Associations between extreme weather events and resource insecurities with depression and anxiety symptoms among older adults in Moshi, Tanzania: Cross-sectional analyses

Abstract

Extreme weather events (EWEs) and resource insecurities are associated with adverse mental health outcomes, yet little is known about their impacts on older adults in climate-affected settings. We conducted a community-based cross-sectional survey 250 randomly sampled older adults from the Prospective Urban Rural Epidemiology cohort in Moshi, Tanzania (mean age 60.6 years, SD 11.1). Multivariable linear regression examined resource insecurity (food, water, sanitation), EWE exposure, social support, and resilience associations with depressive and anxiety symptoms. In adjusted analyses, low food security ( aβ =0.86, 95% CI: 0.54, 1.18), very low food security ( aβ =1.07, 95% CI: 0.73, 1.41), sanitation insecurity ( aβ =0.05, 95% CI: 0.01, 0.09 p  = 0.022 e), and past-year EWE exposure ( aβ =0.39, 95% CI: 0.07, 0.70) were associated with higher depressive symptoms. Low food security ( aβ =0.51, 95% CI: 0.22, 0.79), very low food security ( aβ =0.62, 95% CI: 0.32, 0.93), and water insecurity ( aβ =0.53, 95% CI: 0.02, 1.03) were associated with higher anxiety ssymptoms, while resilience was associated with lower anxiety symptoms ( aβ = −0.07, 95% CI: −0.14,−0.01). Findings highlight interconnected environmental and resource insecurity-related mental health vulnerabilities among older adults, underscoring the importance of integrating resource security and mental health into climate adaptation strategies for older adults in climate-affected low and middle-income settings.