Predictors of Depression, Anxiety, and Stress Symptoms Among Older Adults in Rural North India

Background: Mental health problems among older adults are an important and underrecognized public health concern in India.Depression, anxiety, and stress in later life are influenced by demographic, social, behavioural, and clinical factors, and identifying their independent predictors is essential for designing targeted preventive strategies.Objectives: This study aims to estimate the burden of depression, anxiety, and stress among older adults in rural North India and to identify independent predictors of depression, anxiety, and stress symptoms.Methods: A community-based cross-sectional study was conducted among 384 older adults aged 60 years and above residing in rural districts of North India.Participants were selected through multistage random sampling from three rural blocks, and door-to-door household interviews were carried out.Data were collected using a pretested semi-structured questionnaire.Depression, anxiety, and stress were assessed using the Depression, Anxiety, and Stress Scale (DASS-21).Bivariate analysis was performed using the chisquare test, followed by multivariable binary logistic regression to identify factors independently associated with depression, anxiety, and stress.Results: The sample included 53.4% males and 46.6% females.Most participants were aged 60-65 years (64.3%),64.1% were illiterate, 65.9% were married, and 60.9% belonged to lower socioeconomic strata.In this study, depression was present in 98 participants (25.5%), anxiety in 134 participants (34.9%), and stress in 100 participants (26.0%).This study also demonstrated strong positive correlations between depression, anxiety, and stress scores.Depression showed a strong positive correlation with anxiety (ρ = 0.865, p < 0.001) and stress (ρ = 0.852, p < 0.001).The strongest correlation was observed between anxiety and stress scores (ρ = 0.835, p < 0.001).In the final multivariable models, sleep difficulty, social isolation, chronic morbidity, and physical inactivity emerged as factors independently associated with psychological distress.Conclusion: Psychological distress is common among older adults in rural districts of North India, and sleep difficulty, chronic morbidity, social isolation, and physical inactivity are key predictors.Community-based geriatric mental health programs should incorporate routine screening for these factors and link high-risk older adults to primary care and social support services.