Racial and ethnic differences in the prevalence of depressive symptoms among US nursing home residents

This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file, and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms (score≥10 on the 9-item Patient Health Questionnaire [PHQ-9] scale), and whether associations were explained by resident and nursing home covariates. Stratified analyses further determined independent associations in subgroups of residents. We found that the prevalence rate of PHQ-9 scores≥10 was 8.8% among non-Hispanic white residents (n=653,031), and 7.4%, 6.9%, and 6.6% among black (n=97,629), Hispanic (n=39,752), and Asian (n=16,636) residents, respectively. The reduced likelihoods of significant depressive symptoms for minority residents compared to non-Hispanic whites persisted after sequential adjustments for resident and nursing home covariates, as well as in stratified analyses. The persistently lower rate of significant depressive symptoms among racial and ethnic minority residents suggests that training of nursing home caregivers for culturally sensitive depression screening is needed for improved symptom recognition among minority residents. (author abstract)