Predictors of geriatric depression in community-dwelling and institutionalized older adults, Türkiye

Depression in older adults is shaped by living environment, yet comparative evidence on setting-specific predictors remains limited. This study aimed to compare depression prevalence and identify distinct predictors among community-dwelling and institutionalized older adults. This cross-sectional study included 316 older adults in Ankara, Türkiye: 158 community-dwelling and 158 institutionalized. Face-to-face interviews included a sociodemographic questionnaire, the MSPSS and the GDS-15. Predictors were identified using backward stepwise logistic regression. Ethical approval and informed consent were obtained. Depression prevalence was 20.9% in the institutionalized group and 17.1% in the community-dwelling group (p = 0.389). Community-dwelling participants reported higher social support (MSPSS: 64.7 vs. 56.8; p < 0.001). In the community-dwelling group, poor self-rated health (OR = 10.45; 95% CI: 3.20–34.11) and sleeping fewer than 6 hours per night (OR = 8.33; 95% CI: 2.26–30.69) were significantly associated with depression. In the institutionalized group, poor self-rated health also remained associated with depression, while voluntary admission was strongly protective (OR = 0.07; 95% CI: 0.02–0.23) and non-use of social media was associated with nearly four-fold higher odds of depression (OR = 3.83; 95% CI: 1.22–12.06). Perceived social support remained significant only in the community model and did not remain in the final institutional model. Moderation analysis showed that the association between social support and depression was significant only among involuntarily admitted residents (B = −0.095, p = 0.012). Predictors differed by living setting despite similar depression prevalence. Self-rated health and sleep were prominent in the community, while decisional autonomy and digital connectivity were key in institutional care. Social support appeared protective mainly in the community and among involuntarily admitted residents, supporting context-tailored interventions.

Key messages

• Predictors of geriatric depression differ by living setting: self-rated health and sleep in the community, decisional autonomy and social media use in institutional care.

• Promoting autonomy and social media use may help reduce depression in institutional care for older adults.