Explaining the Urban-Rural Difference in Late-Life Depression in India: Evidence from a Multivariate Decomposition Analysis Based on Longitudinal Aging Study in India, Wave 2017-18

ABSTRACT

Objectives

The study explored the associated factors of depression among older Indian adults and the influences of individual and socio-environmental factors in explaining the rural-urban difference in the prevalence of late-life depression.

Methods

Data come from the Longitudinal Aging Study in India, with a sample of 30,637 older adults aged 60 and above. Multivariable logistic regression and nonlinear multivariate decomposition analyses were conducted to fulfill the objectives.

Results

About 6.2% older adults in urban areas and 9.5% in rural areas were depressed. Older adults in rural areas had significantly higher likelihood to be depressed than those in urban areas. Poor self-rated health, multiple chronic conditions, functional difficulty, low life satisfaction, social inactivity, low satisfaction with living arrangement, ill-treatment and being widowed increased the risk of depression. Additionally, work status similar to urban older adults, physical activity, living arrangement satisfaction, self-rated health and ill-treatment would decrease the urban-rural difference in depression.

Conclusions

The study showed significant rural-urban difference in late-life depression, with a rural disadvantage.

Clinical implications

The findings suggest the need for identifying at-risk populations and developing a framework of targeted policy interventions for mitigating the increased risk of late-life depression among older Indians and in rural areas in particular.

KEYWORDS:

• Depression
• India
• older adults
• rural-urban

Abbreviations

AOR	=	Adjusted odds ratio
CI	=	Confidence interval
SRH	=	Self-rated health
ADL	=	Activities of daily living
IADL	=	Instrumental activities of daily living.
MPCE	=	Monthly per capita consumption expenditure

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The study uses secondary data which is available at The Gateway to Global Aging Data, accessible through. https://g2aging.org/

Contributor statement

Conceived and designed the research paper: PS, TM and SS; Analyzed the data: RP; Contributed agents/materials/analysis tools: TM, SS and PS; Wrote the manuscript: PS, TM, RP and SS; Refined the manuscript: TM, RP, SS and PS. All authors read, reviewed and approved the manuscript.

Ethics approval and consent to participate

The survey agencies that conducted the field survey for the data collection have collected prior informed consent (written and verbal) from all the participants. The Indian Council of Medical Research (ICMR) extended the necessary guidance and ethical approval for conducting the LASI survey.

All methods related to the current analysis were carried out in accordance with relevant guidelines and regulations by the Indian Council of Medical Research (ICMR).https://apps.who.int/iris/handle/10665/43809

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.