title: Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore.
abstract: OBJECTIVE
  Neighborhood socioeconomic status (SES) can be associated with depression. We aimed to assess prevalence of depression amongst community-dwelling elderly in a multiethnic, urban, low-SES, Asian neighborhood, comparing against a higher SES neighborhood.
  
  
  METHODS
  The study population involved all residents aged ≥60 years in two Singaporean housing estates comprising owner-occupied public housing (higher SES) and public rental housing (low SES) in 2012. Having lifetime prevalence of depression was defined as having a score ≥5 on the Geriatric Depression Scale-15 or a history of depression. Demographic/clinical details were collected via questionnaire. Those with depression were referred to local polyclinics. Multilevel multivariate logistic regression determined predictors of depression and depression screening.
  
  
  RESULTS
  Participation was 61.5% (559/909). In the low-SES community, 26.2% (104/397) had depression, compared with 14.8% (24/162) in the higher SES community. After adjusting for other sociodemographic variables, staying in a low-SES community (public rental housing) was independently a ssociated with depression [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) = 1.02-2.84]. Within the low-SES community, not being married (aOR = 2.27, CI = 1.35-3.70), falls (aOR = 2.72, CI = 1.59-4.67), visual impairment (aOR = 2.37, CI = 1.28-4.39), and poorer social network (aOR = 3.70, CI = 1.96-7.14) were associated with depression.
  
  
  CONCLUSIONS
  Residing in a low-SES community was independently associated with depression after controlling for individual SES.
authors.affiliation: a Yong Loo Lin School of Medicine , National University of Singapore, National University Health System , Singapore.
authors.forename: Liang En
authors.initials: LE
authors.lastname: Wee
authors.forename: Yan Zhen
authors.initials: YZ
authors.lastname: Yong
authors.forename: Michelle Wan Xing
authors.initials: MW
authors.lastname: Chng
authors.forename: Shi Hao
authors.initials: SH
authors.lastname: Chew
authors.forename: Lenard
authors.initials: L
authors.lastname: Cheng
authors.forename: Qi Han Aaron
authors.initials: QH
authors.lastname: Chua
authors.forename: Jacklyn Jia Lin
authors.initials: JJ
authors.lastname: Yek
authors.forename: Linus Jian Fa
authors.initials: LJ
authors.lastname: Lau
authors.forename: Pravin
authors.initials: P
authors.lastname: Anand
authors.forename: Joshua Tian Ming
authors.initials: JT
authors.lastname: Hoe
authors.forename: Han Ming
authors.initials: HM
authors.lastname: Shen
authors.forename: Gerald Choon-Huat
authors.initials: GC
authors.lastname: Koh
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D012944:Social Support; D012959:Socioeconomic Factors
keywords: Asia; depression; neighborhood; socioeconomic status