OBJECTIVE: To determine whether depressed older adults who attribute becoming depressed to “old age” rather than illness are more likely
to believe it is not important to seek treatment for depression.
DESIGN: Cross-sectional mailed survey.
SETTING: Academically affiliated primary care physicians’ network.
PARTICIPANTS: Surveys were mailed to 588 patients age ≥65 years who were randomly identified from patient lists of 20 physicians. Surveys
were returned by 429 patients (73%). Patients were eligible for this study if they scored ≥2 points on the 5-item Geriatric
Depression Scale (n=94) and were not missing key variables (final n=90).
MEASUREMENTS AND MAIN RESULTS: Of the 90 depressed patients, 48 (53%) believed that feeling depressed was very important to discuss with a doctor. In unadjusted
analysis, older adults who did not believe it is very important to discuss feeling depressed with a doctor were more likely
to attribute becoming depressed to aging (41% vs 17%; P=.012). In a logistic regression model adjusting for sociodemographic characteristics, number of impairments in basic and
instrumental activities of daily living, medical comorbidity, and physical (PCS-12) and mental (MCS-12) component summary
scores from the Medical Outcomes Study Short-Form-12, depressed older adults who attributed depression to aging had a 4.3
times greater odds than those who attributed depression to illness to not believe it is very important to discuss depression
with a doctor (odds ratio [OR], 4.3; 95% confidence interval [CI], 1.3 to 14.5).
CONCLUSIONS: Among older persons with depression, attributing feeling depressed to old age may be an important barrier to care seeking.
Key words aged - attitude to health - barriers to treatment - depression - health belief
A version of this manuscript was presented at the national meeting of the American Geriatrics Society in Washington, D.C.
in May, 2002.
Support for Dr. Sarkisian was provided by the National Institute on Aging (NIA, and AG01004), by the Brookdale National Fellowship
Program, New York, NY. Data collection was supported by the UCLA Robert Wood Johnson Clinical Scholars Program. Ms. Lee-Henderson
was supported by the John A. Hartford Foundation/American Federation for Aging Research/Lillian R. Gleitsman Medical Student
Geriatric Scholars Program. Support for Dr. Mangione was provided by the NIA-funded UCLA Older Americans Independence Center
(P60-AG10415-11), Bethesda, MD, and by the UCLA Center for Health Improvement in Minority Elders/Resource Centers for Minority
Aging Research, National Institutes of Health, National Institute of Aging (AG-02-004).