Prevalence and predictors of depressive symptoms among rural older Australians and Americans

Objective: To examine the predictors of depressive symptoms among older married rural Australian and American men and women, using comparable measures from two separate studies. Design: Postal survey for Australians; telephone interviews for Americans. Setting: Rural Australia (six states and two territories) and America (Virginia). Participants: Older married rural men and women, aged 65 years and over, in Australia (n = 216) and America (n = 156). Main outcome measures: Whether predictors of depressive symptoms, specifically demographic factors, health, pain, functional limitations and social networks, differed according to nationality or sex. Results: Approximately one-third of older rural Australian (37%) and Americans (28%) reported recently experiencing depressive symptoms. For Australian men and women, pain was the strongest predictor of depressive symptoms. For American women, dissatisfaction with social support predicted depressive symptoms, whereas no variable predicted depressive symptoms in American men. Conclusions: In the context of a globally ageing population, the fact that nearly one in three older rural people on two continents described themselves as recently feeling depressed is a troubling finding of considerable importance to both practitioners and policy-makers. The findings raise questions about the cultural acceptance, definition and manifestations of symptoms of depression in rural communities, as well as the role of different public health and support systems in the two countries.