Urbanicity, Social Connectedness, and Depression in Older Adults: An Analysis of Two African Countries

 描述(申请人提供)：抑郁症是全球发病率和死亡率的一个重要因素，也是全球残疾的主要原因。抑郁症是自杀的主要原因，也是心脏病的主要原因。生活在城市环境中 在许多研究中，它与抑郁症和其他精神疾病的风险增加有关；然而，研究结果各不相同，其机制尚不清楚。提出了一些可能的促成因素，其中之一是城市环境中的社会凝聚力和社会支持的减少。老年人是一个更容易患抑郁症的年龄段，这可能部分是因为他们更有可能被社会孤立。随着世界人口继续老龄化，随着低收入和中等收入国家城市化程度的提高，抑郁症可能会成为一个日益严重的问题。因此，利用参与世界卫生组织(WHO)全球老龄化与成人健康研究(SAGE)的非洲国家的数据，拟议的研究试图探索城市化、社会关系和老年人抑郁之间的关系。这项研究将专门研究当前城市居住地和抑郁症之间的联系，并确定社会凝聚力和支持是否可以解释这种联系。它还将评估在整个生命过程和不同生命阶段的城市居住是否与抑郁症有关。最后，它将确定社会支持和抑郁之间的关系是否在城市和农村地区有所不同。这些目标将通过使用潜变量和多水平方法进行建模的定量分析来研究。拟议的研究将提供高级分析技术和与老龄化相关的心理健康问题方面的培训，并将通过跨国研究支持NIA的全球老龄化倡议。研究结果将有助于理解老年人抑郁的社会和背景决定因素。它还将对解决老年抑郁症的个人和社区一级的干预措施产生重要影响，并对促进精神健康的城市规划政策和城乡精神卫生资源的分配产生影响。

 DESCRIPTION (provided by applicant): Depression is a significant contributor to global morbidity and mortality and is the primary cause of disability worldwide. Depression accounts for the majority of suicides and also a considerable portion of heart disease. Living in urban settings has been linked to an increased risk of depression and other mental illnesses in numerous studies; however findings have varied and the mechanisms are not well understood. A number of possible contributing factors have been suggested, one being a reduction in social cohesion and social support in urban environments. Older adults are an age group that is more vulnerable to depression, which may be due in part to their greater likelihood of being socially isolated. As the world's population continues to age and with increasing urbanization in low- and middle-income countries, depression is likely to become a growing problem. Using data from African countries participating in the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE), the proposed research therefore seeks to explore the relationship between urbanicity, social connections, and depression among older adults. The study will specifically examine the association between current urban residence and depression and determine whether social cohesion and support explain this association. It will also assess whether urban residence across the life course and at different life stages is associated with depression. Lastly, it will determine whether the relationship between social support and depression varies across urban and rural locations. These aims will be studied through quantitative analyses involving modeling with latent variable and multilevel methods. The proposed research will provide training in advanced analytic techniques and aging-related mental health issues and will support the NIA's Initiative on Global Aging through cross-national research. Results of the study will contribute to understanding the social and contextual determinants of depression in older adults. It will also have important implications for individual and community-level interventions to address late life depression, as well as implications for urban planning policy to promote mental health and for the allocation of mental health resources across urban and rural areas.