title: Predictors of and health services utilization related to depressive symptoms among elderly Koreans.
abstract: While the prevalence, comorbidity, risk profile and health care utilization for late-life depression have been described for many Western countries, much less is known about the recent epidemiology of late-life depression in East Asian countries such as Korea. We investigated predictors for depressive symptoms and the association between depressive symptoms and the utilization of both medical care and preventive services in elderly Koreans. Data were obtained from a nationally representative sample of Koreans aged 60 and above (2226 men, 2911 women) who participated in the 2008 wave of the Korean Longitudinal Study of Ageing. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression scale. Risk factors considered included sociodemographics, health behaviors, chronic diseases, and physical function. Health care utilization factors included hospitalization, outpatient clinic use and basic medical checkup. Being female, being unmarried, and having less education, lower household income, physical inactivity and lower weight were associated with depressive symptoms. Presence of chronic diseases and limited physical function also showed a significant association with depressive symptoms. Depressive symptoms were associated with increased odds of hospitalization and outpatient visits, but decreased the odds of utilization of basic medical checkup after controlling for potential confounders. Findings on most risk factors, except lower weight, were consistent with reports from Western countries. It is important to recognize the burden of depressive symptoms in the elderly. The interaction of such symptoms with chronic diseases should be acknowledged and considered in the clinical setting as well as in health care planning and policymaking.
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Shin
authors.forename: Young Kyung
authors.initials: YK
authors.lastname: Do
authors.forename: Joanna
authors.initials: J
authors.lastname: Maselko
authors.forename: Rebecca J N
authors.initials: RJ
authors.lastname: Brouwer
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Song
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D016001:Confidence Intervals; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D005852:Geriatric Psychiatry / Q000379:methods* / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007723:Korea / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011594:Psychometrics; D012044:Regression Analysis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology