title: Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS).
abstract: OBJECTIVE
  To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression.
  
  
  METHODS
  International cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions.
  
  
  RESULTS
  Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16) were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93). In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated.
  
  
  CONCLUSIONS
  Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
authors.forename: Afshin
authors.initials: A
authors.lastname: Vafaei
authors.affiliation: Département de médecine sociale et préventive, Université de Montréal, Montreal, QC, Canada.
authors.forename: Tamer
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: Federal University of Rio Grande do Norte, Natal, RN, Brazil.
authors.forename: Aline do N Falcão
authors.initials: Ado N
authors.lastname: Freire
authors.affiliation: Département de médecine sociale et préventive, Université de Montréal, Montreal, QC, Canada.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.affiliation: Federal University of Rio Grande do Norte, Natal, RN, Brazil.
authors.forename: Ricardo O
authors.initials: RO
authors.lastname: Guerra
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D057227:Femininity; D005783:Gender Identity; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D057228:Masculinity; D012737:Sex Factors