis of major depression, the prevalence rate was 1.6%. Of those reporting significant levels of depression, only 27.6% were currently being treated for an emotional problem. The survey data suggested that cost, transportation, and concern about stigma are not major barriers to This study was supported by a grant from the Aging Services Division, North Dakota Department of Human Services, agreement #1-9201408.The authors wish to extend their gratitude to Marci Lee for organizing and coordinating the survey work; Carrie Kubacki for assisting with the background literature search and instrument construction; Holly Hegstad and Douglas Woods for providing data processing and analysis services;

Health disparities and depression in rural and urban older adults.

“…Further, research on the mental health needs of rural OAs is very scarce with little research investigating the variables associated with depression in this population (Rokke & Klenow, 1998). In addition to the lack of research, the current literature on depression in rural residents reveals conflicting results and limitations that threaten the generalizability and validity of the research findings (St John, Blandford, & Strain, 2002).…”

“…Prevalence rates of Major Depression assessed via structured diagnostic interviews in rural adults (age 15+) ranged from 1.1 % to 39% (Blazer, George, Landerman, et ai., 1985;Crowell, George, Blazer, & Landerman, 1986;Probst, Laditka, Charity, et ai., 2006;Schwab, Warheit, & Holzer, 1974;Sears, Danda, Evans, 1999;Simmons & Havens, 2007). Given the results presented above, it is surprising that many articles state the prevalence rates of depression are lower in rural compared to urban samples (Rokke & Klenow, 1998). An analysis of the results from the aforementioned 24 studies reveals no consensus as to whether prevalence rates of depression are greater in rural versus urban settings, which is likely the result of different measurement techniques utilized and differences in the definition of rural, which will be explained in more detail below.…”

“…Variables found to be significantly associated with depression in at least one of the seven rural OA studies identified include: lower income, less education, living alone, having been widowed, divorced, or separated, greater alcohol use, poorer cognitive status, poorer perceived physical health, a greater number of chronic medical conditions, dissatisfaction with social support, smaller household size, less frequent group participation, taking depression medication, and being female (Buys, Roberto, Miller, Blieszner, 2008;O'Hara, Kohout, & Wallace, 1985;Rokke & Klenow, 1998;Swenson, Baxter, Shetterly, et aI., 2000;Wallace & O'Hara, 1992).…”

“…For example, 44% of Rokke & Klenow's (1998) sample consists of participants living in a city with a population between 10,000 and 50,000; and Neff's (1983) rural sample is made up of 4 counties considered 59% urban.…”

“…Although rural elders represent a unique and growing population, there appears to be an urban bias in gerontological research, with few studies focusing specifically on rural OAs (Coward & Lee, 1984;O'Hara, Kohout, & Wallace, 1985;Rokke & Klenow, 1998). Further, research on the mental health needs of rural OAs is very scarce with little research investigating the variables associated with depression in this population (Rokke & Klenow, 1998).…”