title: Impact of illiteracy on depression symptomatology in community-dwelling older adults.
abstract: BACKGROUND
  In many countries, illiteracy rates among aged people are quite high. However, only few studies have specifically investigated the impact of illiteracy on depression.
  
  
  METHODS
  Data for 1,890 elderly individuals (aged ≥65 years) were obtained from a nationwide dementia epidemiological study conducted in South Korea. Based on their reading ability, the participants were divided into three groups: totally illiterate, partially illiterate, and literate. The Korean version of the Geriatric Depression Scale - Short Form (SGDS-K) was used to detect depression (cut-off score = 8). Multivariate logistic regression analyses were used to assess the association between illiteracy and depression. To explore clinical features of depression in illiterate people, we performed logistic regression to calculate odds ratios of positive responses (or negative responses to reverse-coded items) for each SGDS-K item using literate individuals as the reference group.
  
  
  RESULTS
  Totally illiterate participants had 2.41 times the odds and partially illiterate individuals had 1.59 times the odds of being depressed compared with literate participants after controlling for other variables. Compared with literate individuals, illiterate elderly persons were at increased odds for responding negatively to the majority of SGDS-K items, including "having memory problems," "others are better off than me," and "feeling worthless" even after controlling for various demographic and clinical factors.
  
  
  CONCLUSIONS
  Illiteracy in elderly individuals was associated with a higher rate and increased severity of depression. Illiteracy negatively affected depression symptomatology, especially factors associated with self-esteem. Therefore, clinicians should carefully monitor for the presence of depression in illiterate elderly adults.
authors.affiliation: Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea.
authors.forename: Byung-Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Inje University College of Medicine, Seoul, South Korea.
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Inha University College of Medicine, Incheon, South Korea.
authors.forename: Jae Nam
authors.initials: JN
authors.lastname: Bae
authors.affiliation: Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea.
authors.forename: Sung Man
authors.initials: SM
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, Yangsan Mental Hospital, Yangsan, South Korea.
authors.forename: Shinkyum
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.|Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea.
authors.forename: Hyo-Deog
authors.initials: HD
authors.lastname: Rim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Jee Eun
authors.initials: JE
authors.lastname: Park
authors.affiliation: Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.|Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Maeng Je
authors.initials: MJ
authors.lastname: Cho
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors