title: Depressive symptoms among older adults in urban and rural areas.
abstract: OBJECTIVE
  To determine if there are differences in depressive symptoms between residents of urban areas, small town zones, and predominantly rural regions and to determine factors associated with depressive symptoms among these groups of residents.
  
  
  METHODS
  The study was set in the Canadian province of Manitoba amongst a community-dwelling population of older adults who were cognitively intact. The design of the study was a cross-sectional survey and measures included age, gender, education, living arrangements, number of persons providing companionship, perceived adequacy of income, functional impairment, self-rated health and the Center for Epidemiologic Studies-Depression (CES-D) scale. Urban/rural residence was measured by grouping Census sub-divisions according to 1991 Census population: urban (>19,999); small town (2500 to 19,999); or predominantly rural (<2500).
  
  
  RESULTS
  In the total sample (n = 1382), 11.5% exhibited depressive symptoms: 11.6% in urban areas (n = 844); 14.0% in small town zones (n = 250); 9.0% in predominantly rural regions (n = 288) (p > 0.05, chi-square test). No rural-urban differences were seen in multivariate models. In predominantly rural regions, living alone, perceiving one's income as inadequate, and having functional impairment were associated with depressive symptoms. The only significant factor in small town zones was poorer self-rated health whereas in urban areas, poorer self-rated health, functional impairment, and fewer persons providing companionship were significantly related to depressive symptoms.
  
  
  CONCLUSIONS
  We did not observe rural-urban differences. However, the factors associated with depressive symptoms varied among older adults living in predominantly rural regions, in small towns, and in urban areas.
authors.affiliation: Section of Geriatrics, Department of Medicine, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada. pstjohn@hsc.mb.ca
authors.forename: Philip D
authors.initials: PD
authors.lastname: St John
authors.forename: Audrey A
authors.initials: AA
authors.lastname: Blandford
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Strain
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data*