Household debt and depressive symptoms among older adults in three continental European countries

In this comparative study focusing on the population aged 50 and over in three European countries, we investigate the association between household debt and depressive symptoms, and possible country differences in this association, using data from waves 1, 2, 4, 5 and 6 of the Surveys of Health, Ageing and Retirement in Europe (SHARE) for Belgium, France and Germany. Multilevel regression models with random intercepts for individuals were used to analyse the association between household debt status and number of depressive symptoms (EURO-D score). Country differences in the household debt-depression nexus were tested using country interaction models. After controlling for other measures of socioeconomic position and physical health, low or substantial financial debt was associated with a higher number of depressive symptoms in all countries. Housing debt was strongly linked to depressive symptoms for women while the association was weaker for men. The only country difference was that for both sexes substantial financial debt (more than 5,000€) was strongly associated with depressive symptoms in Belgium and Germany, but the association was weak or non-significant in France. Associations between financial debt and depression were also evident in analyses of within individual changes in depressive symptoms for a longitudinal subgroup, and in analyses using a dichotomised, rather than a continuous, measure of depression. The findings indicate that measures of household indebtedness should be taken into consideration in investigations of social inequalities in depression and suggest a need for mental health services targeted at indebted older people.