BACKGROUND: Although ageing populations are increasingly residing in cities, it is unknown whether depression inequalities are moderated by urbanicity degree. We estimated gender, marital and educational inequalities in depressive symptoms among older European and Canadian adults, and examined whether higher levels of urbanicity, captured by population density, heightened these inequalities. METHODS: Harmonised cross-sectional data on 97 826 adults aged ≥50 years from eight cohorts were used. Prevalence ratios (PRs) were calculated for probable depression, depressed affect and depressive symptom severity by gender, marital status and education within each cohort, and combined using random-effects meta-analysis. Using a subsample of 73 123 adults from six cohorts with available data on population density, we tested moderating effects measured by the number of residents per square kilometre. RESULTS: The pooled PRs for probable depression by female gender, unmarried or non-cohabitating status and low education were 1.48 (95% CI 1.28 to 1.72), 1.44 (95% CI 1.29 to 1.61) and 1.29 (95% CI 1.18 to 1.41), respectively. PRs for depressed affect and high symptom severity were broadly similar. Except for one Dutch cohort with findings in an unexpected direction, there was no evidence that population density modified depressive symptom inequalities. CONCLUSIONS: Despite cross-cohort variation in gender, marital status and educational inequalities in depressive symptoms, there was weak evidence that these inequalities differed by levels of population density.

• Klíčová slova
• Ageing, depression, social epidemiology, urbanisation,
• MeSH
• deprese * epidemiologie   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• stupeň vzdělání MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Kanada epidemiologie   MeSH

PURPOSE: Studies suggest that frequent contact with friends and relatives promote mental wellbeing in later life, but most evidence comes from Western populations. We investigated the prospective relationship between frequency of contact with friends and relatives and quality of life (QoL) among older Central and Eastern European (CEE) adults and whether depressive symptoms mediated the hypothesised longitudinal relationship. METHODS: Data from 6106 participants from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study were used. Frequency of contact with friends and relatives was measured at baseline. QoL, at baseline and follow-up, was measured by the Control, Autonomy, Self-realisation, and Pleasure (CASP) 12-item scale. After assessing the prospective association using multivariable linear regression, the mediational hypothesis was tested using path analysis. RESULTS: There was a significant prospective association between frequency of contact with friends and relatives and CASP-12 score (0-36) in fully adjusted models. Per every one unit increase in frequency of contact, there was a 0.12 (95% CI 0.06, 0.17) increase in CASP-12 score at follow-up, accounting for sociodemographic, health-related and baseline QoL. Pathway results showed that 81% of the longitudinal effect of frequency of contact on QoL was mediated through depressive symptoms. CONCLUSIONS: Frequent contact with friends and relatives improves QoL of older Central and Eastern European adults, partly through buffering against depressive symptoms. Interventions to improve QoL at older ages should incorporate effective management of common mental disorders such as depression.

• Klíčová slova
• Ageing, Central and Eastern Europe, Depression, Older ages, Quality of life, Social networks,
• MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• přátelé * MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• východní Evropa epidemiologie   MeSH

BACKGROUND: Social cohesion has a potential protective effect against depression, but evidence for Central and Eastern Europe is lacking. We investigated the prospective association between social cohesion and elevated depressive symptoms in the Czech Republic, Russia and Poland, and assessed whether alcohol drinking and smoking mediated this association. METHODS: Cohort data from 15 438 older urban participants from the Health, Alcohol and Psychosocial factors In Eastern Europe project were analysed. Baseline social cohesion was measured by five questions, and depressive symptoms were measured 3 years later by the 10-item Center for Epidemiological Depression (CES-D) Scale. Nested logistic regression models estimated ORs of elevated depressive symptoms (CES-D 10 score ≥4) by z-scores and tertiles of social cohesion. RESULTS: Per 1 SD decrease in social cohesion score, adjusted ORs of elevated depressive symptoms were 1.13 (95% CI 1.05 to 1.23) and 1.05 (95% CI 0.99 to 1.13) in men and women, respectively. Further adjustment for smoking and drinking did not attenuate these associations in either men (OR=1.13, 95% CI 1.05 to 1.22) or women (OR=1.05, 95% CI 0.99 to 1.13). Similarly, the fully adjusted ORs comparing the lowest versus highest social cohesion tertile were 1.33 (95% CI 1.10 to 1.62) in men and 1.18 (95% CI 1.01 to 1.39) in women. CONCLUSIONS: Lower levels of social cohesion was associated with heightened depressive symptoms after a 3-year follow-up among older Czech, Russian and Polish adults. These effects appeared stronger in men, and alcohol and smoking played no appreciable role in this association.

• Klíčová slova
• Central and Eastern Europe, cohort study, depression, depressive symptoms, social capital, social cohesion,
• MeSH
• charakteristiky bydlení MeSH
• deprese epidemiologie   MeSH
• interpersonální vztahy * MeSH
• kohortové studie MeSH
• lidé MeSH
• městské obyvatelstvo statistika a číselné údaje   MeSH
• pití alkoholu epidemiologie   MeSH
• postoj ke zdraví * MeSH
• rizikové faktory MeSH
• senioři MeSH
• socioekonomické faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Česká republika MeSH
• Polsko MeSH
• Rusko MeSH