Objective: Prevalence rates of depression in older people may be higher in urban compared to rural settings. This issue has received little research attention, particularly within the context of a single survey. The objectives of this study were to investigate urban-rural differences in prevalence rates of depression for an older Korean population, potential explanatory factors, and the importance of urban/rural residence earlier in life.
Design: The study was a population based cross-sectional survey.
Materials and Methods: A community survey of 1,204 residents aged 65 or over was conducted in an urban and a rural area within Kwangju, South Korea in 2001. Depression was diagnosed using the Geriatric Mental State Schedule, and data on potential confounding factors were collected through a structured questionnaire.
Results: Prevalence rates of depression in the urban and rural samples were 21% and 9% (odds ratio 2.83, 95% CI 2.01-3.97). Urban residence was also associated with adverse socio-economic conditions, reduced social network, and more severe disablement. The association between sample area and depression became weaker after adjusting for demographic and socio-economics factors, social network, disablement, and cognitive function (MMSE) but remained significant (odds ratio 1.83, 95% CI 1.13-2.96). Depression was not associated with duration of urban residence.
Conclusion: An urban environment may implicated in either the onset or maintenance of depression in late-life. This was partially, but not fully explained by adverse social and physical environments measured at an individual level. Earlier urban/rural environment did not appear to modify late-life associations with depression.
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