Symptoms of depression among aged Medicare enrollees: 2002.

This highlight uses data from the Medicare Current Beneficiary Survey (MCBS) to look at self-reported symptoms of depression among Medicare enrollees, and the association of those symptoms with enrollees' socioeconomic, demographic, and health characteristics. The interconnections between mental and physical health are complex and well beyond the scope of this highlight; the goal is to show some of the summary bivariate patterns that emerge from the data.

Since its inception (fall 1991), the MCBS has included questions about the mental health of its participants. Each fall, respondents residing in the community are asked, “Has a doctor ever told you that you had a mental or psychiatric disorder, including depression?” Two questions were added in fall 1996: “Do you have problems making decisions to the point that it interferes with daily activities” and “Do you have trouble concentrating or keeping your mind on what you are doing?” Two additional questions were added in fall 2001: “In the past 12 months, have you had 2 weeks or more when you lost interest or pleasure in things that you usually cared about or enjoyed” and “In the past 12 months, how much of the time did you feel sad, blue, or depressed? Would you say you were sad or depressed all of the time, most of the time, some of the time, a little of the time, or none of the time?”

The material presented here is drawn from the 2002 MCBS Access to Care File, which contains the results of interviews conducted between September 2002 and January 2003. Participants' responses to the questions about decisionmaking, concentration, loss of interest, and periods of sadness were examined separately and together. For the latter analysis, each participant was assigned a score ranging from 1 to 4, according to the number of these questions answered affirmatively (in the case of the sadness question, an affirmative answer was a response of “most of the time” or “all of the time”). Analysis was restricted to those participants age 66 or over at the end of 2002, living in the community, who answered for themselves rather than through proxies.

Table 1

Odds of Reporting Symptoms of Depression, by Selected Enrollee Characteristics: 2002

The bivariate correlations previously discussed are confirmed in multivariate logistic regression analysis. In addition to age, sex, and race, Table 1 also shows the effects of education and living arrangement on the likelihood of self-reported symptoms of depression.

Higher levels of education were associated with a lower likelihood of reporting symptoms.

Generally speaking, married enrollees living with their spouse were less likely to report symptoms (the exception being that widows living alone were less likely to report decisionmaking problems).

Covariate	Problem Making Decisions	Trouble Concentrating	Lost Interest	Sad Most or All of the Time	One or More of These Symptoms
	Odds Ratio
Age(Compared to 66-69 Years)
70-74 Years	1.4	—	—	*1.4	—
75-79 Years	**1.9	**1.4	—	—	**1.3
80 Years or Over	**3.2	**2.0	—	—	**1.5
Sex(Compared to Male)
Female	1.2	**1.3	**1.3	**1.3	**1.3
Race(Compared to Non-Hispanic White)
Non-Hispanic Black	—	—	*0.8	*0.7	0.8
Hispanic	—	—	*1.4	**1.5	—
Other	—	—	—	—	—
Education(Compared to High School Graduate)
None	—	—	1.6	1.8	**1.9
Less Than High School	**1.9	**1.6	**1.5	**1.7	**1.6
Post-High School	—	—	0.9	*0.8	*0.9
Living Arrangement(Compared to Married, Living with Spouse)
Widowed, Living Alone	**0.7	—	**1.3	**1.4	1.1
Widowed, Living with Others	*1.4	—	**1.6	**1.6	**1.4
Divorced/Separated, Living Alone			**1.7	**2.0	**1.5
Divorced/Separated, Living with Others	1.7	—	1.4	—	*1.4
Never Married, Living Alone	*2.0	1.5	—	—	—
Never Married, Living with Others	*2.3	—	—	—	—
Other or Unknown Arrangements	—	—	**2.3	**3.1	**1.8

p<0.05

p<0.01

NOTE: Odds ratio not shown if p>0.10.

SOURCE: Centers for Medicare & Medicaid Services: MCBS Access to Care File, 2002.