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Perception of Unmet Basic Needs as a Predictor of Depressive Symptoms Among Community-Dwelling Older Adults

¹ Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.
² Department of Psychology, Florida State University, Tallahassee.

Address correspondence to Dan G. Blazer MD, PhD, Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Box 3003, Duke University Medical Center, Durham, NC 27710. E-mail: blaze001{at}mc.duke.edu

Background. In previous studies we found that, among older adults (>64 years), perception that basic needs were not being met increased mortality risk and risk for functional decline. In this study, we determined, controlling for reported income and functional status, if perceived inadequate basic needs predicted depressive symptoms.

Methods. Repeated-measures analysis was used to determine, during three intervals in a 10-year longitudinal study (the Duke Established Populations for Epidemiologic Studies of the Elderly, n = 4162 at baseline), if perceived inadequate basic needs at the beginning of each interval predicted more depressive symptoms at the end of the interval. We included time invariant covariates known to be associated with depressive symptoms—age, sex, race, and education. We also included time-varying covariates at the beginning of the three intervals—income, cognitive status, functional status, depressive symptoms, and interval.

Results. In the repeated-measures controlled analyses, the perception of inadequate basic needs was a highly significant predictor of future depressive symptoms (p <.0001). Race, education, baseline depression, baseline function, interval, and income were also significant predictors of depression. The interaction between interval and depression was not significant.

Conclusions. The perception that one's basic needs are not being met predicted future depressive symptoms in a highly controlled analysis. These results suggest that perception of inadequate basic needs, even when income and other known correlates of depression are controlled, is a strong predictor of future depressive symptoms.