Acculturation and the Prevalence of Depression in Older Mexican Americans: Baseline Results of the Sacramento Area Latino Study on Aging

Abstract

OBJECTIVE: HTo determine the association between acculturation, immigration, and prevalence of depression in older Mexican Americans. DESIGN: Cross‐sectional analysis from a cohort study. SETTING: Urban and rural counties of the Central Valley of Northern California. PARTICIPANTS: One thousand seven hundred and eighty‐nine Latinos recruited from a population‐based sample (85% Mexican Americans) with a mean age of 70.6 (range 60–100; standard deviation (SD) = 7.13); 58.2% were women. MEASUREMENTS: Depressive symptoms were assessed with the Center for Epidemiologic Studies—Depression scale (CES‐D). Acculturation was measured with the Acculturation Rating Scale for Mexican Americans—II. Psychosocial, behavioral, and medical histories were also obtained. RESULTS: The prevalence of depression (CES‐D ≥ 16) was 25.4%. Women were at greater risk (32.0%) than men (16.3%; male/female odds ratio (OR) = 2.43, 95% confidence interval (CI) = 1.90–3.09). The prevalence of depression was higher among immigrants (30.4%, OR = 1.70, 95% CI = 1.36–2.13), bicultural participants (24.2%, OR = 1.66, 95% CI = 1.24–2.24), and less‐acculturated participants (36.1%, OR = 2.95, 95% CI = 2.22–3.93) compared with U.S.‐born (20.5%) and more‐acculturated groups (16.1%). When adjustments for education, income, psychosocial, behavioral, and health‐problem factors were made, the least‐acculturated participants were at significantly higher risk of depression than highly acculturated Mexican Americans (OR = 1.56, 95% CI = 1.06–2.31). CONCLUSIONS: These findings are consistent with previously reported estimates of a higher prevalence of depression for older Mexican Americans than non‐Hispanic Caucasians and African Americans and are the first to report the prevalence and risk of depression for older U.S.‐born and immigrant Mexican Americans. The high prevalence of depression of the least acculturated group may be related to cultural barriers encountered by immigrants and less‐acculturated older Mexican Americans and to poorer health status.