Gender differences in depressive symptoms among older adults: a cross-national comparison: the CLESA project.
OBJECTIVE
To assess country-specific gender differences in depressive symptoms and to explore if exposures and vulnerabilities vary by gender among older men and women from four European countries and Israel.


METHODS
Data on 4,449 subjects between 75 and 84 years old were derived from CLESA ("Cross-national determinants of quality of life and health services for the elderly". A ratio score of depressive symptoms derived form the CESD and GDS scales was regressed on education, marital status, living arrangements, comorbidity and disability and all interactions of these factors with gender and country.


RESULTS
The prevalence of depressive symptoms is higher in women than in men in every country, except Sweden. Women are more likely to be exposed to socio-structural risks, and have poorer health and more disability than men in most of the countries. However, women are not more vulnerable to these risk factors.


CONCLUSIONS
Findings indicate that the female excess in depressive symptoms remains after taking into account the higher prevalence of socio-structural and health-related risk factors and that older women are not more vulnerable than older men to these known risk factors, suggesting the existence of additional pathways linked to gender and/or biological sex.
Zunzunegui
Maria Victoria
MV
Dépt. de médecine sociale et préventive, Université de Montréal, CP 6128, Succursale Centre Ville, Montréal, QC, H3C 3J7, Canada. maria.victoria.zunzunegui@umontreal.ca
Minicuci
Nadia
N
Blumstein
Tzuia
T
Noale
Marianna
M
Deeg
Dorly
D
Jylhä
Marja
M
Pedersen
Nancy L
NL
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology