Gender Differences in the Association between Religious Involvement and Depression: The Cache County (Utah) Study

Document Type

Article

Journal/Book Title/Conference

Journals of Gerontology: Series B

Volume

61

Issue

3

Publisher

Oxford University Press

Publication Date

2006

First Page

P129

Last Page

P136

Abstract

We examined the relation between religious involvement, membership in the Church of Jesus Christ of Latter-Day Saints, and major depression in a population-based study of aging and dementia in Cache County, Utah. Participants included 4,468 nondemented individuals between the ages of 65 and 100 years who were interviewed in person. In logistic regression models adjusting for demographic and health variables, frequent church attendance was associated with a reduced prevalence of depression in women but increased prevalence in men. Social role loss and the potential impact of organizational power differential by sex are discussed. Though causality cannot be determined here, these findings suggest that the association between religious involvement and depression may differ substantially between men and women. Previous SectionNext Section DEPRESSION in old age is a public health concern, with reported prevalence rates of major depression ranging from 1% to 4% in community samples (Regier et al., 1993; Ritchie et al., 2004). Depression in later life is often underdiagnosed (Ginsberg, 2005) and undertreated (Mulsant & Ganguli, 1999). The adverse consequences of depression late in life include high health care utilization and poor quality of life and productivity, increased risk of suicide, and increased nonsuicide mortality (Pălsson & Skoog, 1997). The suicide rate in the 65-year-old and older age group has been increasing since 1980 (Lebowitz et al., 1997). In addition, studies generally report that older women are 1.5 to 2.0 times as likely as men to suffer from major depression (Gallo & Lebowitz, 1999; Steffens et al., 2000). Older adults have numerous psychosocial risk factors for depression, including death of loved ones, financial problems, and medical illnesses, that may have differential effects on men and women (Paykel, 1991). Supportive social networks may offset some of their association with depression (George, Blazer, Hughes, & Fowler, 1989). Some studies also suggest that religious involvement may reduce depressive symptoms by offering coping strategies through spiritual, intellectual, and social avenues (Husaini, Blasi, & Miller, 1999; Strawbridge, Shema, Cohen, Roberts, & Kaplan, 1998), but other studies have found no such effect (Courtenay, Poon, Martin, Clayton, & Johnson, 1992; Spendlove, West, & Stanish, 1984). The association between religious involvement and depression has yet to be definitively established, because some studies have used small or nonrepresentative samples of individuals (e.g., medically ill or nursing home patients). Further, not all studies have controlled for potential confounding factors such as education, social supports, physical health, and functional abilities. Depression rates have also been shown to differ by religious affiliation. In a study by Boey (2003), Catholics and Buddhists reported less depression than Protestants among elderly women in Hong Kong (M = 3.5, 3.9, and 6.9, respectively, on the Geriatric Depression Scale–15). Affiliation also can affect the female-to-male ratio for depression, shown to be 1:1 among Jews, compared with the more common 2:1 among Catholics and Protestants (Levav, Kohn, Golding, & Weissman, 1997). Further, Braam and colleagues (2001) argued that a strong religious climate protects against depression in later life, particularly if it is pervasive throughout cultural life. Thus, the study of the effect of religious involvement on depression in populations with a predominant religious group will expand our understanding of this association. Here we report an analysis of the relation between religious involvement and current major depression in a large community-based sample of older adults participating in the Cache County (Utah) Study on Memory Health and Aging (Breitner et al., 1999). An unusual characteristic of the Cache County population is that approximately 90% are members of the Church of Jesus Christ of Latter-Day Saints (LDS). LDS church members tend to have high religious involvement, and the church prohibits the use of alcohol or tobacco. Its members in Cache County therefore have low rates of mortality before the age of 85 and have a conditional life expectancy for men at age 65 that is the highest in the United States (Murray, Michaud, & McKenna, 1998), exceeding national norms by almost 10 years (Manton, Stallard, & Tolley, 1991). The prevalence of major depression among those aged 65 and older in this population has been previously reported as 4.3% in women and 3.0% in men (Steffens et al., 2000). This is somewhat higher than the 4.0% in women and 1.8% in men reported in a community study in France (Ritchie et al., 2004), but it is much higher than the 1.4% in women and 0.4% in men in the NIMH Epidemiological Catchment Area Study (Koenig & Blazer, 1992). The general finding that religious involvement is inversely associated with depression, along with somewhat higher rates of major depression among residents of a community with a predominant religious group (where members generally exhibit high religiosity), begs further study into differences between individuals who demonstrate varying degrees of adherence to their religious beliefs within such a cultural environment. Our purpose in this study was to examine the effect of religious involvement on major depression risk among older adults in a rural county in northern Utah composed primarily of LDS church members. We hypothesized that more frequent church attendance would decrease depression, with a stronger effect for women and for members of the predominant group. Models tested the effect of religious involvement after adjustment for important confounding variables known to affect depression risk.

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