Depressive symptoms, chronic medical conditions and functional status: a comparison of urban and rural elders in Taiwan

Background and purpose The associations of depression, chronic condition and functional disability have not been studied well in Taiwan. The present study hypothesized that strong relations between chronic medical conditions, functional status, and the manifestation of depression would be evident; the interrelationships of the interested measures would differ in urban and rural populations. Methods The study sample was recruited in a community survey in 2001 that included urban and rural elderly dwelling in southern Taiwan. The Chinese-version Geriatric Depression Scale (GDS) was used for data collection on depressive symptoms. Univariate and multivariate logistic regression analyses were performed to identify the predictors for depressive symptoms in urban and rural samples. Results There were 20.1% of urban elders and 12.8% of rural samples classified with depressive symptoms. While controlling for socio-demographics, the prevalence of chronic disease and ADL summary scores were consistently associated with depressive symptoms for urban and rural samples. Cardiovascular disease and hip fracture were significantly predictive of depression for the urban sample, whereas the influence of stroke history was found to be predictive of depression in the rural sample. By individual PADL/IADL items, toileting problems and shopping difficulties were significant predictors of depression for both elderly samples. Conclusion The present findings confirm urban-rural differences in the reporting of associations between depressive symptoms, chronic medical conditions, and functional disability. For developing prevention programs on geriatric depression, it is critical to call more attention to chronic medical conditions, functional status, and social support of urban and rural elderly. Copyright (c) 2005 John Wiley & Sons, Ltd.