Highlights
- •What is the primary question addressed by this study? What are the associations between geographic region and late-life depression (LLD) severity, item-level symptom burden, and treatment, and how do associations between race/ethnicity and LLD outcomes, previously observed in the overall sample, vary by geographic region?
- •What is the main finding of this study? We observed significant regional differences in LLD severity and item-level symptom burden, but not in treatment. Lower levels of LLD severity and item-level symptom burden were observed in the Midwest compared to the Northeast. Magnitudes of racial/ethnic disparities in LLD severity and item-level symptom burden, but not depression care, differed by region.
- •What is the meaning of the finding? LLD varied by geographic region. Furthermore, geographic region may play an important role in patterns of racial/ethnic disparities in LLD outcomes.
ABSTRACT
Objectives
To determine associations between geographic region and late-life depression (LLD)
severity, item-level symptom burden, and treatment; to evaluate whether racial/ethnic
disparities in LLD, previously observed in the overall sample, vary by region.
Methods
We included 25,502 VITAL (Vitamin D and Omega-3 Trial) participants and administered
the Patient Health Questionnaire-8 for depressive symptoms; participants also reported
medication and/or counseling care for depression. Multivariable regression analyses
were performed.
Results
Despite overall lower LLD severity and item-level symptom burden in the Midwest versus
Northeast, higher LLD severity and item-level burden were observed among minorities,
especially Black and Hispanic adults, compared to non-Hispanic whites in this region.
Racial/ethnic disparities in item-level symptoms (e.g., anhedonia, sadness, psychomotor
changes) varied by region. There were no significant differences in depression care
by region; furthermore, regional variation was not observed in racial disparities
in care: e.g., among those with clinician/physician-diagnosed depression, Blacks versus
non-Hispanic whites had greater than 50% lower odds of treatment in all regions.
Conclusion
LLD varied by geographic region. Furthermore, magnitudes of racial/ethnic disparities
in LLD severity and item-level symptom burden, but not depression care, differed by
region.
Key Words
List of abbreviations:
LLD (Late-life depression), US (United States), PA (Physical activity), PHQ (Patient health questionnaire), ZINB (Zero inflated negative binomial), FDR (False discovery rate), VITAL (VITamin D and OmegA-3 TriaL), VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 26, 2021
Accepted:
November 17,
2021
Received in revised form:
November 17,
2021
Received:
March 29,
2021
Footnotes
Previous presentation: The Gerontological Society of America 2020 Annual Scientific Meeting, Virtual Conference, November 4-7, 2020.
Identification
Copyright
© 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
