Latent Class Analysis: a new vision of the phenomenon of depression in elderly men in the Brazilian Northeast

Leão, Rita de Cássia Hoffmann; Silva, Vanessa de Lima; Moreira, Rafael da Silveira

doi:10.1590/1981-22562017020.160159

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Original Articles • Rev. bras. geriatr. gerontol. 20 (06) • Nov-Dec 2017 • https://doi.org/10.1590/1981-22562017020.160159 copy

Latent Class Analysis: a new vision of the phenomenon of depression in elderly men in the Brazilian Northeast

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to identify the prevalence of depression in elderly men and associated factors using Latent Class Analysis.

Method:

a cross-sectional, epidemiological study evaluating 162 Primary Care users resident in the community in Recife, Brazil, was carried out. The Yesavage Geriatric Depression Scale was used as a screening instrument. The study was based on descriptive analysis and Latent Class Analysis, which allows the indirect measurement of the phenomenon of Depression by measuring the latent phenomenon of depression through 15 directly observed questions/answers from the scale used followed by ordinal logistic regression.

Results:

Elderly men with up to four years of schooling had a 2.43 times greater chance of developing depression. Those with normal levels of cortisol were less likely to become depressed while elderly men with low levels of Vitamin D and testosterone and high levels of thyroid stimulating hormones (TSH) were more likely to be depressed. The prevalence of the highest level of depression in the study population was 29% and was associated with low levels of education and alterations in the clinical data investigated.

Conclusion:

The study concluded that Latent Class Analysis allowed an innovative perspective of the phenomenon of depression and its relationship with associated factors, allowing a better and broader approach to this phenomenon in clinical practice.

Keywords:
Men's Health; Elderly; Depression; Epidemiology; Logistic Models

Universidade do Estado do Rio Janeiro Rua São Francisco Xavier, 524 - Bloco F, 20559-900 Rio de Janeiro - RJ Brasil, Tel.: (55 21) 2334-0168 - Rio de Janeiro - RJ - Brazil
E-mail: revistabgg@gmail.com

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[1] Correspondence Rita de Cássia Hoffmann Leão ritachl@yahoo.com.br

Latent Classes	Happy and motivated	Discouraged but motivated	Bored and helpless	Depressed and hopeless
Are you basically satisfied with your life?	18.60	84.70	73.40	100.00
Have you dropped many of your activities and interests?	91.20	100.00	100.00	100.00
Do you feel that your life is empty?	0.00	20.30	54.00	100.00
Do you often get bored?	43.00	85.40	100.00	86.50
Are you in good spirits most of the time?	2.20	0.00	27.00	78.80
Are you afraid that something bad is going to happen to you?	9.80	84.50	84.70	97.80
Do you feel happy most of the time?	4.60	100.00	0.00	100.00
Do you often feel helpless?	38.50	33.20	100.00	72.80
Do you prefer to stay at home, rather than going out and doing new things?	82.50	92.40	100.00	100.00
Do you feel you have more problems with memory than most?	6.60	47.60	13.50	40.50
Do you think it is wonderful to be alive now?	0.00	0.00	9.00	28.50
Do you feel pretty worthless the way you are now?	0.00	0.00	11.20	30.60
Do you feel full of energy??	42.90	100.00	93.30	100.00
Do you feel that your situation is hopeless?	0.00	0.00	4.50	39.40
Do you think that most people are better off than you are?	86.80	100.00	100.00	89.10

Latent Class Analysis		GDS Analysis*			Total
Latent Class Analysis		Without depression	Suspicion of depression	Depressed
Happy and motivated	n	22	25	0	47
	% Line	46.80	53.20	0.00	100.00
	% Column	100.00	21.60	0.00	29.00
	Standardized Residual	7.9	-3.3	-3.4
Discouraged but motivated	n	0	24	0	24
	% Line	0.00	100.00	0.00	100.00
	% Column	0.00	20.70	0.00	14.80
	Standardized Residual	-2.1	3.3	-2.2
Bored and helpless	n	0	43	0	43
	% Line	0.00	100.00	0.00	100.00
	% Column	0.00	37.10	0.00	26.50
	Standardized Residual	-3	4.8	-3.2
Depressed and hopeless	n	0	24	24	48
	% Line	0.00	50.0	50.00	100.00
	% Column	0.00	20.70%	100.00	29.60
	Standardized Residual	-3.3	-4	8.2
Total	n	22	116	24	162
	% Line	13.60	71.60	14.80	100.00
	% Column	100.00	100.00	100.00	100.00
	% do Total	13.60	71.60	14.80	100.00

Independent variables of each block	Simples				Multiple
	OR	CI 95%		p-value	OR	CI 95%		p-value
	OR	Inf	Sup	p-value	OR	Inf	Sup	p-value
Block 1
Age < median (69)	1.00
Age ≥ median (69)	1.37	0.78	2.39	0.265
Caucasians	1.00
Non-Caucasians	1.49	0.78	2.83	0.225
No schooling	1.97	0.87	4.43	0.100	1.90	0.76	4.70	0.166
Up to 4 years of schooling	1.74	0.79	3.82	0.167	2.43	1.01	5.89	0.048
5 years or more of schooling	1.00				1.00
Individual income <median 790	1.20	0.67	2.14	0.529
Renda individual ≥median 790	1.00
Renda familiar <median-1580	1.08	0.62	1.88	0.788
Renda familiar ≥median-1580	1.00
Leisure activities	1.00
No leisure activities	1.50	0.86	2.62	0.152
N.people/room<median 2	1.45	0.77	2.73	0.239
N.people/room≥median 2	1.00
Single	1.00
Married	2.21	0.64	7.58	0.206
Separated or widowed	2.28	0.61	8.45	0.218
Block 2
Heart disease	1.23	0.65	2.32	0.522
Without heart disease	1.00
Rheumatologic diseases	0.97	0.53	1.77	0.920
Without rheumatologic diseases	1.00
Diabetes	0.86	0.47	1.57	0.625
Without diabetes	1.00
Cancer	0.82	0.21	3.16	0.775
Without cancer	1.00
Block 3
Low Vitamin D level	14.14	6.18	32.32	<0.001	10.33	4.06	26.27	<0.001
Normal Vitamin D level	1.00				1.00
Low TSH level *	1.00				1.00
Normal TSH level	3.68	0.34	39.45	0.280	11.31	0.97	131.98	0.053
High TSH level	12.10	1.10	132.53	0.041	15.73	1.30	189.95	0.030
Low cortisol level	1.00				1.00
Normal cortisol level	0.26	0.14	0.50	<0.001	0.34	0.17	0.69	0.003
High cortisol level	0.53	0.23	1.17	0.120	0.55	0.22	1.37	0.200
Low testosterone level	7.73	3.89	15.36	<0.001	3.24	1.41	7.42	0.005
Normal testosterone level	1.00				1.00