Marital quality and depression among the elderly in Japan

Studies indicated that being married has a protective effect on health. However, as for marital quality, such effect is less clear. To investigate the association of marital status/quality with depression among the elderly, we used a cross-sectional data (N=8294, mean age: 74 years) from three communities in Japan. Those scored higher than 5 in 15-item Geriatric Depression Scale (GDS-15) were considered being depressed. Mean GDS scores were 3.74 and 3.66 for married men and women, while such scores were 4.81 and 4.21 for widowed/separated/never married men and women, respectively. Logistic regression analyses were employed to investigate the association of marital status with depression. Widowed/separated/never married elderly had higher odds for depression than married counterparts even after adjustment for age in years, illnesses, higher level of activities of daily living, and educational background. Odds ratios were 2.01 (p<0.001) and 1.23 (p<0.05) for men and women, respectively. Further analyses indicated that quality of marriage had a stronger association with depression. Those who were dissatisfied with their marriages were more likely to be depressed than widowed/separated/never married elderly with odds ratios of 2.30 (p<0.10) and 3.26 (p<0.01) for men and women, respectively, even after adjustment for possible confounders. Our results indicate the importance of the quality of marriage for mental health of the elderly. Factors associated with marital dissatisfaction needs to be further investigated to understand the old age depression.