Selittävätkö koettu stressi ja itsearvioitu stressinhallintakyky sosioekonomisen aseman ja masennusoireiden välistä yhteyttä iäkkäillä henkilöillä?

Socioeconomic health inequalities are substantial in Finland. The health of people with lower socioeconomic status is worse in many ways and depressive symptoms are more common among them. Although the health of the population has improved in general, health inequalities have persisted. The aim of this study was to investigate the association between socioeconomic status and depressive symptoms, and to find out if the perceived stress and self-rated stress-coping ability explain the association between them in older adults. This cross-section study is based on the data from Active Ageing – Resilience and External Support as Modifiers of the Disablement Outcome (AGNES) study. The data was collected in 2017-2018 and the participants were 75-, 80- and 85-year-old people (n = 1021) living in Jyväskylä region. The sample size of this study is 947 participants. The 20-item version of the Center for Epidemiologic studies Depression Scale (CES-D) was used to measure the prevalence of depressive symptoms. The cut-off score of CES-D for clinically significant symptoms was 16 or more. Perceived economic situation and length of education in years were used as indicators of the socioeconomic situation. Self-rated stress-coping ability was measured using the 10-item Connor-Davidson Resilience Scale and the perceived stress was assessed using self-evaluation. The main method of analysis was logistical regression. Lower extremity performance, cognitive performance and the number of chronic diseases were used as background variables in the regression analyses. In total, 15,4 % of the participants had clinically significant depressive symptoms. The participants who experienced their economic situation as poor or satisfactory had significantly higher probability of having depressive symptoms (odds ratio OR = 3,13; 95 % confidence interval CI = 1,45–6,74; p = 0,004) compared to those who experienced their economic situation as very good. Length of education was not associated with the probability of depressive symptoms. Perceived stress was associated with a greater risk of depressive symptoms (OR = 2,99; 95 % CI = 1,99 – 4,49; p < 0,001), but it didn’t explain the association between socioeconomic status and depressive symptoms. However, when considering the self-rated stress-coping ability in the regression model, the association between socioeconomic status and depressive symptoms became statistically insignificant (OR = 2,06; 95 % CI = 0,90 – 4,73; p = 0,089). Lower perceived economic situation significantly increased the risk of depressive symptoms in older adults. The association was explained by lower self-rated stress-coping ability but not by the higher probability of experienced stress of the participants who perceived their economic situation as poor or satisfactory. Interventions that improve stress-coping ability may have an important role in prevention and treatment of depressive symptoms in older adults. Diminishing the health inequalities at the structural level and in the service system is also of great importance.