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Body Mass Index and Depressive Symptoms in Older Adults: The Moderating Roles of Race, Sex, and Socioeconomic Status

From the Department of Psychology, Florida State University, Tallahassee, FL (NS-E, ABB, KHG, LAE); Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND (SAW, RDC); and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC (DGB).

Objective: Although the long-term health risks associated with obesity in older adults have been well documented, less is known about the psychological consequences. The current study examined the relationship between body mass index (BMI) and subsequent depressive symptoms. The authors anticipated that BMI would predict depressive symptoms, and that this relationship would be greater among women, individuals of higher socioeconomic status (SES), and white subjects.

Methods: A three-year longitudinal epidemiological design was employed. Participants were obtained from a biracial sample of community-dwelling older adults (N = 2406) and were interviewed in their home by trained interviewers. A comprehensive survey assessed age, gender, race, SES (education and income), and health functioning variables. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. BMI was derived from self-reported weight and height.

Results: BMI was found to predict depressive symptoms. Contrary to predictions, the influence of BMI on depressive symptoms was greater for African Americans than whites and, in particular, African Americans with less education. There were no sex differences.

Conclusion: Among older adults, BMI was associated with depressive symptoms although the effect size was small. Factors contributing to this relationship may differ from those observed in younger populations, for example, health functioning may play a larger role. Obesity appears to have the most adverse impact on those who are most likely to be overweight, lower SES African Americans.

Key Words: Body mass index • older adults • depressive symptoms • race • sex • socioeconomic status

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