Depression among older adults in the United States and England.
BACKGROUND
Depression negatively affects health and well being among older adults, but there have been no nationally representative comparisons of depression prevalence among older adults in England and the United States.


OBJECTIVE
The authors sought to compare depressive symptoms among older adults in these countries and identify sociodemographic and clinical correlates of depression in these countries.


METHODS
The authors assessed depressive symptoms in non-Hispanic whites aged 65 years and older in 2002 in two nationally representative, population-based studies: the U.S. Health and Retirement Study and English Longitudinal Study of Ageing.


METHODS
A total of 8,295 Health and Retirement Study respondents and 5,208 English Longitudinal Study of Ageing respondents.


METHODS
The authors measured depressive symptoms using the eight-item Center for Epidemiologic Studies Depression Scale. The authors determined whether depressive symptom differences between the United States and England were associated with sociodemographic characteristics, chronic health conditions, and health behaviors.


RESULTS
Significant depressive symptoms (Center for Epidemiologic Studies Depression Scale score ≥4) were more prevalent in English than U.S. adults (17.6% versus 14.6%, adjusted Wald test F([1, 1593]) = 11.4, p < 0.001). Adjusted rates of depressive symptoms in England were 19% higher compared with the United States (odds ratio: 1.19, 95% confidence interval: 1.01-1.40). U.S. adults had higher levels of education, and net worth, but lower levels of activities of daily living/instrumental activities of daily living impairments, tobacco use, and cognitive impairment, which may have contributed to relatively lower levels of depressive symptoms in the United States.


CONCLUSIONS
Older adults in the United States had lower rates of depressive symptoms than their English counterparts despite having more chronic health conditions. Future cross-national studies should identify how depression treatment influences outcomes in these populations.
Zivin
Kara
K
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, 48109, USA. kzivin@umich.edu
Llewellyn
David J
DJ
Lang
Iain A
IA
Vijan
Sandeep
S
Kabeto
Mohammed U
MU
Miller
Erin M
EM
Langa
Kenneth M
KM
D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology
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