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Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan

  • Y. Abe (a1), N. Fujise (a2), R. Fukunaga (a2), Y. Nakagawa (a3) and M. Ikeda (a2)...


Background: The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression.

Methods: A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used.

Results: Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area.

Conclusions: Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.


Corresponding author

Correspondence should be addressed to: Mananbu Ikeda, MD, PhD, Department of Psychiatry and Neuropathobiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan. Phone: +81-96-373-5184; Fax: +81-96-373-5186. Email:


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Barua, A., Ghosh, M. K., Kar, N. and Basilio, M. A. (2010). Socio-demographic factors of geriatric depression. Indian Journal of Psychological Medicine, 32, 8792.
Blay, S. L., Andreoli, S. B., Fillenbaum, G. G. and Gastal, F. L. (2007). Depression morbidity in later life: prevalence and correlates in a developing country. American Journal of Geriatric Psychiatry, 15, 790799.
Blazer, D. G. II. and Hybels, C. F. (2005). Origins of depression in later life. Psychological Medicine, 35, 112.
Burke, W. J., Rocceaforte, W. H. and Wengel, S. P. (1991). Short form of the Geriatric Depression Scale: a comparison with the 30-item form. Journal of Geriatric Psychiatry and Neurology, 4, 173178.
Chiu, H. C., Chen, C. M., Huang, C. J. and Mau, L. W. (2005). Depressive symptoms, chronic medical conditions and functional status: a comparison of urban and rural elders in Taiwan. International Journal of Geriatric Psychiatry, 20, 635644.
Evans, R. J. (2009). A comparison of rural and urban older adults in Iowa on specific markers of successful aging. Journal of Gerontological Social Work, 52, 423438.
Ford, D. E. and Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention. JAMA, 262, 14791484.
Fukunaga, R., Abe, Y., Nakagawa, Y., Koyama, A., Fujise, N. and Ikeda, M. (in press). Living alone is associated with depression among the elderly in a rural community in Japan. Psychogeriatrics.
Kawachi, I. and Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78, 458467.
Koizumi, Y. et al. (2005). Association between social support and depression status in the elderly: results of a 1-year community-based prospective cohort study in Japan. Psychiatry and Clinical Neuroscience, 59, 563569.
Lawton, M. P. (1975). The Philadelphia geriatric center morale scale: a revision. Journal of Gerontology, 35, 8589.
Lee, J., Park, J., Bae, N. and Cho, Y. (2008). Factors related to depressive symptoms among the elderly in urban and rural areas. Journal of Agricultural Medicine & Community Health, 33, 204220.
Lehtinen, V., Michalak, E. and Wilkinson, C. (2003). Urban-rural differences in the occurrence of female depressive disorder in Europe-evidence from the ODIN study. Social Psychiatry and Psychiatric Epidemiology, 38, 283289.
Liang, J., Asano, H., Bollen, K. A., Kahana, E. F. and Maeda, D. (1987). Cross-cultural comparability of the Philadelphia Geriatric Center Morale Scale: an American-Japanese comparison. Journal of Gerontology, 42, 3743.
Loke, S. C., Abdullah, S. S., Chai, S. T., Hamid, T. A. and Yahaya, N. (2011). Assessment of factors influencing morale in elderly. PLoS ONE, 6, e16490.
Mechakura-Tahiri, S., Zunzunegui, M. V., Préville, M. and Dubé, M. (2009). Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec. International Journal of Geriatric Psychiatry, 24, 12261236.
Mendes de Leon, C. F., Rapp, S. S. and Kasl, S. V. (1994). Financial strain and symptoms of depression in a community sample of elderly men and women: a longitudinal study. Journal of Aging Health, 6, 448468.
Muraoka, Y., Ikuchi, S. and Ihara, K. (1996). The physical and psychological and social background factor of elderly depression in the community. Japanese Journal of Geriatric Psychiatry, 7, 397407. (in Japanese)
Okwumabua, J. O., Baker, F. M., Wong, S. P. and Pilgram, B. O. (1997). Characteristics of depressive symptoms in elderly urban and rural African Americans. Journal of Gerontology, 52, 241246.
Pan, A. et al. (2008). Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China. Journal of Affective Disorder, 105, 167175.
Sarai, K. (1983). A community-study of mental health using SDS in the elderly: 3: a rural population of an island village. Hiroshima Medicine, 36, 15781591. (in Japanese)
St John, P. D., Blandford, A. A. and Strain, L. A. (2006). Depressive symptoms among older adults in urban and rural areas. International Journal of Geriatric Psychiatry, 21, 11751180.
Watanabe, N., Hasegawa, K. and Yoshinaga, Y. (1995). Suicide in later life in Japan: rural and urban differences. International Psychogeriatrics, 7, 253261.
Yesavage, J. A. and Blink, T. L. (1983). Development and validation of a Geriatric Depression Scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.



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