Status of geriatric depression among older adults in rural-urban communities across southeastern states of Nigeria: A cross-sectional study

Abstract

Depression in later life is a substantial yet under-recognized public health concern in low- and middle-income countries, including Nigeria, where rapid population aging heightens vulnerability. Evidence from community settings remains limited, particularly in southeastern Nigeria. This study examined the prevalence and sociodemographic factors associated with severe depressive symptoms among community-dwelling adults aged 60 years and older. A cross-sectional survey was conducted from June 2024 to August 2025 across 30 rural and urban communities in five southeastern states, using multistage purposive sampling to recruit 718 eligible participants. Data were collected through interviewer-administered questionnaires incorporating the Geriatric Depression Assessment Questionnaire and the Geriatric Depression Scale – Short Form. Severe depressive symptoms were highly prevalent. Advanced age, female gender, Christian religious affiliation, being married and living with family were significantly associated with higher odds of severe depressive symptoms, while educational level showed no association. Several associated sociodemographic factors contradicted widely held assumptions about the protective nature of traditional social structures, highlighting the need for further investigation into the quality and context of social relationships in later life. These findings underscore the urgent need for routine geriatric mental health screening, community-based support strategies and culturally responsive interventions within Nigeria’s primary care and social welfare systems.