Depression in the elderly: results from Passi d'Argento surveillance, Italy

Background Population ageing requires targeted responses to specific problems like depression. Passi d’Argento (Silver Steps - PDA) is a national system aimed to follow over time health conditions and monitor preventive health measures of over64 aged people to support policy making notably at regional level. We reported specifically PDA data about depression and the main associated factors, because of its high and arising prevalence in the elderly population. Methods Between 2012 and 2013, a random sample of 24,129 over64 people in 19 Italian Regions were interviewed by telephone or face-to-face through a standardized questionnaire. Symptoms of depressions were assessed following the PHQ2 (Patient Health Questionnaire 2). A weighted logistic regression analysis was conducted by considering as eligible only variables whose p value in the univariate analysis was lower than 0.20. The model was built using a backward procedure based on the log-likelihood ratio test (p < 0.05). Results Out of 17,723 eligible interviews, 3,707 people (21,3%) referred depression symptoms. A positive association with depression was found for women (OR 2.18, CI 95%: 2.01-2.35), age over74 (OR 1.5, CI 95%: 1.47-1.70), low education level (OR 1.71, CI 95%: 1.58-1.84), low economic conditions (OR 5.22 CI 95%: 4.69-5.81), social isolation (OR 2,62, CI 95%: 2,39-2,88), diabetes (OR 1.59, CI 95%: 1.46-1.73), disability (OR 6.41 CI 95%: 5.7-7.22), feeling unsafe in the borough (OR 1.82 CI 95%: 1.65-2.02), presence of 3 or more chronic diseases (OR 4.51, CI 95%: 3.99-5.10). We found no association for urinary and fecal incontinence, hearing, vision and dental problems, marital status, smoking, nationality, physical activity level. Conclusion Surveillance allowed health professionals and decision makers to assess the extensions of depression in over 64 aged population and it is a promising approach to establish a risk profile to select people more likely to be depressed for targeting interventions.