Older women in rural areas tend to suffer from recurrent bouts of depression

Being female and living in a rural area are among several factors that predicted whether an elderly person with depression recovered over the course of a year, finds a recent study in Depression Research and Treatment. Additional risk factors included having high levels of stress, being chronically ill and having a low estimate of one's own mental health.

"Our results suggest that when older depressive people are single or separated, have multiple chronic diseases, suffer from severe stress, report a high number of hassles, and consider themselves to be in poor mental health, they should receive special attention from health professionals," wrote the study authors.

Furthermore, older women living in rural areas tended to suffer from recurrent bouts of depression, cycling between recovery and relapse, according to the study. Lead author Samia Mechakra-Tahiri of the Université du Québec à Trois-Rivières in Québec, Canada added, "Older women do not seem to be at greater risk of persistent depression, but do seem to suffer more from fluctuating emotional states, at least among those living in the community."

The study followed 2752 elderly people living near Quebec, Canada over 12 months. Of the 164 people with depressive symptoms at the beginning of the study, 80 percent had recovered by the end.

Previous studies of depressed elderly people have had opposite findings, with one study showing that 73 percent of those who were depressed at the start of the study remained depressed. But, Mechakra-Tahiri explained, those studies looked at patients in medical facilities, not in their own homes or with family. This difference in results is both notable and unexpected, Mechakra-Tahiri said.

"Older adults who live in assisted living or residential units for older adults would likely score differently," said Norman Abeles, Ph.D., professor emeritus of psychology at Michigan State University in East Lansing. People in those situations may also have more physical symptoms and cognitive problems, he noted. The link between rural living and an increased risk of depression, while known to mental health professionals, may not be more widely known, Abeles added.

"Our [earlier research] revealed that the higher probability of depression outside metropolitan areas was not explained by the age or gender composition of the sample, nor by respondents' socioeconomic status, health status or social relationships," said Mechakra-Tahiri. Living in a rural area may be a risk factor due to isolation and the stress of working in agriculture, with its economic uncertainty and dependence on crops and weather, she added.