Racial/ethnic disparities in depression prevalence among the elderly based on DSM-IV and a Single-Item Screen

Background: Studies on racial/ethnic disparities in depression prevalence have provided mixed results due to differences in study populations, measurements, and methods. Few studies have been conducted among the elderly. Objective: To compare depression prevalence by racial/ethnic groups among the elderly. Design: An observational cross-sectional study using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (2001-2002), a nationally representative survey. Participants: 8205 people age 65+. Methods: DSM-IV criteria for major depression and a Single-Item Screen for depression (“How much of the time during the past 4 weeks have you felt downhearted and depressed?”) were employed. Bivariate analysis and logistic regression were utilized to compare non-Hispanic blacks and Hispanics with non-Hispanic whites. Results: The study sample had a mean age of 74.7 years, 57.9% were female, and 17.8% were nonwhite (8.0% non-Hispanic blacks and 5.4% Hispanics). Based on bivariate analysis significantly higher proportions of non-Hispanic blacks (4.8%, p=0.10) and Hispanics (5.2%, p=0.05) were identified as having a DSM-IV diagnosis of major depression than were non-Hispanic whites (3.5%). Also based on bivariate analysis significantly higher proportions of non-Hispanic blacks (9.5%, p=0.01) and Hispanics (11.4%, p<0.01) were identified as being depressed using the Single-Item Screen than were non-Hispanic whites (6.8%). After controlling for demographic characteristics, socioeconomic status, and health status, no significant racial/ethnic disparities in the prevalence of depression were found based on the DSM-IV criteria or the Single-Item Screen. Conclusion: Racial/ethnic disparities in depression prevalence were consistent whether measured by DSM-IV criteria or by a single-item depression screen.