Aging, Economic Hardship, and Depression Among Ethnic Groups in Bangladesh: A Cross-Sectional Study

Depression is a major public health issue, particularly among elderly populations, and is influenced by sociodemographic, health, and lifestyle factors. Ethnic variations in depression remain underexplored in Bangladesh. This study aimed to determine the prevalence of depression among elderly individuals from different ethnic groups and to identify associated risk factors.

This cross-sectional study was conducted among 632 respondents aged 55 years and above in Rangamati, Sylhet, and Mymensingh, Bangladesh. Depression symptoms were assessed using the validated Patient Health Questionnaire (PHQ-9). Respondents were categorized as "not depressed" (score 0-9) and "depressed" (score ≥ 10). Data were collected using a structured questionnaire on sociodemographic, economic, and lifestyle factors. Descriptive statistics and logistic regression were used to estimate odds ratios (OR) with 95% confidence intervals (CI) at a significance level of p < 0.05. Analyses were performed in Stata 14.2.

The prevalence of depression was 26.6% (168/632). The mean age of participants was 59.73 years (SD = 8.08). Older participants had higher odds of depression: aged 60-70 years (OR = 1.25, 95% CI: 1.01-1.56, p < 0.05) and aged ≥ 71 years (OR = 2.85, 95% CI: 2.15-3.79, p < 0.001) compared to those aged < 60 years. Ethnic differences observable Chakma (43.45%, 73/632), Manipuri (41.67%, 70/632), and Garo (14.88%, 25/632) showed significant variation (p < 0.001). Longstanding health problems increased depression risk (OR = 6.47, 95% CI: 4.12-9.82, p < 0.001). Hypertension, frequent doctor visits, and poor wealth were also associated with depression. Dietary factors, such as sugar, alcohol, and red meat, showed exploratory associations.

Depression is prevalent among elderly populations in Bangladesh, with significant variation across ethnic groups. Age, chronic illness, and socioeconomic disadvantage were key predictors. Findings highlight the need for culturally sensitive mental health interventions and targeted support for elderly minorities and those with chronic conditions.