Context: Depression among older adults (≥age 60) is a problem that could be exacerbated by global trends in urbanization and population aging. The study purpose was to assess whether urban, relative to rural, residence is associated with depression among older adults and whether associations differ in countries with developed versus developing economies.Context: Depression among older adults (aged 60 years or older) is a problem that could be exacerbated by global trends in urbanization and population aging. The study purpose was to assess whether urban, relative to rural, residence is associated with depression among older adults and whether associations differ in countries with developed versus developing economies.
Evidence acquisition:In 2017, the authors identified and extracted information from comparative studies of urban-rural depression prevalence among older adults. Studies were identified in PubMed, PsychINFO, and Web of Science and limited to English language articles published after 1985. Eighteen studies met inclusion criteria. Random effects meta-analysis was conducted to produce weighted pooled ORs estimating the association between urban-rural residence and depression for all study participants (N=31,598) and sub-analyses were conducted for developed (n=12,728) and developing (n=18,870) countries.Evidence synthesis: Depression prevalence was significantly higher among urban residents in ten studies and significantly higher among rural residents in three studies (all three conducted in China). Associations between urban-rural residence and depression generally remained significant after adjusting for covariates. In developed countries, the odds of depression were significantly higher among urban than rural residents (pooled OR=1.44, 95% CI=1.10, 1.88).However, in developing countries, this association was not observed (pooled OR=0.91, 95% CI=0.46, 1.77).
Conclusions:Converging trends of urbanization and population aging could increase the global burden of depression among older adults. The pathways through which urban-rural residence influences depression risk among older adults might differ by country context. Future research should focus on measuring variation in these contexts.
3CONTEXT Human longevity is increasing, and the demographic composition of societies is aging. Between 2015 and 2050, global life expectancy at birth is projected to increase from 70 to 77 years. 1 By 2050, the proportion of the world's population aged more than 60 years is projected to double and the proportion aged more than 80 years is projected to triple. 2,3 In Europe, the proportion of the population aged more than 60 years is expected to increase from 24% to 34% between 2015 and 2050. Increasing trends are also expected in Latin America (from 11% to 26%), North America (from 21% to 28%), and Asia (from 12% to 25%). 3 These increases in longevity pose challenges for policymakers as they are forced to address the implications of population aging within the context of other societal changes. As Beard and Bloom descr...