Factors associated with psychiatric disorders and treatment seeking behaviour among older adults in India

ObjectivesTo find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression.DesignA cross-sectional study was conducted using large representative survey data.Setting and participantsData for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017–2018. The effective sample size was 30 888 older adults aged 60 years and above.Primary and secondary outcome measuresThe outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff’s decomposition were used to fulfil the objectives of the study.ResultsThere was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was −0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults.ConclusionsFindings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.

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“…Marital status was coded as currently married, widowed and others. Others included respondents who separated/divorced/never married 52…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff’s decomposition analysis of data from the LASI baseline survey, 2017–2018

et al. 2022

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“…In the review of the included studies, educational intervention, gender, educational level, socioeconomic status, past medical histories, personal brief, mistrust of mental health providers, stigma, health status, alcohol consumption, utilization of family practice, and living with families were associated HSBs among older people living in rural areas [ 26 , 27 , 30 , 33 , 34 , 36 , 38 ]. Education was found to be essential for HSBs.…”

Section: Resultsmentioning

confidence: 99%

“…Being female was associated with low usage of professional care for symptoms of depression [ 27 ]. In addition, female patients had a lower probability of seeking treatment for other psychiatric disorders [ 36 ]. Lower educational level, monthly income, and the presence of one or more major medical conditions were associated with lower usage of professional care for the symptoms of depression [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Good health conditions and no recent alcohol consumption were both associated with self-treatment for symptoms [ 33 ]. Older adults with low socioeconomic status had a lower probability of seeking treatment for psychiatric disorders [ 36 ]. The most reported barrier to treatment for depression was the personal belief that “I should not need help”.…”

Section: Resultsmentioning

confidence: 99%

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Older People’s Help-Seeking Behaviors in Rural Contexts: A Systematic Review

Ohta¹,

Ryu²,

Sano

2022

IJERPH

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Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people’s health. However, no related comprehensive evidence exists so far. This study investigates the present condition of older people’s HSBs in rural contexts in aging societies. We conducted a systematic review by searching six databases (PubMed, Cochrane Library, EMBASE, Medline, and Web of Science) for original studies regarding HSBs of older people in rural contexts published until January 2022. Extracted articles were analyzed based on participants, settings, HSB causes and contents, and older people’s HSB outcomes in rural contexts. Sixteen studies were included in the systematic review: seven investigated the associations between HSBs and participants’ backgrounds, and three the quality of life. Six studies investigated HSB perception, diagnosis, clarifying HSB contents, professional care trend, self-rated health, and mortality. Unlike few studies investigating the association between HSBs and health-related outcomes, this systematic review explains the current evidence regarding rural older people’s HSBs. Due to insufficient evidence from longitudinal studies in clarifying interventions for effective HSBs, future studies should use observational and interventional designs.

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“…Age was recoded as young-old (60–69 years), old-old (70–79 years) and oldest-old (80+ years); living arrangement was recoded as living alone, living with spouse, living with children and living with others; marital status was recoded as currently married, widowed and others (others included divorced/ separated/ never married) [ 28 ]; work status was recoded as never worked, currently working, currently not working and retired [ 29 ]. Further, social participation was recoded as no and yes.…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017–18

Srivastava

Muhammad

2022

BMC Geriatr

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Introduction The Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India. Materials and methods The data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017–18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study. Results A proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively. Conclusions Adverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.

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Factors associated with psychiatric disorders and treatment seeking behaviour among older adults in India

Cited by 22 publications

References 58 publications

Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff’s decomposition analysis of data from the LASI baseline survey, 2017–2018

Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff’s decomposition analysis of data from the LASI baseline survey, 2017–2018

Older People’s Help-Seeking Behaviors in Rural Contexts: A Systematic Review

Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017–18

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