title: Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec.
abstract: OBJECTIVE
  To compare the prevalence of depression within the elderly Quebec population residing in rural areas, urban areas and metropolitan Montreal, and to assess differences in the associations between social relationships and depression across these urban and rural settings.
  
  
  METHODS
  Data originate from the first wave of the ESA (Etude de Santé des Ainés) longitudinal study on mental health of community dwelling older persons aged over 65 (n = 2670). Depression, including major and minor depression, measured using a computer questionnaire; the ESA-Q developed by the research team and based on the DSM-IV criteria. Assessments of associations between depression and geographic area, informal social networks and community participation were estimated adjusting for demographic, socioeconomic and health characteristics.
  
  
  RESULTS
  The prevalence of depression was higher in rural (17%) and urban areas (15.1%) than in metropolitan Montreal (10.3%). The odds ratio of rural (OR = 2.01 95% CI 1.59-2.68) and urban (OR = 1.75; 95% CI 1.25-2.45) areas compared to the metropolitan area increased slightly after adjustment by all social and health covariates. Our study indicated that social support and the lack of conflict in intimate relationships were associated with lower prevalence of depression in all areas.
  
  
  CONCLUSIONS
  Geographic differences in depression exist within the elderly population in Quebec that may generate significant impact on their health and functional abilities. Further research should be conducted to explain these differences.
authors.affiliation: Faculty of Medicine, Départment of Social and Préventive Medicine, Université de Montréal (Québec), C.P. 6128, Succursale centre-ville, Montréal (Québec) H3C 3J7, Canada. samiatahiri@yahoo.fr
authors.forename: Samia
authors.initials: S
authors.lastname: Mechakra-Tahiri
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.forename: Michel
authors.initials: M
authors.lastname: Préville
authors.forename: Micheline
authors.initials: M
authors.lastname: Dubé