Risk of depression and distress in people aged 70+ in a rural area in Germany

BACKGROUND: Mental health of people living in rural areas is largely unknown. We aim to evaluate mental health of individuals aged 70+ in a German rural region. METHODS: We conducted a cross-sectional study (2018-2019). Participants were a representative sample living in a rural area. Main outcomes for this study were depression and general health (assessed with the PHQ-9 and the GHQ-28, respectively). As independent variables we assessed socio-demographics and access to care. RESULTS: Of the 460 participants, 140 (30.4%) were 70+ years old and 320 were between 18-69 (69.6%). The older age group was predominantly male (63.6%) and did not have university degrees (71.9%). 2.2% were employed. 2.1% reported depression symptoms (younger groups: 7.8%, p = 0.019) and 11.0% distress symptoms (younger groups: 28.0%, p < 0.001). Depression and distress were inversely associated with financial worries (p < 0.001). Higher education status was positively associated with depression (p = 0.051). Discussion: Older age was associated with less depression and distress. Results suggest that financial worries in old age contribute significantly to mental health conditions in old age. Interventions to reduce financial stress in old age are needed. Furthermore, longitudinal research is needed to evaluate how depression risk develops in rural areas in different groups.