Sociodemographic factors associated with depressive symptoms and self-care agency capacity in hypertensive older adults from Loja, Ecuador: a cross-sectional study

Abstract

Background Hypertension is one of the leading chronic diseases affecting older adults and is frequently associated with depressive symptoms and difficulties in self-care. Sociodemographic conditions may influence both mental health and self-care behaviors; however, evidence in older hypertensive populations from Ecuador remains limited. Therefore, this study aimed to analyze the association between sociodemographic factors, depressive symptoms, and self-care agency capacity among older adults with hypertension living in Loja, Ecuador. Methods A cross-sectional study was conducted among 222 older adults diagnosed with hypertension residing in urban, rural, and urban-marginal areas of Loja, Ecuador. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II), while self-care agency capacity was evaluated using the Self-Care Agency Capacity Scale for Patients with Hypertension. Descriptive analyses, Spearman correlation, bivariate analyses, and multiple linear regression models were performed, adjusted for sociodemographic variables. Results Most participants showed high self-care agency capacity (69.4%), whereas 84.2% presented minimal depressive symptoms. After adjustment, place of residence remained independently associated with self-care agency capacity, with participants living in urban-marginal areas showing higher self-care agency capacity scores than those residing in rural areas. Depressive symptoms were significantly associated with sex, age and place of residence. No statistically significant correlation was observed between depressive symptoms and self-care agency capacity (rho = 0.111; p = 0.100). Conclusion Sociodemographic factors were associated with both depressive symptoms and self-care agency capacity among older adults with hypertension. These findings highlight the importance of considering social determinants and mental health conditions in the comprehensive management of chronic diseases in older populations.