Psychological Distress and Related Variables in Older Adults from Northeast Brazil

Population aging is reshaping public health priorities across Latin America, yet most evidence on late-life psychological distress comes from high-income societies. Brazil's Northeast combines rapid aging with persistent structural deprivation. The aim of this study was to estimate the prevalence of psychological distress among older adults in this region and to examine its association with food insecurity, sociodemographic position, and health-related behaviors. A convenience sample of 355 adults aged 60 to 94 years was recruited in Paraíba, Piauí, and Bahia. Participants completed a sociodemographic and health questionnaire, the short-form Brazilian Food Insecurity Scale, and the Kessler Psychological Distress Scale (K10). Distress exceeded the validated screening cutoff in 64.5% of the sample, and 40.8% reported food insecurity. Older adults with food insecurity scored higher on the K10 than their food-secure peers (p = 0.001, d = -0.847), an association that persisted under multivariable adjustment. Lower income, lower schooling, and medication use were also associated with greater distress, and physical activity and life satisfaction with less. Because the design was cross-sectional and the sample non-probabilistic, these associations describe co-occurrence rather than chronicity or causal direction. Even so, the findings support addressing food security alongside mental health care in this population.