Living Arrangements and Risk for Late Life Depression: A Meta-Analysis of Published Literature

OBJECTIVE: The goal of this study was to determine the relationship between living arrangements and risk for depression among older people. METHOD: MEDLINE, EMBASE, The Cochrane Library database was used to identify potential studies. The studies were divided into cross-sectional and longitudinal subsets. Qualitative meta-analysis of the cross-sectional studies and longitudinal studies was performed, respectively. For prevalence and incidence rates of depression, odds ratio (OR) and relative risk (RR) were calculated, respectively. RESULTS: The qualitative meta-analysis showed that older people living alone had a higher risk of depression than those not living alone (OR: 1.44; 95% confidence interval [95% CI]: 1.04-1.99); Relative risk (RR: 1.27, 95% CI: 0.89-1.80) and those living with families (OR: 2.59, 95% CI: 1.60-4.20). Older people living in a nursing home (OR: 2.90, 95% CI: 0.94-8.94; RR: 1.94, 95% CI: 1.18-3.20) or institutionalized setting (OR: 1.86, 95% CI: 1.37-2.52; RR: 2.03, 95% CI: 1.12-3.70) had a higher risk of depression than those living in home. CONCLUSIONS: Despite the methodological limitations of this meta-analysis, living arrangements appear related to the risk for depression in the older population. Older persons living alone, in a nursing home, or in an institutionalized setting have higher risk for depression.