Prevalência, uso de serviços de saúde e fatores associados à depressão em idosos no Brasil.

Abstract

Depression is one of the most common mental health conditions in the global population, affecting 3.8% of the world's population, and it is estimated that approximately one third of the world's older adults population has the disease. Objectives: to estimate the prevalence of depression in the older adults population in Brazil and associated factors, and to describe characteristics of the use of health services and health treatments provided to older adults with depression. Method: Cross-sectional, analytical study, with secondary data from the 2019 National Health Survey (PNS), with a sample of 22,728 older adults selected by simple random sampling throughout the country in the period between August 2019 and March 2020. The outcome was the self-report of a diagnosis of depression given by a doctor or other mental health professional, and the exposures were sociodemographic variables, a social network score, socioeconomic variables. Descriptive analyzes of exposures and outcome were performed. Descriptive and analytical analyzes were used. To evaluate the association between exposures and depression, a bivariate step was used using the chi-square test, and multiple analyzes were used using logistic regression. The association measure used was the Odds Ratio (OR). Results: The prevalence of depression was 11.8% (95% CI: 11.1-12.57), with higher rates in females (15.9%, 95% CI: 14.9-16.9; p < 0.0001), in the age groups of 60 to 69 years (13.2%, 95% CI: 12.0-14.1; p = 0.0001) and 70 to 79 years (10.6%, 95% CI: 9.5-11.8; p = 0.0008), among individuals of white ethnicity (14.0%, 95% CI: 13.0-15.1; p < 0.0001), those living without a partner (13.3%, 95% CI: 12.3-14.3; p < 0.0001), among people with higher education, 12 years or more (14.3% 95% CI: 12.1-16.7; p = 0.0040), among those belonging to "Socioeconomic Class A" (14.6%, 95% CI: 9.2-22.5; p = 0.0091), among urban residents (12.5%, 95% CI: 11.7-13.2; p < 0.0001) and in the Southern region (17.1%, 95% CI: 15.5-18.9, p < 0.0001), and in older individuals with multimorbidity (13.7%, 95% CI: 12.8-14.6; p < 0.0001). As for treatment, it was observed that 71.6% (95% CI: 67.9-75.0) of the population with depression receives medication treatment. There is a higher likelihood of depression among elderly individuals (OR=2.46; 95% CI: 2.06-2.94), those aged 60 to 69 years (OR=1.67; 95% CI: 1.31-2.14); individuals of white ethnicity (OR=2.95; 95% CI: 1.62-5.39), residents of the Southern region (OR=3.01; 95% CI: 2.27-4.00), and those with multimorbidity (OR=1.79; 95% CI: 1.49-2.14). Conclusion: Women, younger age groups (70 to 79 years), people with white skin color, residents of the South region, and those with multimorbidity were associated with greater chances of depressive disorder. Such findings can contribute to the development of public policies to create and develop strategies to combat and prevent the disease in the older adults population. The results encourage changes in the treatment of the disease, by encouraging the adoption of non-pharmacological measures and changes in lifestyle variables and social activities, which can impact mental health and trigger depression in this population.