Using 2019 Brazilian National Health Survey data from 22,705 older adults, a latent comorbidity dimension built from five self-reported conditions was strongly and positively associated with depression, which was also more prevalent among women and those with higher income and less prevalent with advancing age.
Depression prevalence among Brazilian older adults in the 2019 National Health Survey was 11.8%.
Hypertension was the most frequent of the five self-reported comorbid conditions, at 56.4%.
A latent comorbidity dimension showed a strong positive association with depression.
Depression prevalence was higher among women than men.
Higher income was associated with higher depression prevalence.
Increasing age was inversely associated with depression among older adults.
The authors conclude that latent-dimension modeling gives an integrated view of chronic conditions and that comorbidity accumulation substantially affects mental health in this population.
This study used data from Brazil's 2019 National Health Survey, covering 22,705 people aged 60 and older, to examine how having several chronic conditions relates to depression. The researchers combined five self-reported conditions (high blood pressure, diabetes, high cholesterol, coronary artery disease, and stroke) into a single overall 'comorbidity' measure using a statistical technique called generalized structural equation modeling. About 11.8% of the older adults reported depression, and high blood pressure was the most common condition at 56.4%. The overall comorbidity measure was strongly linked to depression, with a reported prevalence ratio of 12.61. Women had nearly three times the prevalence of depression compared with men (ratio 2.82). Higher-income groups had slightly higher depression prevalence (ratios 1.11 to 1.16), and each additional year of age was associated with slightly lower depression prevalence (ratio 0.98). This research suggests that depression in older Brazilians is closely tied to the burden of chronic physical conditions, supporting the case for integrated, multi-professional care in the public health system. Because the study is a cross-sectional survey with self-reported conditions, it shows associations at one point in time and cannot show whether the conditions lead to depression or the reverse.
Muñoz F, da Cruz R, Silveira L, Diaz M. (2026). Latent dimension of comorbidities and depression in older adults: a cross-sectional study using National Health Survey data, Brazil, 2019.. Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil. https://doi.org/10.1590/S2237-96222026v35e20250722.pt