Aging, health, and depressive symptoms: are women and men different?

This study investigated whether age and self-reported health status comparisons affected reports of depressive symptoms differently for older women and men.

Cross-sectional survey design conducted in a large health maintenance organization (HMO) that provides comprehensive, prepaid benefits to its members. Study subjects were enrollees who were 65 years of age or older. The dependent measure was their reports of depressive symptoms as measured using the Center for Epidemiologic Studies-Depression Scale (CES-D). The explanatory variables were patients' gender, age, self-reported health status comparisons, living status, and physical impairments.

The difference in the proportion of females reporting high depressive symptoms (CES-D>or=16) was 3.8% between the 75-84 year age group and the youngest female group (26.9% vs. 23.1%, respectively). The difference for males was 13.7% (26.5% vs. 12.8%, respectively) (OR(5) = 0.44, 95% CI(5) = 0.27, 0.73). Similar findings occurred among females and males who self-reported that they were in poor health (OR(5) = 0.20, 95% CI(5) = 0.06, 0.72). Aging and self-reported comparisons affected females and males similarly when high depressive symptoms were examined using a higher cut point (CES-D>or=21), although females were more than 50% more likely to report symptoms than males.

As females aged and self-reported health status comparisons declined, their depressive symptoms increased steadily, but at a lower rate than males' depressive symptoms. Older persons in fair or poor self-reported health should especially be screened for increasing depressive symptoms. Although females generally report greater risk of high depressive symptoms, it is still a concern for males as they age and their health declines.