This quantitative epidemiological study aimed to analyze the prevalence of major depression in 237 older adults aged 60 to 104 years living in long-term care facilities in a large city in the state of Ceará, Northeastern Brazil. A sociodemographic questionnaire (age, gender, education, duration of institutionalization) was administered and the DSM-IV-TR was used as a reference for the clinical assessment of major depression. The Katz scale was used to classify dependence in activities of daily living and the Pfeffer scale was used to classify dependence in instrumental activities of daily living. The Mini Mental State Examination and the Category Fluency Test were used to assess cognitive function. Data underwent descriptive and analytical statistics with a significance level of 5%. The participants' mean age was 75.3 ± 8.6 years. Of these, 82 older adults (34.6%) presented a diagnosis of major depression. Major depression was significantly associated family visits (p = 0.036). The prevalence of major depression in institutionalized older adults is high. The assessment of the prevalence of major depression should be carried out based on internationally accepted clinical criteria rather than on depressive symptoms screening tests since the diagnosis itself is what will determine the non-drug or drug therapy.

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