The effect of polluting cooking fuels on depression among older adults in six low- and middle-income countries

Little is known about the association between polluting cooking fuel and depression among older adults living in low- and middle-income countries (LMICs).To evaluate the association between polluting cooking fuel and depression in older population of LMICs.We derived data from WHO Study on global AGEing and adult health (SAGE), which was conducted in six LMICs including China, India, Ghana, South Africa, Mexico and Russia. We applied logistic regression with the propensity score method to examine the relationship of polluting cooking fuel and depression among adults ≥50 years old.Overall, the odds ratio (OR) of depression was 1.57 [95% confidence intervals (CIs), 1.26-1.93] for older adults relying on polluting cooking fuel in six LMICs. In India and China, polluting cooking fuel was associated with depression with ORs of 2.06 (95%CI, 1.44-2.94) and 1.59 (95%CI, 1.01-2.49), respectively. Positive OR of depression was identified for those polluting cooking fuel users aged over 65 years old (OR, 1.65; 95%CI,1.16-2.36) and those aged 50-65 (OR, 1.50; 95%CI,1.14-1.97). Polluting cooking fuel was associated with depression for females (OR, 1.80; 95%CI, 1.32-2.46), however we did not observe significant association for males. Positive effect of polluting cooking fuel was identified in both rural (OR, 1.72; 95%CI, 1.26-2.34) and urban areas (OR, 1.44; 95%CI, 1.07-1.95). For individuals relying on solid fuel, cooking in a room used for living/sleeping and using open stove/fire was associated with depression with ORs of 1.30 (95%CI, 1.14-1.48) and 1.15 (95%CI, 1.01-1.31), respectively. However, no significant effect was identified for hood.Polluting cooking fuel was related to depressive symptoms among older adults in LMICs. In addition, cooking ventilation could be useful intervention to control health hazard of solid fuel.