Objectives: Despite recent demographic shifts, little is known about the association between race/ethnicity, language barriers, and mental health among US nursing home residents. We aimed to quantify the relationship between Spanish language barriers and depression in US nursing homes.

Design: Cross-sectional study.

Setting and participants: Latino and non-Latino White adults aged ≥50 years newly admitted to US nursing homes.

Methods: Using national 2022 Minimum Data Set 3.0, we identified 19,780 Latino newly admitted residents who wanted or needed a Spanish interpreter to communicate with a physician or health care staff, and residents without need for interpreter (n = 56,969 Latino residents, 812,456 non-Latino White residents). A clinical depression diagnosis and self-reported Patient Health Questionnaire (PHQ-9) scores ≥10 for moderate/severe depressive symptoms were evaluated using multivariable log binomial models.

Results: Our sample was mostly female, and ≥75 years. Depression prevalence was 29.5% and 31.5% for Spanish and English-speaking Latino residents, respectively, and 36.0% for English-speaking non-Latino White residents; moderate/severe depressive symptoms were reported in 17.5% and 15.9% for Spanish and English-speaking Latino residents, respectively, and 15.6% for English-speaking non-Latino White residents. Antidepressant use was common (lowest: 32.2% Spanish-speaking, Latino residents; highest: 43.2% non-Latino White residents); psychotherapy was received by <2%, in all language groups. Compared with English-speaking non-Latino White residents, the prevalence of clinically diagnosed depression was lower among Latino residents [Latino residents adjusted prevalence ratio (aPR), 0.93; 95% CI, 0.92-0.95], and among Latino residents, lower among those who spoke Spanish than English (aPR, 0.95; 95% CI, 0.93-0.98), with similar patterns for moderate/severe depressive symptoms [aPR (Latino residents vs non-Latino White residents), 0.93; 95% CI, 0.91-0.95; aPR (Spanish-speaking vs English-speaking Latino residents), 0.95; 95% CI, 0.91-0.99].

Conclusions and implications: Latino residents newly admitted to nursing homes appear to have less clinically diagnosed depression and are less likely to report moderate/severe depression. Language barriers in nursing homes should be addressed to help meet the needs of residents from ethnic minority populations.