Prevalence of depression in elderly and relations to chronic diseases
Abstract
Background/Aim. Depression is the most prevalent mental disorder which affects approximately 7% of the world’s older population. This study aimed at examining the prevalence of depression among older adults and its relations to chronic illnesses. Methods. Study was conducted within the National Health Survey of the Serbian population in 2013. The questionnaires used as instruments in this study were created in accordance with the questionnaires of the European Health Interview Survey – Second Wave. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms. The relations between depression symptoms (a dependent variable) and a set of independent variables were examined with univariate and multivariate logistic regression analyses. Results. The study showed that there was a 10.0% prevalence of depression within this population with statistically significant differences between the genders – 12.6% of women and 6.5% of men. The multivariate analysis revealed that multimorbidity [odds ratio (OR) = 1.89], chronic pain (OR = 2.35) and self-evaluations of poor health (OR = 8.37) were strongly associated to depression. In terms of individual chronic illnesses, the study showed that strokes double the odds of developing depression (OR = 1.82) while the deformities of lower spine increased this odds by 27%. Conclusion. Depression is very frequent in older persons who suffer from chronic diseases and medical conditions. It is crucial to enable adequate screening in primary healthcare institutions in order to diagnose depression in its early stages and start its treatment as soon as possible.
References
Mohebbi M, Agustini B, Woods RL, McNeil JJ, Nelson MR, Shah RC, et al. Prevalence of depressive symptoms and its associat-ed factors among healthy community-dwelling older adults liv-ing in Australia and the United States. Int J Geriatr Psychiatry 2019; 34(8): 1208‒16.
El-Gilany AH, Elkhawaga GO, Sarraf BB. Depression and its associated factors among the elderly: A community-based study in Egypt. Arch Gerontol Geriatr 2018; 77: 103‒7.
Dao ATM, Nguyen VT, Nguyen HV, Nguyen LTK. Factors As-sociated with Depression among the Elderly Living in Urban Vietnam. Biomed Res Int 2018; 2018: 2370284.
WHO. Mental health of older adults. 2017 December [cited 2019 Jun 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
Pruchno RA, Wilson-Genderson M, Heid AR. Multiple Chronic Condition Combinations and Depression in Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 2016; 71(7): 910‒5.
Wright PP, Thorpe CW. Triple Threat among the Elderly: De-pression, Suicide Risk, and Handguns. J Emerg Nurs 2016; 42(1): 14‒8.
Aly HY, Hamed AF, Mohammed NA. Depression among the elderly population in Sohag governorate. Saudi Med J 2018; 39(2): 185‒90.
Alamri SH, Bari AI, Ali AT. Depression and associated fac-tors in the hospitalized elderly: a cross-sectional study in a Saudi teaching hospital. Ann Saudi Med 2017; 37(2): 122‒9.
Li N, Chen G, Zeng P, Pang J, Gong H, Han Y, et al. Prevalence of depression and its associated factors among Chinese elderly people: A comparison study between community-based popu-lation and hospitalized population. Psychiatry Res 2016; 243: 87‒91.
Ni Y, Tein JY, Zhang M, Yang Y, Wu G. Changes in depression among older adults in China: A latent transition analysis. J Af-fect Disord 2017; 209: 3‒9.
Alexopoulos SG. Depression in the elderly. Lancet 2005; 365(9475): 1961–70.
Buvneshkumar M, John KR, Logaraj M. A study on prevalence of depression and associated risk factors among the elderly in a rural block of Tamil Nadu. Indian J Public Health 2018; 62(2): 89‒94.
Laksham KB, Selvaraj R, Kameshvell C. Depression and its de-terminants among the elderly in selected villages of Puducher-ry - A community-based cross-sectional study. J Family Med Prim Care 2019; 8(1): 141‒4.
Patra P, Alikari V, Fradelos EC, Sachlas A, Kourakos M, Rojas Gil AP, et al. Assessment of Depression in Elderly. Is Per-ceived Social Support Related? A Nursing Home Study: De-pression and Social Support in Elderly. Adv Exp Med Biol 2017; 987: 139‒50.
Behera P, Sharan P, Mishra AK, Nongkynrih B, Kant S, Gupta SK. Prevalence and determinants of depression among elderly per-sons in a rural community from northern India. Natl Med J India 2016; 29(3): 129‒35.
Zhang H, Gao T, Gao J, Kong Y, Hu Y, Wang R, Mei S. A com-parative study of negative life events and depressive symptoms among healthy older adults and older adults with chronic dis-ease. Int J Soc Psychiatry 2017; 63(8): 699‒707.
Han J. Chronic Illnesses and Depressive Symptoms among Older People: Functional Limitations as a Mediator and Self-Perceptions of Aging as a Moderator. J Aging Health 2018; 30(8): 1188‒204.
Jani BD, Purves D, Barry S, Cavanagh J, McLean G, Mair FS. Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: a cross sectional study. PLoS One 2013; 8(9): e74610.
Ahn S, Kim S, Zhang H. Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support. Int J Environ Res Public Health 2017; 14(1): pii: E16.
Kroenke K, Strine TW, Spritzer RL, Williams JB, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009; 114(1‒3): 163‒73.
Rangaswamy SM. World Health Report: Mental health: New Understanding New Hope. Geneva, Switzerland: The World Health Organization; 2001.
Barua A, Ghosh M.K, Kar N, Basilio MA. Prevalence of depres-sive disorders in the elderly. Ann Saudi Med 2011; 31(6): 620–4.
Li D, Zhang DJ, Shao JJ, Qi XD, Tian L. A meta-analysis of the prevalence of depressive symptoms in Chinese older adults. Arch Gerontol Geriatr 2014; 58(1): 1–9.
Nogueira EL, Rubin LL, Giacobbo Sde S, Gomes I, Cataldo Neto A. Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil. Rev Saude Pub-lica 2014; 48(3): 368‒77.
Cahoon CG. Depression in Older Adults. Am J Nurs 2012; 112(11): 22–30.
Pirkis J, Pfaff J, Williamson M, Tyson O, Stocks N, Goldney R, et al. The community prevalence of depression in older Australi-ans. J Affect Disord 2009; 115(1‒2): 54‒61.
Baiyewu O, Yusuf AJ, Ogundele A. Depression in elderly people living in rural Nigeria and its association with perceived health, poverty, and social network. Int Psychogeriatr 2015; 27(12): 2009‒15.
He G, Xie JF, Zhou JD, Zhong ZQ, Qin CX, Ding SQ. Depres-sion in left-behind elderly in rural China: Prevalence and asso-ciated factors. Geriatr Gerontol Int 2016; 16(5): 638-43.
Sendra-Gutiérrez JM, Asensio-Moreno I, Vargas-Aragón ML. Characteristics and factors associated with depression in the elderly in Spain from a gender perspective. Actas Esp Psiquiatr 2017; 45(5): 185‒200.
National Collaborating Centre for Mental Health. Depression in adults with a chronic physical health problem. Treatment and management. NICE Clinical Guidelines, No. 91. Leicester: British Psychological Society; 2010.
Gunn JM, Ayton DR, Densley K, Pallant JF, Chondros P, Herrman HE, et al. The association between chronic illness, multimor-bidity and depressive symptoms in an Australian primary care cohort. Soc Psychiatry Psychiatr Epidemiol. 2012; 47(2): 175‒84.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007; 370(9590): 851‒8.
Comijs HC, Nieuwesteeg J, Kok R, van Marwijk HW, van der Mast RC, Naarding P, et al. The two-year course of late-life depres-sion; results from the Netherlands study of depression in older persons. BMC Psychiatry 2015; 15:20.
Hegeman JM, van Fenema EM, Comijs HC, Kok RM, van der Mast RC, de Waal MWM. Effect of chronic somatic diseases on the course of late-life depression. Int J Geriatr Psychiatry. 2017; 32(7): 779‒87.
Egede LE. Major depression in individuals with chronic medi-cal disorders. Prevalence, and correlates and association of health resource utilization, lost productivity and functional disability. Gen Hosp Psychiatry 2007; 29(5): 409‒16.
Jani BD, Purves D, Barry S, Cavanagh J, McLean G, Mair FS. Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: a cross sectional study. PLoS One 2013; 8(9): e74610.
Fan H, Yu W, Zhang Q, Cao H, Li J, Wang J, et al. Depression after heart failure and risk of cardiovascular and all cause mor-tality: a meta-analysis. Prev Med 2014; 63: 36‒42.
Ozaki Y, Sposito AP, Bueno DR, Guariento ME. Depression and chronic diseases in the elderly. Rev Soc Bras Clin Med 2015; 13(2): 149‒53.
Romanelli J, Fauerbach J, Buch D, Ziegelstein R. The significance of depression in older patients after myocardial infarction. J Am Geriatr Soc 2002; 50(5): 817–22.
Jiang W. Depression and Cardiovascular Disorders in the El-derly. Psychiatr Clin North Am 2018; 41(1): 29‒37.