Collective efficacy and depressive symptoms in Brazilian elderly

The objective was to investigate the association between depressive symptoms and collective efficacy among the elderly in a municipality in southern Brazil. A cross-sectional population-based design was carried out. Structured interviews were held at the homes of 1007 elderly individuals. The presence of depressive symptoms was measured using the Geriatric Depression Scale, exposures were a standard 8-item collective efficacy scale and a single item about elderly participation in groups. Data were analyzed using Poisson regression to obtain the crude and adjusted prevalence ratios (PRs). The sample consisted mostly of female (63%), white (96%) and married (64%) elderly individuals. The mean age, income and educational level were, respectively: 73 years (SD=4), R$ 1836 (SD=2170) and 5 years of education (SD=4). After controlling for demographic, socioeconomic, behavioral and health-related variables, participants who reported low collective efficacy at the places where they lived presented a prevalence of depressive symptoms that was twice as high as the prevalence among those who reported high collective efficacy. In the same way, elderly individuals who did not participate in groups presented prevalence of the outcome around 64% higher than among those who took part in one or more groups. The study suggests that creation of and participation in social networks and community groups may be an important strategy for promoting mental health among the elderly.