Depression and Cognitive Impairment Among Older Adults in Mexico City

Objective. To estimate the prevalence of depression in older adults 60 years and older and its relationship with cognitive impairment, demographic and social variables, and health service utilization. Materials and Methods. The data are from the first wave of the “Integral study of depression among the elderly in Mexico City's Mexican Institute of Social Security, (IMSS) policyholders.” The IMSS offers health care and social security services to roughly half of the population in Mexico. The sample for this study (n=7,525) is representative of the population 60 years and older and was selected though a multi-stage probability design by conglomerates. Elevated depression symptomatology was assessed using the 30-item Geriatric Depression Scale. Cognitive impairment was assessed using the Mini-Mental State Examination. Regression analyses were carried out with models able to accommodate the unequal probability of selection and possible clustering of participants by sampling unit. Results. The estimated prevalence of depression was 20.4%. As expected, participants with depression had lower scores in health-related quality-of-life scales (p <0.05) and had higher odds of cognitive impairment, compared to participants without depression (31% vs. 18.4%; p < 0.001; adjusted Odds Ratio [aOR] = 1.4; 95% confidence interval [95% CI], (1.1-1.9), as well as for seeking healthcare for emotional problems in the past 6 months (19.7 vs. 8.2%; p = 0.001; aOR= 1.9; 95% CI 1.4, 2.7). Conclusions. It is estimated that one of every five older adults had depression and 28% of these additionally exhibit cognitive impairment in this sample of Mexican older adults.