Later-life mental health in Europe: a country-level comparison

J Gerontol B Psychol Sci Soc Sci. 2009 Sep;64(5):666-76. doi: 10.1093/geronb/gbp026. Epub 2009 May 4.


Objectives: To investigate the influence of country of residence on depression and well-being among older Europeans, after establishing the between-country measurement invariance of both constructs.

Methods: We used data from a cross-sectional nationally representative population-based sample of older Europeans, the Survey of Health, Ageing, and Retirement in Europe (SHARE). The analysis sample comprised 13,498 older Europeans from nine countries. The EURO-D was used to measure depression, and a well-being outcome was derived from self-report items available in SHARE. The between-country measurement invariance of both mental health outcomes was established using modern psychometric modeling techniques.

Results: After adjustment for demographic characteristics and the presence of chronic illness, Spain was the country scoring highest on depression and Denmark highest on well-being. Optimal mental health was associated with higher educational attainment and being married.

Discussion: There is considerable between-country heterogeneity in later-life mental health in Europe. The Scandinavian countries, the Netherlands, and Austria, do best (low depression/high well-being), followed by Germany and France, whereas residents of Spain, Italy, and Greece report the worst mental health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Chronic Disease / epidemiology
  • Chronic Disease / psychology
  • Comorbidity
  • Cross-Cultural Comparison*
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Europe
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Marital Status
  • Middle Aged
  • Models, Statistical
  • Multivariate Analysis
  • Quality of Life / psychology*