Prevalence of Depression and the associated risk factors among the Elderly

 

Sangroyangla1, Temjentula2, Temjenyangla Imchen3, Tsungrosenla Longkumer4, Vizayieno5, Khumjanbeni Murry6*

1-5B.Sc Nursing IV Year, College of Nursing, Christian Institute of Health Sciences and Research, Dimapur, Nagaland

6Associate Professor, Psychiatric Nursing, College of Nursing, Christian Institute of Health Sciences and Research, Dimapur, Nagaland

*Corresponding Author Email: khummurry@gmail.com

 

ABSTRACT:

Depression is the most common psychiatric disorder among the elderly. Although India is the second most populous country in the world, with the elderly accounting for 8 percent of its total population (UNDFA 2017 report), depression in the elderly is not yet perceived as an important health problem in the country. A cross sectional descriptive study was adopted to assess the prevalence of depression and the associated risk factors among the elderly. A total of 60 participants were selected using non- probability purposive sampling technique. A self-administered questionnaire was used to assess the risk factors and depression was assessed by using short form GDS (Geriatric Depression Scale). Chi- square and Fishers exact test were done to analyze the data. The total sample was 60, the males accounted for 36 (60%) and females accounted for 24 (40%) of the total sample. Among the total samples, 47 (78%) were found to be depressed. Among the various risk factors, age was significantly associated with depression (p value <0.0001). Prevalence of depression was found to be higher in female (87.5%). Awareness programmes regarding depression among elderly could ensure better quality of life for the geriatric population.

 

KEYWORDS: Elderly, prevalence of depression, risk factors, Fisher’s exact test.

 

 


 

INTRODUCTION:

Depression is common in the elderly and is a major public health problem. The WHO (2005) also emphasizes that depression, which is the fourth most common illness, can lead to physical, emotional, social and economic problems.

 

 

 

 

 

 

 

 

 

 

 

 

Depression in late life is associated with significant morbidity, including deficits in a range of cognitive functions and considerable influence on functional impairment, disability, decreased quality of life and has a negative effect on the body’s recovery from illness, increases the rate of suicide, increases use of health care services and expenses and can result in early death and disturbance in the general state of wellness.

 

According to WHO (2011), the overall prevalence rate of depressive disorders among the elderly varies from 10-20%, depending on the cultural situations. A study by Shubhangi S. Dumbray et al (2014) revealed that 70% of the elderly had mild depression, 29% had moderate depression and only 1% had severe depression. Depression is one of the serious psychological problems the elderly experience. Depressed older adults experience higher rates of insomnia and memory loss. They also have longer than normal reaction times, increasing the hazards associated with cooking, driving, self-medication and other tasks that require full attention. Depression can become chronic or recurrent and can lead to sustained impairment in an individual’s ability to take care of his/her everyday activities. Identifying the problems early can help the elderly to have a better quality of life

 

OBJECTIVES OF THE STUDY:

1.     To assess the prevalence of depression among the elderly.

2.     To identify the associated risk factors related to depression

 

RESEARCH HYPOTHESES:

There will be a significant association of depressive symptoms among elderly with selected risk factors.

 

METHODS AND MATERIALS:

A cross sectional descriptive research design was used for the study. It was conducted in adult inpatient and outpatient departments of Christian Institute of Health sciences and Research (CIHSR) Dimapur. Elderly patients above 60 years of age visiting CIHSR during the study period were selected using purposive sampling technique. Sample size was 60.  The instrument consisted of three parts; part I included the demographic data, Part II consisted of 18 questions to identify risk factors and part III was the Geriatric Depression Scale (short form), a free standardized questionnaire. Pilot study was carried out to check the feasibility of the instrument and some modifications were made in the risk factors questionnaire. The study was approved by the Nursing Research committee of CIHSR and permission obtained from the concerned authority. Informed written consent was taken. Data was collected using self-administered questionnaire .   Data analysis was done using descriptive and inferential statistics.  Modified theory of Transition by Meleis et al was used as a basis for the study

 

RESULTS:

Table: 1 Frequency distribution of depression among elderly

 

Number

Percentage

No depression (>30)

13

22%

Depression (<30)

47

78%

Total

60

100%

 

The above table shows that 78% (47) of the elderly had depression.

 

 

Table: 2 Association between risk factors and depression using fisher’s exact test (FET) n=60

Sl. No

Risk factors

Prevalence of depression

Total

Calculated ‘P’ value using FET

 

 

No

Yes

 

 

1

Gender

a.     male

b.    female

 

11

3

 

25

21

 

36

24

 

0.1296

2

Age in years:

a.     60-64

b.    65-69

c.     70-74

d.    75 and above

 

1

5

2

5

 

42

15

12

5

 

16

20

14

10

 

 

0.0001

3

Marital status

a.     divorced

b.    single

c.     married

d.    widowed

 

0

1

8

1

 

0

1

41

8

 

0

2

49

9

 

 

0.4304

4

Living with:

a.     alone

b.    partner

c.     children

d.    others

 

0

11

1

2

 

0

35

9

2

 

0

46

10

4

 

 

0.2871

5

Educational level

a.     primary

b.    secondary

c.     college

d.    illiterate

 

 

8

2

3

1

 

 

23

2

6

15

 

 

31

4

9

16

 

 

0.131

6

Occupation:

a.     government

b.    private

c.     self employed

d.    any other

 

8

0

0

 

6

 

14

2

7

 

23

 

22

2

7

 

29

 

 

0.2125

7

Financial support

a.     children

b.    pension

c.     spouse

d.    others

 

 

3

5

2

4

 

 

6

12

10

8

 

 

9

17

12

12

 

 

0.6841

8

Income

a.     no income

b.    1000-5000

c.     5001-10,000

d.    >10,000

 

2

2

3

 

7

 

7

14

11

 

14

 

9

16

14

 

21

 

 

0.53

9

Sleep disturbance

a.     yes

b.    no

 

 

6

8

 

 

23

23

 

 

29

31

 

0.9794

10

Appetite

a.     normal

b.    increased

c.     decreased

 

11

0

3

 

23

0

23

 

34

0

26

 

 

0.0718

11

Recent loss of loved ones

a.     yes

b.    no

 

 

2

12

 

 

12

34

 

 

14

46

 

 

0.4848

12

Participation in social activities

a.     yes

b.    no

 

 

13

1

 

 

39

7

 

 

52

8

 

 

0.6669

13

Participation in family activities

a.     yes

b.    no

 

 

14

0

 

 

44

2

 

 

58

2

 

 

0.99

*P value of <0.05 is considered significant and P <0.01 is considered highly significant.

The above table shows that there is significant association between depression and age.

 

DISCUSSION:

This study was done to assess the prevalence of depression among elderly and the risk factors involved in depression. The study findings revealed that 78% (47) of the subjects had depression. A study done by Balaji Arumugam, (2013) on “Prevalence of Geriatric Depression Among Rural and Urban Slum Community” in Chennai, found that the overall prevalence of depression was 41.1% and 45.8% in urban and rural communities respectively. The prevalence of depression was found to be higher in female (87.5%) than male (69.4%) in our study, which is similar to that reported by Fleming et al (1998). In the same study, depression was also significantly and positively correlated with female gender but in our study there is no significant association between female gender and depression.

 

The risk factors associated with depression was analyzed using Fisher’s Exact Test. The study findings revealed only a significant association between increasing age and depression (p < 0.0001). However, a study by Shankar Radhakrishnan (2013) on prevalence of depression among geriatric population in a rural area in Tamil Nadu, with a sample size of 400, found that various demographic factors such as advanced age, sex, education, monthly income, spouse living status, history of chronic ailments and smoking showed a statistically significant association with depression which is in contrast to our study. The difference in the sample size between the two studies may have contributed to the difference in the findings.

 

IMPLICATION FOR NURSING PRACTICE.:

The nurses working in hospital and community should conduct routine screening and planned teaching regarding prevention and identification of depression apart from routine health education.

 

Nurses should help make individuals, families and communities to become aware of the risk factors for screening, early detection and treatment of depression.

 

To organize screening programs along with the doctors and other health personnel.

 

NURSING EDUCATION:

Students can be given opportunity to participate in screening program along with other health personnel during community posting.

 

Nursing curriculum to provide more emphasis on awareness, early detection and treatment of depression in the elderly.

 

NURSING ADMINISTRATION:

Nursing administrators can organize mass health education on depression in the community.

Organize health awareness program at schools, universities, other institutions, etc.

 

NURSING RESEARCH:

Interventional studies can be conducted to reduce depression and improve quality of life.

To keep up to date with other research studies and journals for treatment of elderly with depression.

 

CONCLUSION:

The prevalence of depression among elderly was assessed and also comparisons were made between prevalence of depression and associated risk factors to establish correlation between depression and risk factors among the elderly visiting CIHSR, Dimapur, Nagaland. This study revealed that the prevalence of depression in elderly increases with ageing. Depressive disorders among the elderly people can go undetected even more often than in younger adults because they are often mistakenly considered as a part of the ageing process. Studies indicate that the prevalence of depression is high in the elderly. Screening for depression can be made routine for all elderly patients. Awareness programs of the prevalence and identification of elderly depression can be conducted in the community so that it is identified and treated at the earliest ensuring better quality of life for the geriatric population.

 

REFERENCE:

1.      Caring for our elders: early responses; India Ageing Report- 2107. Available from: https://india.unfpa.org/sites/default/files/pub-pdf/India%20Ageing%20Report%20-%202017%20%28Final%20Version%29.pdf

2.      World Federation for Mental Health. Depression: a global crisis (2012) Available from: https://www.who.int/mental_health/management/depression/wfmh_paper_depression_wmhd_2012.pdf

3.      Shubhangi S. Dumbray, Shubhada Kale, Arpana Jadhav and Neetu P. V. (2014) A descriptive study to assess prevalence of depression among geriatric group (age 60 years and above). Available from: http://www.ajms.co.in/sites/ajms2015/index.php/ajms/article/view/689

4.      Arumugam B, Nagalingam S and Nivetha R. (2013) Geriatric Depression among Rural and Urban Slum Community in Chennai – A Cross Sectional Study. Available from: https://www.researchgate.net/publication/270525082_Geriatric_Depression_among_Rural_and_Urban_Slum_Community_in_Chennai_-_A_Cross_Sectional_Study

5.      Barry KL, Fleming MF, Manwell LB, Copeland LA. (1998) Prevalence of and Factors Associated with Current and Lifetime Depression in Older Adult Primary Care Patients. Available from: https://www.researchgate.net/publication/13685720_Prevalence_of_and_Factors_Associated_with_Current_and_Lifetime_Depression_in_Older_Adult_Primary_Care_Patients

6.      Radhakrishnan S and Nayeem A. (2013) Prevalence of depression among geriatric population in a rural area in Tamilnadu. Available from: http://www.ijnpnd.com/article.asp?issn=2231-0738;year=2013;volume=3;issue=3;spage=309;epage=312;aulast=Radhakrishnan;type=0

7.      Suresh K and Jamuna D. (2018) Depression among Residents of Free and Pay Stay Care Homes for the Aged. Available from: https://www.omicsonline.org/open-access/depression-among-residents-of-free-and-pay-stay-care-homes-for-the-aged-2167-7182-1000480-104503.html

 

 

 

 

 

 

Received on 13.09.2019         Modified on 25.09.2019

Accepted on 12.10.2019      ©A&V Publications All right reserved

Asian J. Nursing Education and Research. 2019; 9(4):552-554.

DOI: 10.5958/2349-2996.2019.00119.8