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Depressive and subthreshold depressive symptomatology among older adults in a socioeconomically deprived area in Brazil

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Carina Akemi Nakamura, Marcia Scazufca, Tim J. Peters, Lais Fajersztajn, Pepijn Van de Ven, William Hollingworth, Ricardo Araya, Darío Moreno-Agostino

Original languageEnglish
JournalInternational Journal of Geriatric Psychiatry
Issue number2
Early online date3 Dec 2021
Accepted/In press2021
E-pub ahead of print3 Dec 2021

Bibliographical note

Funding Information: We would like to acknowledge the staff of all 20 participating UBSs for supporting the recruitment of participants and the Guarulhos Health Secretariat for supporting the conduction of the study. This study was funded by São Paulo Research Foundation (FAPESP, process number 2017/50094‐2) and the Joint Global Health Trials initiative jointly funded by Medical Research Council, Wellcome Trust, and the UK Department for International Development (MRC, process number MR/R006229/1). CAN is supported by FAPESP (2018/19343‐0), MS by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq‐Brazil, 307579/2‐19‐0) and DMA by the ESRC Centre for Society and Mental Health at King’s College London (ESRC Reference: ES/S012567/1). The views expressed are those of the author(s) and not necessarily those of the ESRC or King's College London. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2021 John Wiley & Sons Ltd.

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Depressive and subthreshold depressive symptomatology are common but often neglected in older adults. Objective: This study aimed to assess rates of depressive and subthreshold depressive symptomatology, and the characteristics associated, among older adults living in a socioeconomically deprived area of Brazil. Methods: This study is part of the PROACTIVE cluster randomised controlled trial. 3356 adults aged 60+ years and registered in 20 primary health clinics were screened for depressive symptomatology with the Patient Health Questionnaire-9 (PHQ-9). Depressive status was classified according to the total PHQ-9 score and the presence of core depressive symptoms (depressed mood and anhedonia) as follows: no depressive symptomatology (PHQ-9 score 0–4, or 5–9 but with no core depressive symptom); subthreshold depressive symptomatology (PHQ-9 score 5–9 and at least one core depressive symptom); and depressive symptomatology (PHQ-9 score ≥ 10). Sociodemographic information and self-reported chronic conditions were collected. Relative risk ratios and 95% CIs were obtained using a multinomial regression model. Results: Depressive and subthreshold depressive symptomatology were present in 30% and 14% of the screened sample. Depressive symptomatology was associated with female gender, low socioeconomic conditions and presence of chronic conditions, whereas subthreshold depressive symptomatology was only associated with female gender and having hypertension. Conclusions: Depressive and subthreshold depressive symptomatology is highly prevalent in this population registered with primary care clinics. Strategies managed by primary care non-mental health specialists can be a first step for improving this alarming and neglected situation among older adults.

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