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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2000 Jul 1;91(4):313–317. doi: 10.1007/BF03404296

Correlates of Dysphoria in Canadian Seniors: The Canadian Study of Health and Aging

Truls Østbye 118,218,✉, Runa Steenhuis 318, Ruth Walton 118, John Cairney 418
PMCID: PMC6979637  PMID: 10986793

Abstract

Objective: To examine the correlates of dys-phoria in elderly Canadians.

Method: Randomly sampled elderly underwent screening in 1992 (CSHA-1) and in 1997 (CSHA-2). Community-living subjects without dementia at CSHA-1 were re-interviewed at CSHA-2 (n = 5234). A score <53 on the mental health component of the Medical Outcomes Study Questionnaire (SF-36) was used to measure dysphoria. Sociodemographic, functional, social support, disease and lifestyle correlates of dysphoria were examined.

Results: 4.76% of men, and 8.59% of women were classified as dysphoric. The occurrence declined with age. In multivariate analyses, chronic pain, poor self-rated health, functional dependency and, in men only, being married, were significantly related to dysphoria. Perceived social support remained significant after controlling for sociodemographic, functional and disease variables.

Conclusion: Dysphoria is common among the elderly, especially elderly women. Given the interrelationships and number of correlates of dysphoria, elderly Canadians require broad programs promoting health and social support as well as functional and economic independence.

References

  • 1.Slater SL, Katz IR. Prevalence of depression in the aged: Formal calculations versus clinical facts. J Am Geriatr Soc. 1995;43(1):78–79. doi: 10.1111/j.1532-5415.1995.tb06248.x. [DOI] [PubMed] [Google Scholar]
  • 2.Turner RJ, Wheaton B, Lloyd D. The epidemiology of social stress. American Sociological Review. 1995;60:126–40. doi: 10.2307/2096348. [DOI] [Google Scholar]
  • 3.Offord DR, Boyle MH, Campbell D, et al. One year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry. 1996;41:554–63. doi: 10.1177/070674379604100904. [DOI] [PubMed] [Google Scholar]
  • 4.Bland RC, Newman SC, Orn H. Epidemiology of mental disorders in Edmonton. Acta Psychiatr Scand. 1988;77(Suppl338):72–80. doi: 10.1111/j.1600-0447.1988.tb08550.x. [DOI] [PubMed] [Google Scholar]
  • 5.Robins L, Regier D, editors. Psychiatric Disorders in America. New York: Free Press; 1991. [Google Scholar]
  • 6.Wade TJ, Cairney J. Age and depression in a nationally representative sample of Canadians: A preliminary look at the National Population Health Survey. Can J Public Health. 1997;88:297–302. doi: 10.1007/BF03403892. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Kennedy GJ, Kelman HR, Thomas C, et al. Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry. 1989;146(2):220–25. doi: 10.1176/ajp.146.2.220. [DOI] [PubMed] [Google Scholar]
  • 8.Newmann JP. Aging and depression. Psychology and Aging. 1989;4:150–65. doi: 10.1037/0882-7974.4.2.150. [DOI] [PubMed] [Google Scholar]
  • 9.Kessler RC, Foster C, Webster PS, House JS. The relationship between age and depressive symptoms in two national surveys. Psychology and Aging. 1992;7:119–26. doi: 10.1037/0882-7974.7.1.119. [DOI] [PubMed] [Google Scholar]
  • 10.Mirowsky J, Ross C. Age and depression. J Health Soc Behav. 1992;33:187–205. doi: 10.2307/2137349. [DOI] [PubMed] [Google Scholar]
  • 11.Hocking LB, Koenig HG, Blazer DG. Epidemiology and geriatric psychiatry. In: Tsuang MT, Tohen M, Zahner GEP, editors. Textbook in Psychiatric Epidemiology. New York: Wiley-Liss; 1995. pp. 437–52. [Google Scholar]
  • 12.Unutzer J, Patrick DL, Simon G, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA. 1997;277(20):1618–23. doi: 10.1001/jama.1997.03540440052032. [DOI] [PubMed] [Google Scholar]
  • 13.Weissman M, Leaf PJ, Blazer DG, et al. Affective disorders in five United States communities. Psych Med. 1988;18:141–53. doi: 10.1017/S0033291700001975. [DOI] [PubMed] [Google Scholar]
  • 14.Stallones L, Marx MB, Garrity TF. Prevalence and correlates of depressive symptoms among older U.S. adults. Am J Prev Med. 1990;6:295–303. doi: 10.1016/S0749-3797(18)30998-X. [DOI] [PubMed] [Google Scholar]
  • 15.Schleifer SJ, Macari-Hinson MM, Coyle DA, et al. The nature and course of depression following myocardial infarction. Arch Intern Med. 1989;149:1785–89. doi: 10.1001/archinte.1989.00390080059014. [DOI] [PubMed] [Google Scholar]
  • 16.Borson S, Barnes RA, Kukull WA, et al. Symptomatic depression in elderly medical outpatients. J Am Geriatr Soc. 1986;34:341–47. doi: 10.1111/j.1532-5415.1986.tb04316.x. [DOI] [PubMed] [Google Scholar]
  • 17.Feldman E, Mayo R, Hawton K, et al. Psychiatric disorder in medical in patients. Q J Med. 1987;63:405–12. [PubMed] [Google Scholar]
  • 18.Koenig HG, Meador KG, Shelp F, et al. Depressive disorders in hospitalized medically ill patients: A comparison of young and elderly veterans. J Am Geriatr Soc. 1991;39:881–90. doi: 10.1111/j.1532-5415.1991.tb04455.x. [DOI] [PubMed] [Google Scholar]
  • 19.Kukull WA, Koespell TD, Inui TS, et al. Depression and physical illness among elderly general medical clinic patients. J Affect Disord. 1986;10:153–62. doi: 10.1016/0165-0327(86)90037-6. [DOI] [PubMed] [Google Scholar]
  • 20.Bridges KW, Goldberg DP. Psychiatric illness in inpatients with neurological disorders. BMJ. 1984;289:656–58. doi: 10.1136/bmj.289.6446.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.DePaulo JR, Folstein MF, Gordon B. Psychiatric screening on a neurological ward. Psychol Med. 1980;10:125–32. doi: 10.1017/S0033291700039659. [DOI] [PubMed] [Google Scholar]
  • 22.Magni G, Diego DL, Schifano F. Depression in geriatric and adult medical inpatients. J Clin Psychol. 1985;41:337–44. doi: 10.1002/1097-4679(198505)41:3<337::AID-JCLP2270410306>3.0.CO;2-7. [DOI] [PubMed] [Google Scholar]
  • 23.Levkoff SE, Cleary PD, Wetle T. Differences in determinants of physician use between aged and middle-aged persons. Med Care. 1987;25(12):1148–60. doi: 10.1097/00005650-198712000-00004. [DOI] [PubMed] [Google Scholar]
  • 24.Murrell SA, Himmelfarb S, Wright K. Prevalence of depression and its correlates in older adults. Am J Epidemiol. 1983;117:173–85. doi: 10.1093/oxfordjournals.aje.a113528. [DOI] [PubMed] [Google Scholar]
  • 25.Blazer DG, Hughes DC, George LK. The epidemiology of depression in an elderly community population. The Gerontologist. 1987;27:281–87. doi: 10.1093/geront/27.3.281. [DOI] [PubMed] [Google Scholar]
  • 26.Van Goldberg EL, Natta P, Comstock GW. Depressive symptoms, social networks and social support of elderly women. Am J Epidemiol. 1985;121:448–56. doi: 10.1093/oxfordjournals.aje.a114017. [DOI] [PubMed] [Google Scholar]
  • 27.Reker GT. Personal meaning, optimism and choice: Existential predictors of depression in community and institutional elderly. The Gerontologist. 1997;37:709–16. doi: 10.1093/geront/37.6.709. [DOI] [PubMed] [Google Scholar]
  • 28.Oxman TE, Berkman LF, Kasi S, et al. Social support and depressive symptoms in the elderly. Am J Epidemiol. 1992;135(4):356–68. doi: 10.1093/oxfordjournals.aje.a116297. [DOI] [PubMed] [Google Scholar]
  • 29.Grant I, Patterson TL, Yager J. Social support in relation to physical health and symptoms of depression in the elderly. Am J Psychiatry. 1988;145:1254–58. doi: 10.1176/ajp.145.10.1254. [DOI] [PubMed] [Google Scholar]
  • 30.Clayton PJ. Bereavement and depression. J Clin Psychiatry. 1990;51(Suppl):34–38. [PubMed] [Google Scholar]
  • 31.Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-IIIR psychiatric disorders in the United States. Results from the National Co-morbidity Study. Arch Gen Psychiatry. 1994;51:8–19. doi: 10.1001/archpsyc.1994.03950010008002. [DOI] [PubMed] [Google Scholar]
  • 32.The Canadian Study of HealthAging Working Group. The Canadian Study of Health and Aging: Study methods and prevalence of dementia. CMAJ. 1994;150:899–913. [PMC free article] [PubMed] [Google Scholar]
  • 33.The Canadian Study of HealthAging Working Group. Risk factors for Alzheimer’s disease in Canada. Neurology. 1994;44:2073–80. doi: 10.1212/WNL.44.11.2073. [DOI] [PubMed] [Google Scholar]
  • 34.Østbye T, Crosse E. The net economic costs of dementia in Canada. CMAJ. 1994;151:1457–64. [PMC free article] [PubMed] [Google Scholar]
  • 35.The Canadian Study of HealthAging Working Group. Patterns of caring for persons with dementia in Canada: The Canadian Study of Health and Aging. Can J Aging. 1994;13:470–87. doi: 10.1017/S0714980800006334. [DOI] [Google Scholar]
  • 36.Ware JE, Jr, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. Boston, Massachusetts: The Health Institute; 1993. [Google Scholar]
  • 37.McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires. New York: Oxford University Press; 1996. [Google Scholar]
  • 38.Teng EL, Chui HC. The Modified Mini-Mental State (3MS) Examination. 1987;48:314–18. [PubMed] [Google Scholar]
  • 39.Fillenbaum GG. Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. [Google Scholar]
  • 40.Berwick DM, Murphy JM, Goldman PA, et al. Performance of a five-item mental health screening test. Med Care. 1991;29:169–76. doi: 10.1097/00005650-199102000-00008. [DOI] [PubMed] [Google Scholar]
  • 41.Lee KI, Koval JJ. Determinants of the best significance level in forward stepwise logistic regression. Communications in Statistics — Simulation and Computation. 1997;26:559–75. doi: 10.1080/03610919708813397. [DOI] [Google Scholar]
  • 42.Mickey RM, Greenland S. The impact of con-founder selection strategies. Am J Epidemiol. 1989;129:125–37. doi: 10.1093/oxfordjournals.aje.a115101. [DOI] [PubMed] [Google Scholar]
  • 43.Mirowsky J. Age and the gender gap in depression. J Health Soc Behav. 1996;37:362–80. doi: 10.2307/2137263. [DOI] [PubMed] [Google Scholar]
  • 44.Jorm AF. Sex and age differences in depression: A quantitative synthesis of published research. Aust N Z J Psychiatry. 1987;21:46–53. doi: 10.3109/00048678709160898. [DOI] [PubMed] [Google Scholar]
  • 45.Bebbington PE, Dunn G, Jenkins GL, et al. The influence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity. Psychological Medicine. 1998;28:9–19. doi: 10.1017/S0033291797006077. [DOI] [PubMed] [Google Scholar]
  • 46.Salokangas RK, Poutanen O. Risk factors for depression in primary care. Findings of the TADEP project. J Affect Disord. 1998;48:171–80. doi: 10.1016/S0165-0327(97)00171-7. [DOI] [PubMed] [Google Scholar]
  • 47.Lu C-H, Liu C-Y, Yu S. Depressive disorders among the Chinese elderly in a suburban community. Public Health Nursing. 1998;15:196–200. doi: 10.1111/j.1525-1446.1998.tb00339.x. [DOI] [PubMed] [Google Scholar]
  • 48.Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14:237–47. doi: 10.1016/0163-8343(92)90094-Q. [DOI] [PubMed] [Google Scholar]
  • 49.Durkheim E. Suicide: A Study in Sociology. New York: The Free Press; 1951. [Google Scholar]
  • 50.Ross CE, Mirowsky J, Goldsteen K. The impact of the family on health: The decade in review. J Marriage and the Family. 1990;52:1059–78. doi: 10.2307/353319. [DOI] [Google Scholar]
  • 51.Greenberg AM, Goldstein RD. Depressive disorders. In: Tasman A, Kay J, Lieberman JA, editors. Psychiatry. Philadelphia: WB Saunders; 1997. pp. 990–1019. [Google Scholar]
  • 52.Raskind MA. The clinical interface of depression and dementia. J Clin Psychiatry. 1998;59(Suppl10):9–12. [PubMed] [Google Scholar]
  • 53.Grove WM, Andreasen NC. Concepts, diagnosis and classification. In: Paykel ES, editor. Handbook of Affective Disorders. New York: The Guildford Press; 1997. pp. 25–41. [Google Scholar]

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