The 89th Annual Meeting of the American Association of Physical Anthropologists (2020)

Age-related and culturally specific causes of depression underdiagnosis among older adults: Results from the Study on global AGEing and adult health


Anthropology, University of Oregon

April 16, 2020 , Platinum Ballroom Add to calendar

Cultural competency should be prioritized when dealing with any issue surrounding mental health. Older adult populations are growing rapidly in lower and middle-income countries (LMICs) and depression is a neglected form of disability that is especially pronounced in older adults. The current study analyzes data among older adults collected in Wave 1 of the World Health Organization’s Study on global AGEing and adult health (SAGE) in order to examine the underlying factors related to underdiagnosis of depression in Ghana, Mexico, India, China, South Africa, and Russia. These countries were compared to observe the societal and individual influences that lead to patterns of depression diagnosis. We test two hypotheses: 1) lower rates of underdiagnosis of depression being associated with easily accessed and utilized healthcare facilities; and 2) the underdiagnosis of depression being associated with higher levels of stigma. Functional quality of life was a consistent predictor of the underdiagnosis of depression in all countries tested (B’s = 0.02 to 0.04, p’s < 0.001). Other predictors of underdiagnosis varied greatly by country but include age (p’s< 0.05 in China and Russia), gender (p’s< 0.05 in China and India), income (p’s < 0.05 in China and India), memory status (p’s< 0.05 in China and India), healthcare quality (p’s < 0.05 in India and Ghana), social cohesion (p’s< 0.05 in Mexico, India, and Ghana), and stigma (p’s < 0.05 in India and Ghana). Both age-related stressors and cultural differences should be considered when addressing the underdiagnosis and, therefore, treatment of depression.

NIH NIA Interagency Agreement YA1323-08-CN-0020; NIH R01-AG034479; WHO; Ministry of Health in Mexico; Shanghai CDC in China; NDH in South Africa; University of Ghana Medical School; USAID; UO Bray Fellowship.