Depressive and subthreshold depressive symptomatology in older adults living in a socioeconomically deprived area in Brazil and characteristics associated

International journal of geriatric psychiatry

Int J Geriatr Psychiatry. 2021 Nov 23. doi: 10.1002/gps.5665. Online ahead of print.


Depressive and subthreshold depressive symptomatology are common but often neglected in older adults.

OBJECTIVES: 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. 3,356 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 (RRR) 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 neglect situation among older adults. This article is protected by copyright. All rights reserved.

PMID:34811807 | DOI:10.1002/gps.5665


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