Risk indicators for depression in aged care: The contribution of a meaningful life, mastery and environmental fit

Objectives: Depression is a pernicious, growing problem in the aged care population. Knowledge about the risk factors for depression focuses on unchangeable, medical factors; therefore, a deeper, systematic understanding of modifiable psychological risk indicators is needed. Methods: This secondary analysis used data from an observational cohort study (T1, n = 147; T2, n = 81) of adults aged ≥65 years recruited from 15 aged care facilities in Melbourne, Australia. Meaningful existence, mastery, social support and person-environment fit were investigated as risk indicators. Results: Generalised estimating equation analysis identified that changes in meaningful existence (b = –0.06, P <.05), mastery (b = –0.05, P <.05) and person-environment fit (b = –0.02, P <.05) were significantly associated with change in depression score. These remained significant controlling for socio-demographic variables, cognitive impairment and functional impairment. Conclusion: Because these psychological risk factors—meaningful existence, mastery and person-environment fit—are suitable therapeutic targets, they are well positioned to inform prevention and intervention programs.