Introduction The Family Healthcare Strategy (FHCS), the new model of Primary Care adopted by the Brazilian Ministry of Health, with its territoriality and regular visits by community health workers, provides an excellent network for treating depressed elderly. We aimed to estimate the prevalence of depression among older adults registered with FHCS teams in two large Brazilian cities, one in the Southeast and the other in the Amazon.
Method Survey with adults aged 60 and over registered in FHCS teams' lists in São Paulo and Manaus. Participants were randomly drawn from lists of clients of 23 teams in São Paulo and 29 in Manaus, and were interviewed at home. Depression was assessed with the PHQ-9, and classified as mild or moderate to severe. Ordinal logistic regression was used to assess statistical associations between depression and sex, age, illiteracy, family income and centre.
Results 1020 participants were included, 446 in São Paulo and 574 in Manaus, of whom 248 (24.3%; 95% CI 21.7 to 27.1) were classified as mild depression and 93 (9.1%; 95% CI 7.4 to 11.1) as moderate to severe depression. The prevalence of mild and moderate to severe depression was very similar in the two centres. Women were almost twice as likely as men to present with depression of any severity. We did not find any association between depression and age, illiteracy or family income.
Conclusion Depression is highly prevalent among primary care clients, especially women. Mental healthcare must be integrated into primary care in order to reduce the treatment gap for depression.