Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community

Abstract

Background: Depression in old age is an important public health problem causing considerable morbidity and disability worldwide. There is a dearth of community studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian community.Methods: We recruited 1000 participants aged over 65 years from Kaniyambadi block, Vellore, India. We assessed their socio-demographic profile, psychiatric morbidity, cognitive functioning, anthropometrics and disability status using the following structured assessment tools: Geriatric Mental State, Community Screening Instrument for Dementia, Modified CERAD 10 word list learning task, History and Aetiology Schedule Dementia Diagnosis and Subtype, WHO Disability Assessment Scale II, and Neuropsychiatric Inventory. We adopted a case control framework to study the factors associated with geriatric depression.Results: Prevalence of geriatric depression (ICD-10) within the previous one month was 12.7% (95% CI 10.64–14.76%). Low income (OR 1.78; 95% CI 1.08–2.91), experiencing hunger (OR 2.58; 95% CI 1.56–4.26), history of cardiac illnesses (OR 4.75; 95% CI 1.96–11.52), transient ischemic attack (OR 2.43; 95% CI 1.17–5.05), past head injury (OR 2.70; 95% CI 1.36–5.36) and diabetes (OR 2.33; 95% CI 1.15–4.72) increased the risk for geriatric depression after adjusting for other determinants using conditional logistic regression. Having more confidants (OR 0.13; 95% CI 0.06–0.26) was the significant protective factor. Age, female gender, cognitive impairment and disability status were not significantly associated with geriatric depression. DSM-IV diagnosis of major depression was significantly correlated with experiencing hunger, diabetes, transient ischemic attack, past head injury, more disability and less nourishment; having more friends was protective.Conclusions: Geriatric depression is prevalent in rural south India. Poverty and physical ill health are risk factors for depression among elderly while good social support is protective.

Is Mental Health a Burning Health Issue for Indian Elderly?

“…This finding is corroborative with the study conducted by Blazer et al [53]. Nevertheless, some other studies from Indian communities showed higher prevalence of depression with increasing age [26,27]. It is clearly demonstrated in the present study that rural and urban elderly differ significantly in the prevalence of depression.…”

“…A cross-sectional study in South India has revealed 21.7 percent of total elderly aged 60 years and above with depressive systems (36.0 percent were males and 64.0 percent were females) and prevalence of cognitive impairment was higher among the depressive individuals [25]. A study related to the nature, prevalence and factors associated with depression among rural South Indian community found poverty and physical ill health were the risk factors for the depression even when good social support was available [26]. Lower prevalence of depression was associated with higher standards of living, matriarchal family and a high female literacy rate and higher prevalence of depression was associated with unemployed, illiterate, housewife and widow in rural South India [27].…”

Physical activity and depressive symptoms in older adults

“…11,39 Age and chronic medical conditions were also significantly predictive of depressive symptoms in both bivariate and multivariate analyses, consistent with prior studies. 40,41 Some studies have indicated that the prevalence of depression declines from midlife to older adulthood. 27 This was partially supported in the current study, as the quadratic age trend indicated that the odds of moderate depressive symptoms declined somewhat from age 60 to 72 and only increased thereafter.…”

Proportion and Factors Associated with Depressive Symptoms among Elderly in an Urban Slum in Bangalore

“…12 With an absolute precision of 4.5 % and confidence level of 95 %, it was estimated that the minimum required sample size was 406 subjects. Allowing for a 20 % non-response, the minimum sample needed for the study was increased to 466 subjects.…”

“…8 Published studies reveal that prevalence of depression among elderly in developing countries ranges from 5.22 to 45.9 %. [9][10][11][12][13][14][15][16][17][18][19] Recent estimates indicate that, in India, depression results in loss of 961,000 disability adjusted life years (DALYs) per year among elderly. 20 As depression is potentially treatable condition, a significant reduction in DALYs is expected.…”