title: Geographic Elevation, Car Driving, and Depression among Elderly Residents in Rural Areas: The Shimane CoHRE Study.
abstract: Given that public transportation networks are often worse in rural areas than in urban areas, it is difficult for elderly non-drivers to access health-promoting goods, services, and resources related to mental health. Moreover, geographical location, assessed by elevation, could modify this association in a rural area. The aim of this study was to test whether the association between car driving (being a driver or not) and depression, as measured by the Zung Self-Rating Depression Scale (SDS), varied by elevation. Data were collected from a cross-sectional study conducted in the town of Ohnan located in a rural area of Japan. After excluding participants with missing data (n = 26), 876 participants were analysed in this study. After adjustment for potential confounders, being a non-driver had a significantly higher odds ratio of SDS (40+) among elderly people living at a low elevation (odds ratio = 2.17, 95% confidence interval = 1.28-3.71). However, similar findings were not observed among elderly people living at a high elevation. These results suggest that car driving importantly predicts depression in elderly people living at relatively low elevations in rural areas.
authors.affiliation: Institute of General Education, Kyoto Sangyo University, Motoyama, Kamigamo, Kita-ku, Kyoto 603-8555, Japan. thamano@cc.kyoto-su.ac.jp.|Department of Functional Pathology, School of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan. thamano@cc.kyoto-su.ac.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamano
authors.affiliation: Center for Community-Based Health Research and Education (CoHRE), Organization for the Promotion of Project Research, Shimane University, 223-8 Enya-cho, Izumo, Shimane 693-8501, Japan. cohre1@med.shimane-u.ac.jp.
authors.forename: Miwako
authors.initials: M
authors.lastname: Takeda
authors.affiliation: Center for Primary Health Care Research, Lund University, Clinical Research Centre (CRC), Building 28, floor 11, Jan Waldenstr&#246;ms Gata 35, Sk&#229;ne University Hospital, Malm&#246; SE-205 02, Sweden. kristina.sundquist@med.lu.se.|Stanford Prevention Research Center, Stanford University, Medical School Office Building (MSOB), 251 Campus Drive MC 5411, Stanford, CA 94305, USA. kristina.sundquist@med.lu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Department of Functional Pathology, School of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan. nabika@med.shimane-u.ac.jp.|Center for Community-Based Health Research and Education (CoHRE), Organization for the Promotion of Project Research, Shimane University, 223-8 Enya-cho, Izumo, Shimane 693-8501, Japan. nabika@med.shimane-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nabika
mesh_terms: D000368:Aged; D000531:Altitude; D001334:Automobile Driving; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012424:Rural Population
keywords: depression; elderly people; elevation; rural area