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Characteristics and factors associated with depression in the elderly in Spain from a gender perspective.

INTRODUCTION
Depression is a main cause of disability and it is a priority public health problem among the elderly because of its significant consequences regarding morbidity and mortality, especially in women.


METHODS
We selected records of people aged 65 and over out of the 2014 European Health Survey in Spain (n=6,520). We then performed a descriptive analysis stratified by gender of relevant variables such as demographic, socioeconomic, health status, health care and health determinants. We studied its connection with the presence of depressive disorders diagnosed by the PHQ-8 questionnaire. In a second phase we adjusted logistic regression models in order to assess depressive disorders based on the significant variables.


RESULTS
12.6% of depressive disorders are detected (16.8% women; 7.1% men). Many of the variables are related to depressive disorders in bivariate analysis; however, only a regular or bad/very bad perceived state of health (ORm=6.7; ORw=3.8); bedrest; the difficulty or inability to walk; and severe (ORm=3.5, ORw=2) and extreme pain (ORm=5; ORw=3.9) remain after multivariate adjustment in both sexes. Differentially depression in women is connected with not being able to read or write, the presence of chronic disease, and lack of interest from others; and in men a moderate degree of pain.


CONCLUSIONS
The greater frequency and vulnerability of depression in elderly women may be connected to their educational level, their suffering from chronic diseases and social support. Longitudinal studies need to be undertaken to confirm the role and influence of these factors.