Investigating factors associated with depression of older women in Macau

Background. Mental health burdens pose a grave threat to quality of life and economic productivity worldwide. Women must balance the economic, emotional and health needs of the household with their own emotional and health needs. Aims. The purpose of this study is to explore the depression level of a group of older women in the community in Macau, and to identify factors associated with depression. Design. A descriptive survey. Research method. The survey was conducted during the period July and August 2004 in six parishes in Macau; 1042 older people aged 60-98 completed a structured questionnaire. Outcome measures. Four main outcome variables were employed in the study: predisposing characteristics, physical, psychosocial and health needs/behaviours outcomes. Results. Among the women, 11·9% (n = 124) had been identified as depressed. Multiple logistic regression analyses were used to identify a model to predict older women who will have depression. The results showed that variables like having hypertension (p = 0·010), a poor social network (p < 0·001), low self-perceived scores on health status (p < 0·001) and ability to meet living costs (p < 0·001), and a low level of ability to do housework (p < 0·001) were significant risk factors for depression. Conclusion. Providing a suitable living environment and improving health conditions for older people may improve depressive symptoms, and maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms. Apart from the findings, these conclusions resonate with recent Macau guidance on managing depression in older women. This stresses the importance of prevention, early detection and stepped care, with more intensive treatment for greater severity of illness and a multifaceted approach to management. Relevance to clinical practice. It is important to regularly screen for depressive symptoms among older women in the community. Focusing on older women with increasing physical disability and social isolation should help in both the prevention and recognition of onset of depression. Light therapy and antidepressants were suggested and providing a suitable living environment and improving health conditions for older people may improve depressive symptoms; maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms.