AUTHOR=Marin Ivet Bayes , Fernández Daniel , Ayuso-Mateos Jose Luis , Leonardi Matilde , Tobiasz-Adamczyk Beata , Koskinen Seppo , Sanchez-Niubo Albert , Cristóbal-Narváez Paula 

TITLE=Healthy aging and late-life depression in Europe: Does migration matter?

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.866524

DOI=10.3389/fmed.2022.866524

ISSN=2296-858X

ABSTRACT=Background: There is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyse differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy ageing, and lifestyle behaviours. The second aim was to examine the impact of healthy ageing on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonised data from different population-based cohort studies. 
Methods: We analysed cross-sectional, predominantly nationally representative, community-based data from European participants in the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy ageing, and lifestyle behaviours according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors.  
Results: Data on 122,571 individuals aged ≥50 years were analysed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy ageing was also better in non-migrants (51.7; SD=9.7) than in migrants (39.6; SD=18.2). The results of the logistic regression showed that migration status (OR=1.231 [CIs;0.914 – 1.547]) and increased number of years since migration in the host country (OR=0.003 [CIs;0.001 – 0.005]) were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms (OR=0.244 [CIs;0.211 – 0.278]), whereas better healthy ageing was associated with fewer depressive symptoms (OR=-0.100 [CIs;-0.102 – -0.098]). The interaction between migration and healthy ageing status was also significant (OR.=-0.019 [CIs; -0.025 - -0.014]).
Conclusion: Migrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy ageing was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and ageing processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.