Assessment Of Depression Among Elderly Residing In An Urban Area: A Cross Sectional Study

Abstract

BACKGROUND AND OBJECTIVES Depression in elderly is often overlooked as a clinical diagnosis, since it is assumed to be a normal response to ageing. In India, its prevalence ranges from 11 to 32% and is found to be significantly higher than the rest of the world. Burden of this disease is progressively increasing in urban population. Despite the known effectiveness of treatment for depression, the majority of people in need do not receive it. Earlier recognition of depression and its risk factors can reduce the morbidity and improve the quality of life. Hence this study was undertaken to assess depression and its associated risk factors among elderly residing in urban area. METHODOLOGY A community based cross sectional study, conducted from January to December 2014 among urban adults aged 60 years and above residing in Ashok Nagar area, Belagavi. A total of 850 participants were included in the study. After obtaining the ethical clearance, pilot study was conducted. Written informed consent was obtained from every participant. Data was collected by house to house visit using a predesigned questionnaire, which included Socio-demographic details, KATZ Activity of Daily Living scale (KATZ ADL) and Geriatric Depression Scale-15 (GDS- Short Form). Statistical analysis was done using χ2 test, Z test, Univariate and Multiple logistic regression analysis to find out the risk factors associated with depression and ‘p’ value less than 0.05 was considered significant. RESULTS Among 850 elderly studied, 409 (48.1%) were men and 441(51.9%) were women. The age ranged from 60 to 85 years with mean age of 68 years. Most (89.4%) of them, were literates, with a larger proportion (39.5%) being housewives, 73.3% belonged to nuclear families and 66.1% of participants had their own house. Around half (51.2%) of the population belonged to Class III socio-economic status. About 26.2% elderly were sedentary and 16.6% had difficulty to perform daily activities. The prevalence of depression was found to be 36.7%, with a higher preponderance in women than men (40.8% vs 32.3%). It was found to increase with advancing age. Significant association with depression were found with history of stressful events, personal or family history of depression and with problems in family. Disrupted marital status, lower socio economic status, chewing tobacco, alcohol consumption, presence of hypertension, diabetes, sedentary lifestyle and obesity were also significantly associated with depression. Depression was found to increase with increase in dependence in activities of daily living. CONCLUSION AND INTERPRETATION The present study revealed that the prevalence of depression was considerably high in the urban population in South India, with a significant gender difference. A positive family history of depression, disrupted marital status, low socio-economic status, substance abuse, chronic diseases and sedentary lifestyle were related to depression among the elderly studied. Mental wellbeing of the elderly in India needs to be given consideration in the health policy of the country.