Self-perception of depressive symptoms, self-reported medical diagnosis, and associated factors: findings from the Brazilian Longitudinal Study of Aging, 2019-2021

OBJECTIVES: To estimate the prevalence of self-reported physician-diagnosed depression and to assess its association with self-perceived depressive symptoms, sociodemographic variables, physical activity, alcohol consumption, and smoking among Brazilian older adults. METHODS: This study employed a cross-sectional design using data from the Brazilian Longitudinal Study of Aging. The outcome was the self-reported physician-diagnosed depression. Independent variables included sociodemographic factors, physical activity, alcohol consumption, and smoking. The association between the outcome and self-perception of depressive symptoms was evaluated. RESULTS: Data from 6,872 older adults were included. The prevalence of self-reported physician-diagnosed depression was 12.2% (95% confidence interval - 95%CI 11.4; 13.0). Self-perceived depressive symptoms were reported by 15.6% (95%CI 14.7; 16.5). Self-reported physician-diagnosed depression was higher among females (prevalence ratio - PR 2.23; 95%CI 1.80; 2.89), individuals with up to eight years of schooling (PR 1.32; 95% CI 1.10; 1.61), and those who did not engage in physical activity (PR 1.32; 95% CI 1.10; 1.57). CONCLUSION: The prevalence of self-reported physician-diagnosed depression among Brazilian older adults was 12.2%, independently associated with female sex, lower schooling, and physical inactivity. However, the prevalence of self-perceived depressive symptoms was even higher and was also associated with self-reported physician-diagnosed depression. Self-report may be a valuable tool, reinforcing the need for a hybrid approach that combines it with objective methods when addressing depression among older people.