title: Urban environment, physical inactivity and unhealthy dietary habits correlate to depression among elderly living in eastern Mediterranean islands: the MEDIS (MEDiterranean ISlands Elderly) study.
abstract: OBJECTIVE
  To evaluate factors associated with depression in elderly.
  
  
  METHODS
  During 2005-2007, 553 men and 637 women (aged 65 to 100 yrs) living in various Greek islands and in Cyprus participated in the study. The sampling was random and multistage (according to age sex distribution of the referent population). Depressive symptoms were evaluated using the Geriatric Depression Scale (GDS).
  
  
  RESULTS
  Twenty five per cent of men and 35% of women were classified in the highest GDS category (i.e. GDS score > 10), indicating intense depressive symptoms, while 54% of men and 70% of women scored above the depression cut-off (i.e. GDS score > 5) indicating mild-to-severe depressive symptoms. Among the investigated characteristics, living in urban environment, physical inactivity and history of hypertension were correlated with the presence of depressive symptoms (p < 0.05), after adjusting for various confounders. Moreover, the consumption of fish, vegetables and cereals is more prevalent among people with low or moderate depression (p < 0.05).
  
  
  CONCLUSIONS
  The prevalence of depression is quite high between elderly people living in Greek islands and Cyprus. Urban environment that may also interact with sedentarism and unhealthy dietary habits seems to promote depression in the studied population. Efforts to lower the prevalence of depression in the elderly should target on the aforementioned factors that employ functional impairment, social environment and dietary habits.
authors.affiliation: Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Mamplekou
authors.forename: V
authors.initials: V
authors.lastname: Bountziouka
authors.forename: T
authors.initials: T
authors.lastname: Psaltopoulou
authors.forename: A
authors.initials: A
authors.lastname: Zeimbekis
authors.forename: N
authors.initials: N
authors.lastname: Tsakoundakis
authors.forename: N
authors.initials: N
authors.lastname: Papaerakleous
authors.forename: E
authors.initials: E
authors.lastname: Gotsis
authors.forename: G
authors.initials: G
authors.lastname: Metallinos
authors.forename: G
authors.initials: G
authors.lastname: Pounis
authors.forename: E
authors.initials: E
authors.lastname: Polychronopoulos
authors.forename: C
authors.initials: C
authors.lastname: Lionis
authors.forename: D
authors.initials: D
authors.lastname: Panagiotakos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D038441:Diet, Mediterranean; D004777:Environment; D005247:Feeding Behavior; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008521:Mediterranean Islands / Q000453:epidemiology; D015995:Prevalence; D011594:Psychometrics; D012307:Risk Factors; D057185:Sedentary Behavior; D014505:Urban Population / Q000706:statistics & numerical data*