Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar

PLoS One. 2021 Jan 28;16(1):e0245489. doi: 10.1371/journal.pone.0245489. eCollection 2021.

Abstract

Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Depression / epidemiology*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Myanmar / epidemiology
  • Social Class*

Grants and funding

The research was funded by AMED (Japan Agency for Medical Research and Development), for the project titled, “Development of a Health-Equity Assessment Tool Based on Social Epidemiological Survey for Older Adults in Myanmar and Malaysia” (17934739), Grants in aid for Scientific Research from the Japan Society for the Promotion of Science, for the project titled, “Differences in Social Capital Influence on Depression among Older People—A Comparative Study of Three Asian Countries” (19K19472), and Grants in aid for Health and Labor Administration Promotion Research Project titled ‘Study on promotion of active and healthy aging in ASEAN (20BA2002)’. In addition, the World Health Organization for Health Development funded the research as research to accelerate universal health coverage in light of population ageing in ASEAN countries for research titled, “Development and Validation of Questionnaire Instrument for Evaluating the Determinants of Health Status and Universal Health Coverage in Older Adults in Selected Population in Myanmar and Malaysia (WHO Kobe Centre - WKC: K18015)”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.