ABSTRACT
Background: The increase in worldwide life expectancy among the elderly is contributing to an increase in cognitive impairment (CI). A more complicated etiology makes CI an essential clinical concern for elderly patients with depression. Ageing populations as a result of demographic change have accelerated the development of certain geriatric conditions, including CI and depression. Aims and Objectives: The objective was to identify the prevalence and contributing factors of CI and depression in the elderly rural community. Materials and Methods: A descriptive, cross-sectional, and community-based study was conducted in rural field practice area of Medical College, Kolkata, among 133 geriatric people during time period of March–June, 2022. The prevalence of CI was measured using the Mini-Mental State Examination (MMSE) scale and depression was assessed using the geriatric depression scale. Data were analyzed in SPSS software version 16. Results: Mean age of the participants was 65.68 (±6.03) years. The prevalence of CI was 86.5%, with a mean MMSE score of 19.27 ± 4.34, and the depression was 77.5% and 7.07 ± 3.39. Conclusion: Almost two-third of the geriatric population is suffering from depression and CI. To handle the issue of CI, depression, and its resulting effects, new and modified geriatric health policies are very much needed.
ABSTRACT
ABSTRACT BACKGROUND: Diabetes mellitus is a chronic disease with long-term consequences that is often associated with depressive symptoms. This relationship predicts increased morbidity and mortality rates, leading to serious health consequences. OBJECTIVE: To identify the prevalence and health factors associated with depressive symptoms among older adults with diabetes mellitus. DESIGN AND SETTING: An observational cross-sectional study was conducted among 236 older adults in the Basic Healthcare Units of Jequié, Brazil. METHODS: A survey containing sociodemographic, behavioral, and health conditions was used as a data collection instrument, in addition to the Geriatric Depression Scale. The main inclusion criterion was older adults diagnosed with diabetes mellitus. To identify the risk factors associated with depressive symptoms among older adults with diabetes mellitus, logistic regression analysis was conducted for calculating the odds ratio (OR), and a 95% confidence interval (CI) was considered statistically significant. RESULTS: The prevalence of depressive symptoms was 24.2% among older adults with diabetes, corroborating the Brazilian average of 30%. The final multivariate analysis model for the risk of depressive symptoms showed a significant association with diabetes complications [OR = 2.50, 95% CI 1.318-4.74)] and osteoporosis [OR = 2.75, 95% CI 1.285-5.891)]. CONCLUSION: A high prevalence of depressive symptoms was observed among older adults with diabetes. Critically examining older adults with diabetes mellitus is necessary, and screening for depressive symptoms is highly recommended, especially for those with complications resulting from diabetes mellitus and musculoskeletal comorbidities, such as osteoporosis, as it seems to be associated with depressive symptoms.
ABSTRACT
Introduction: Depression in elderly population is a serious public health concern but is often undetected and ignored as a medical problem, leading to poor quality of life. Aim and Objectives: The objectives of this study were to estimate the prevalence and degree of depression among the elderly population using a Geriatric Depression Scale (GDS?15) Short Form and to study some correlates associated with depression in them. Materials and Methods: A community-based cross-sectional study was conducted with a sample size of 100 elderly subjects using systematic random sampling technique. After getting informed consent, information was collected using GDS?15 Marathi version. Results: Of 100 respondents interviewed, 52 were 70 years and above and 54 were male. The prevalence of depression among the elderly was 84.0%. Sixteen (8 males and 8 females) were suffering from severe depression. Age, sex, death of spouse, education, occupation, and morbidity status were found to be significantly associated with depression. Conclusions: The prevalence of depression among the urban elderly was very high. By identifying risk factors for depression among the elderly population and screening them on time, we can go a long way in adding life to their years instead of years to life of the elderly.
ABSTRACT
Geriatric Depression (GD) prevalence rate is on the rise as is the geriatric population in India. It can be correlated to Kaphaja Unmada in Ayurveda based on its causes and symptoms. GD patients have symptoms like Mandavakchesta (slowing of speech and actions), Tushnibhava (depressed look), Anaannabhilasha (disinclination for food). GD has several causative factors like decreased physical agility, cognitive decline, lack of financial liberty, social isolation, long standing diseases and medicines etc. Following the surge of industrialization, urbanization like western countries after 1980s, the family systems and values in India have changed. Nuclear families are on rise and elderlies in families are considered as burden. Contrastingly, earlier elderlies were regarded as source of wisdom and guidance. This study is an attempt to go through all the possible literature offline and online to find out the causes and solutions of GD in India. Findings showed that along with the common causative factors related to the old age in elderlies, ignorance from younger family members is also equally important. GD is a psychosomatic disease, so treatments approach involving the body, mind, family dynamics and values using family psychotherapies and psychoeducation, Medhya rasayana and if needed modern psychiatric medication can address all types of GD and related mental health problems in India.
ABSTRACT
Background: The world's elderly population is increasing rapidly. According to the 2011 census elderly population contributes to 7.4% of the total population. Both physical and mental disorders are prevalent among the elderly. Symptoms of depression in older people are often overlooked and untreated. Depression leads to loss of appetite, diminution of food intake, and weight loss consequently leading to malnutrition. Methodology: A community-based cross-sectional study was conducted among the geriatric population of urban field practice area using a predesigned, semi-structured questionnaire. Geriatric Depression was assessed using Geriatric Depression Scale and Nutritional Status using the Mini Nutritional Assessment Scale. House to house survey of the Geriatric population was conducted after obtaining written consent. Results: Out of 260 participants, 51.5% of the population were males, 49.2% of the population belonged to 60-69 years age group and 16.9% of them were more than 80 years of age. The prevalence of geriatric depression was 68.5 %,). The majority (64%) of the elderly population were at risk of malnutrition. Depression scores were negatively correlated with nutritional scores. Conclusion: The prevalence of depression and malnutrition was considerably high among the elderly population. Malnutrition among the elderly is a significant determinant of malnutrition.
ABSTRACT
Geriatric mental health issues have yet to receive their due recognition in India. Geriatric mental health is plagued by many challenges that prevent the development and progress of its services. The present article is a narrative review that looks at the various challenges faced by geriatric mental health in India. The article describes different specific and general unique challenges faced by geriatric mental health and discusses in detail the nature of each challenge and what must be done to overcome it. The challenges range from demography of Indian aging to sexual issues in the elderly, geriatric depression, dementia care, and the aging lesbian, gay, bisexual, cross-dressers and transgender community. Old age people face special physical and mental health challenges in routine life which are necessary to be recognized and rehabilitate. Mental health problems are often under identified or overlooked by themselves, health‑care professionals and even by family members of older people, and the stigma related to mental illness makes people reluctant to seek help. The prevalence of co-morbid condition of illnesses is a powerful demonstration of the link between physical and mental illnesses. Various issues related to policy and research that challenge geriatric mental health are also discussed in this article. The need to incorporate geriatric mental health into primary health care along with the need to train primary care workers and preventive work aimed at suicide prevention in the elderly is stressed. The article addresses these challenges with the aim of positing before the clinician the various challenges faced by geriatric mental health in India in the current era.
ABSTRACT
Background: Depression at any age needs attention. Geriatric population being most vulnerable, are more prone to many morbidities, physically and mentally. Geriatric depression is one among them which needs prompt attention. The objectives of the present study were to estimate the prevalence of geriatric depression and association of depression with various sociodemographic factors.Methods: A cross sectional study carried out among 300 geriatric subjects. A structured interview schedule was used to collect data.Results: The prevalence of depression was found to be 44.4%. Female gender, marital status, family type was found to be positively associated with depression.Conclusions: Geriatric depression in our study is found to be on little higher side. Lifestyle modifications and support from family members are needed to improve the quality of life of these people.
ABSTRACT
The population increase of the elderly in Chile, as well as worldwide, has caused the appea-rance of phenomena specific to older adulthood, including Geriatric Depression. The aim of this review is to describe the main concepts and risk factors of Geriatric Depression. This review is structured in three main sections: "Older adulthood", "Geriatric Depression", and "Factors associated with Geriatric Depression", the latter is subdivided into "Psychosocial Components" and "Physical Components". Finally, in the discussion it is highlighted that for future investigations, as well as for professionals, it is key to include an approach to older adulthood as a complex evolutionary cycle that is in a constant relationship with its social context.
Subject(s)
Humans , Aging/psychology , Depression/epidemiology , Chile , Population Dynamics , Risk FactorsABSTRACT
With changing socioeconomic, demographic, and development scenario, there is a cultural shift in looking after the elderly population which may lead to depression in this age group. Materials and Methods: The study was a hospital-based cross-sectional study conducted in the orthopedic department of a tertiary care setting on 157 elderly individuals. This study was conducted with objectives to estimate the proportion of depression using the Geriatric Depression Scale Short Form (GDS-SF) questionnaire along with its associated factors in geriatric population coming to the orthopedic department of the institute. The study tools were GDS-SF, Katz Index of Independence in activities of daily living (ADL), the Lawton instrumental ADL, and health-related quality of life by the Centers for Disease Control. Results: The proportion of depressed individuals was 70/157 (44.6%) using GDS as a tool. The maximum number was in the age group of 60–74 years. Women outnumbered men (51.3% vs. 38.31%) for depression. The depression using GDS score was more prevalent in rural elderly, illiterate, and elderly who were economically dependent on their children and who belonged to lower middle socioeconomic status. Approximately 98% of the study participants were found to be independent using ADL. Approximately 60% males and 68% females were dependent for the instrumental ADL using Lawton score. Most of the study participants had arthritis as a major impairment sharing almost equal proportion among males and females. Conclusion: The current study concludes that there is a very high proportion of elderly subjects who are experiencing depression using the GDS-SF tool. There should be regular screening for this disease in this age group even in a tertiary care setting.
ABSTRACT
Background: Depression is the leading cause of disease burden ranked as third worldwide and also common among elderly people. The study was conducted to find out the prevalence of depression and its correlates among geriatric slum dwellers.Methods: This community based cross-sectional, an observational analytical epidemiological study was conducted from January 2018 to April 2018 among geriatric people residing in the urban slums of Bankura town. Out of 295 slums, 30 slums were selected by cluster sampling method. From each cluster 7 geriatric people were selected by systematic random sampling method and data were collected by interview method using interviewer-administered both close and open-ended, the predesigned pretested questionnaire which included 15 items Geriatric depression scale short form (GDS-SF). To reveal the ultimate predictor variables, bivariate analysis and followed by logistic regression was done.Results: Out of 210 people 59.1% was suffering from depression. In multiple logistic regression, we found that people who were suffering from chronic illness were 10.3 times more depressed. Married people were 6 times more depressed than others and 60 to 69 years people were found 4.4 times more depressed than elder geriatrics. People who belonged to poor socio-economic status (IV+V), were found as 2.7 times more depressed. Decision maker within the family was observed more depressed 1.8 times than others.Conclusions: Chronic illness, economic insecurity due to lower socio-economic status, over-thinking of marital people for their spouse’s security and health and newer identity as ‘senior citizen’ attributed to depression among geriatrics people.
ABSTRACT
Background: Depression in old age is an emerging public health problem leading to morbidity and disabling effect on the quality of life. Depression in elderly is not yet perceived as a public health problem and is grossly underdiagnosed and undertreated. The physical and social environment plays an important role on the mental health of the elderly. Hence the present study was undertaken to assess and compare the depression among elderly residing in old age homes (OAHs) and community. The objective of the study was to assess and compare depression among elderly residing in OAHs and those living in community.Methods: A cross sectional study was done from October to December, 2016 among 100 elderly, of which 50 were inmates of old age homes and 50 were living in community selected by house to house survey. A pre tested, externally validated short form geriatric depression scale (GDS-15) in the local language is used after taking informed consent.Results: Prevalence of depression was high among inmates of old age homes (80%) compared to those of community (52%), this difference was statistically significant (p=0.003). On analyzing the association between sociodemographic factors and depression among the elderly residing in the community, it was found that marital status and presence of chronic disease were significantly associated with depression (p<0.05). Whereas among the elderly residing in old age homes, no significant asociation was found between depression and the sociodemographic factors.Conclusions: High prevalence of depression observed among the studied population indicates the need of screening for depression among elderly.
ABSTRACT
Background: In elderly mental disorders are overlooked or underdiagnosed. Almost 20% of elderly above 60 years of age suffer from a mental or neurological disorder, and the most common ones are dementia and depression. Studies have pointed out the increased prevalence of depression in old‑age homes. Objectives: The objectives are as follows: (1) To estimate and compare the prevalence of geriatric depression among people living in public and private old‑age homes and (2) to study the factors associated with depression and compare the facilities in public and private old‑age homes. Materials and Methods: A cross‑sectional questionnaire‑based study was conducted among geriatric population in old‑age homes of Mysore. Depression was assessed using the short form of geriatric depression scale‑15, cognitive impairment using Mini‑Mental State Examination‑30. Data relating to sociodemographic variables and facility assessment were collected separately. Results: The overall prevalence of depression in old‑age homes of Mysore was 33.3% (46.3% in public and 21.6% in private old‑age homes with P = 0.002). The facilities offered and reason for stay also varied significantly across both homes. Marital status, education, economical dependency, and uncorrected impairment were the factors associated with depression. Among the psychosocial factors, feeling of loneliness, and neglect were significant predictors in both settings. Other psychosocial factors such as feeling satisfied by the status of their children’s life, advice taken by their children, financial and personal losses in the past 1 year, and presence in social events were significant predictors only in private old‑age home. Conclusion: Prevalence of depression in the old‑age homes differs significantly with the type of home, the facilities offered, and the reason cited by the inmates for admission probably is the contributing factor for the variation in depression.
ABSTRACT
Background: Depression among elderly has been a neglected health issue. Various factors hinder its early diagnosis. The objectives of this study are to screen for depression among elderly using geriatric depression scale-15 and to determine its influencing factors.Methods: A community based cross sectional study on geriatric depression was done in villages catered by a primary health centre in Puducherry. Permanent residents of the study setting, aged ≥60 years consenting for the study were included. Line listing of elderly individuals in the study setting was done and subjects were selected by simple random sampling. A pretested structured questionnaire was used to collect socio-demographic and clinic-psychological variables. Hindi mental state examination scale was used to screen for cognitive impairment (score <23). Geriatric Depression Scale (GDS-15) was used to screen for depression (score >5) among geriatric individuals. Appropriate statistical tests of significance were done.Results: Among the 360 elderly individuals screened using GDS-15 tool, 41.4% of them were found to be at a higher risk of developing depression. Significant factors for risk of depression in univariate analysis include being female, illiterate, unemployed, widow/single, having sleep problems, dependency in activities of daily living and cognitive impairment. Predictors for risk of depression evident by multivariate analysis include presence of unemployment, sleep problems and cognitive impairment.Conclusions: A higher proportion of elderly was observed to be at risk of depression. Primary care physicians may consider screening for depression in elderly with identified risk factors and act accordingly.
ABSTRACT
Objective:To investigate the relationship between the depressive symptoms and blood biochemical indexes in elderly inpatients.Methods:Totally 201 inpatients without depression were enrolled in this study.Blood tests and the Geriatric Depression Scale-5 (GDS-15) were performed on all of the patients.The patients were divided into non-depressive symptoms group and depressive symptoms group according to GDS-15 score.Differences between two groups were compared, and multiple linear regression analysis was used to screen for risk factors by SPSS 22.0.Results:Serum total protein (TP) [ (60.7±4.3) vs. (63.5±5.6) g/L] and hemoglobin [ (121.6±20.1) vs. (129.7±19.4) g/L] were lower in the depressive symptoms group than in the non-depressive symptoms group (Ps<0.05).There were no differences between the two groups in age, BMI, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol (Ps>0.05).Multiple linear regression analysis showed that TP was the predictive variable for GDS-15 score (β=-0.4, P<0.05).Conclusion:Serum total protein and hemoglobin levels in patients with depressive symptoms may be significant lower than those in patients without depressive symptom.There is association between serum total protein and depressive symptoms.
ABSTRACT
Background: Retirement makes an impact on the psychological health of elders. Geriatric depression is common among elders and it is a major public health challenge in India. Aims & Objectives: To assess the level of Geriatric depression and its relationship with socio demographic factors. Materials and Methods: 5 retired associations out of 36 associations located in Madurai district were selected by simple random sampling which has the total members of 1934.As the stratum varies in each association, 64 respondents are selected from each association irrespective of the number of samples by adopting stratified disproportionate sampling method on the basis of the Krejice and Morgan (1970) sample table. Socio demographic details were collected with questionnaire and Geriatric depression was assessed with Geriatric Depression rating scale. Results: 28.1 per cent have medium level and 9.1 per cent have high level of Geriatric depression. Female has high level of geriatric depression when compared to male. Conclusion: Socio demographic factors of retired elders have a major impact on Geriatric depression and it has to be dealt as public health issue.
ABSTRACT
On account of improved life expectancy, better education and health facilities in India, the proportion of the geriatric population has gone up. In India, prevalence of depression estimated to be 4.5% in the year 2015, which affects about 57 million people. Objective: To determine the prevalence of depression and its epidemiological correlates among geriatric people residing in southern Haryana, India. Material and Methods: This community based study with cross-sectional design was conducted in rural and urban field practice areas of department of Community Medicine. Geriatric people were contacted by investigators through house to house visit. Study subjects were screened for depression by using standard shorter version Geriatric Depression Scale (GDS-15). Pearson’s Chi-square test was used for categorical variables. Stepwise multiple logistic regression was used to find out an independent factors associated with depression. Result: A total of 308 elderly persons belonging to rural and urban areas participated in our study. Prevalence of depression (GDS score >5) among the elderly population in the present study was found to be 22.72% (95% CI: 18.2-27.8). Conclusion: Present study depicted that every fourth elderly person was suffering with depression. Nuclear family, sleep problems, not consulting elderly in decisions, chronic morbidity, lack of physical activities, and death of close relatives were identified as risk factors of depression.
ABSTRACT
The adult population is booming at an alarming rate leading to the most difficult challenges faced by both developing and developed nations. The rapid changes in social and cultural values have marked influence on the psychological well being of the elderly. Depression among the elderly remains unrecognized or inadequately treated condition. The goal of this study was to determine the magnitude of depression in elderly people living in central India. MATERIALS AND METHOD- 200 elderly individuals of 60 years of age or more reporting to the institute who gave consent for the study were screened. While those individuals who refused to provide consent were excluded. Demographic details were recorded, and level of depression was assessed using Geriatric depression scale (Sheikh & Yesavage, 1986.) RESULT: The data was analysed and the results were recorded. The Chi-square test was used for categorical variables. In this study, severe depression was found in 30% elderly while 50% were mildly depressed. Also, Women were more depressed as compared to men. CONCLUSION- The high prevalence of depression among elderly especially females emphasize increased need of family and community support and availability of better health care services. The small sample size of this study is limitation, so large-scale studies are needed for a better picture of mental health in rural older adults in India.
ABSTRACT
Background: With increasing life expectancy people are living longer but they are not necessarily healthier than before. Nearly a quarter (23%) of the overall global burden of death and illness is in people aged over 60, and much of this burden is attributable to long-term illness like non-communicable diseases and mental health problems. Aims & Objectives: Aim of the study the magnitude of depression among elderly population of Agra. Objectives To estimate the prevalence of depression in elderly population of Agra. 2. To study the factors associated with depression among elderly population of Agra. Material and Methods: This study was conducted among 355 elderly in urban Agra. Data was collected by house to house visit using pre-designed and pre-tested schedule. Geriatric depression scale (GDS-30) was used to assess the burden of depression in study population. Results: The mean age of the study participants was 68.05 years. Depression was found in 50.1% among study population and 15.5% had severe depression. Depression was more among the Illiterates, Muslims, financial dependents, those who were suffering from chronic disease/s, encountered a stressor in the last 6 months, less religious, not living with partner or suffered elderly abuse. Conclusion: High burden of depression was found among the victims of elderly abuse. Stressful life events and absence of spouse were found to be significant risk factors for depression. To deal with these factors we suggest a link worker Geriatric Age Social Health Agent (G-ASHA) to act as a link between family, community and authorities.
ABSTRACT
Objective To investigate the practical value of a logistic regression model of serum indexes in distinguishing between geriatric depression and geriatric depressive state. Methods A total of 160 patients were recruited from the outpatient department from January 2013 to January 2016 ,and were divided into a depression group (n= 80)and a depressive state group (n= 80) ,with retrospective diagnoses based on the Chinese Classification of Mental Disorders-Third-Edition(CCMD-3).Serum samples were collected and enzyme linked immunosorbent assays (ELISA)were used to determine the concentrations of brain-derived neurotrophic factor (BDNF ) ,glial cell line-derived neurotrophic factor(GDNF) ,fibroblast growth factor 2(FGF-2) ,vascular endothelial growth factor (VEGF) ,interleukin-1β(IL-1β) ,interleukin-6 (IL-6) ,interleukin-10 (IL-10) ,tumor necrosis factor-α(TNF-α) ,cortisol (CORT ) ,and platelet-derived growth factor (PDGF).Binary logistic regression analysis was used to establish the regression model ,and the ROC curve was drawn to explore its value of differentiating geriatric depression from depressive state. Results The levels of serum BDNF , GDNF and VEGF in the depression group were lower than those in the depressive state group (BDNF :208.7 ± 41.4 vs.262.9 ± 84.6 ng/L ,GDNF :92.3 ± 18.6 vs. 101.4 ± 30.9 ng/L ,VEGF :223.1 ± 98.2 vs. 257.8 ± 77.2ng/L) ,while the levels of IL-1βand CORT in the depression group were higher than in the depressive group(IL-1β:27.0 ± 4.9 vs.19.6 ± 5.7 μg/L ,CORT :96.3 ± 16.7 vs.83.0 ± 17.3 nng/L).In multivariate logistic regression analysis ,BDNF(OR = 0.987 ,P = 0.001) ,IL-1β(OR =1.29 ,P = 0.000)and CORT (OR = 1.065 ,P = 0.000)were selected to build the regression model. The regression equation was P=1/[1+e-(- 8.546 - 0.013(BDNF)+ 0.258(IL -1β)+ 0.063(CORT)) ]and the area under the ROC curve was 0.966.Compared with retrospective diagnoses made two weeks later ,the correct diagnosis rate of the logistic model was 90.47%. Conclusions The Logistic regression model of serum indexes can further differentiate between geriatric depression and depressive state which also offers additional benefits for the diagnosis ,differential diagnosis ,and treatment of depression.
ABSTRACT
Objective To explore the intertemporal decision-making function in geriatric depressive patients and it's correlation with impulsive personality traits.Methods Forty patients with geriatric depression(GD group) and Forty demographic characteristic matched health controls (HC group) were recruited.The delay discounting task was used to measure the decision-making function,and the barratt impulsiveness scale was used to measure the impulsive traits.The delay discounting rate (k) transformed to common logarithm lgk.Results Lgk and the scores of barratt impulsiveness scale,attention impulsiveness subscale,motor impulsiveness subscale in GD group((-2.00±0.81),(42.67±8.51),(46.50± 16.84),(43.50± 10.45)) were more larger than those in HC group ((-2.31±0.51),(32.27±6.18),(34.81±8.15),(26.88±7.65),and the differences were statistically significant (t=2.060,P=0.043;t=6.252,P<0.01;t=3.951,P<0.01;t =8.117,P<0.01).In addition,lgk had positive correlation with the scores of motor impulsiveness factor in GD group(r=0.408,P=0.009).Conclusion The delayed discounting ability is impaired and correlated with the motor impulsiveness in GD patients.