Depression among the elderly population in Sohag governorate

The prevalence and distribution of risk factors for depression and emotional mental disorders in the elderly in Indonesia

BACKGROUND

Depression is a mental health disorder. The prevalence of mental health disorders in the elderly is high.

AIMS

This study was to determine the mental status depression and emotional of the elderly based on their characteristics.

METHODS

This study was a further analysis of Basic Health Research 2018 data. The population was all households from all districts/cities in 33 provinces in Indonesia with a cross-sectional design. The sample was all elderly, with a total sample of 82,304,000 people. The respondents included young elderly (60-69 years), middle elderly (70-79 years), and old elderly (>80 years).

RESULT

Depression is experienced by most of elderly aged 60 to 69 years as many as 3,756,384 respondents (59.72%), females as many as 3,885,191 respondents (61.77%), living in urban areas, as many as 3,147,131 respondents (50.03%), graduated from elementary school as many as 2,052,22 respondents (32.63%), not working as many as 3,535,241 respondents (56.21%), and quintile one expenditure level as many as 1,532,358 respondents (24.36%).

CONCLUSIONS

Emotional disorders of depression in elderly are due to the adaptation process to physical and psychosocial changes. Family support is a must to improve elderly's quality of life on mental health aspects, especially depression. Furthermore, better treatment by medical personnel is required.

The effects of social media intergenerational program on depressive symptoms, intergenerational relationships, social support, and well-being in older adults: A quasi-experimental research

Depressive symptoms are common among older adults. This quasi-experimental study aims to examine the effects of a social media intergenerational program on depressive symptoms, intergenerational relationships, social support, and well-being in older adults. This study enrolled 100 older adults who were divided into the intervention group (n=50) and control group (n=50). The intervention group received 5 weeks of the social media intergenerational program. The control group maintained their daily routines. Data were collected using structured questionnaires at baseline and 5 and 9 weeks after enrollment. We found that approximately 35% of older adults had mild to severe depressive symptoms. Compared to the control group, the intervention group exhibited significantly greater improvements in depressive symptoms, intergenerational relationships, social support, and well-being in the fifth week and the ninth week after intervention. Intergenerational social media activities were recommended for older adults to improve their depressive symptoms, and promote intergenerational relationships and well-being.

Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis

BACKGROUND

There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS

Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.

RESULTS

One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.

LIMITATIONS

The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.

DISCUSSION

A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.

Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys

BACKGROUND

The reported prevalence of depressive symptoms (depression hereafter) among older adults varied widely across different studies. This was a meta-analysis to systematically examine the global prevalence of depression among older populations and its associated factors.

METHODS

A systematic literature search was performed in PubMed, EMBASE, PsycINFO, and Web of Science. Due to the differences in demographic and clinical characteristics between studies, random-effects model was used to calculate the pooled prevalence of depression and its 95% confidence interval (95% CI).

RESULTS

In total, 55 studies with 59,851 individuals met the study criteria and were included in the analyses. The overall prevalence of depression was 35.1% (95%CI: 30.2-40.4%). Subgroup analyses revealed that different sampling methods (Q=10592.49, p = 0.037), Geriatric Depression Scale versions (Q=13712.55, p < 0.001) and income levels (Q=14.028, P < 0.001) were significantly associated with the pooled prevalence of depression in older adults. In the meta-regression analyses, time of survey (B=0.012, z = 2.30, p = 0.029) was positively associated, and mean age (B=-0.018, z = 2.10, p = 0.044) was negatively associated with the prevalence of depression in older populations. The funnel plot and Egger's test did not reveal any significant publication bias (Egger's test: t = 1.93, p = 0.059).

CONCLUSION

This meta-analysis found that over a third of older populations globally had depression. Effective preventive measures, regular screening and timely interventions are needed to address this highly prevalent public health problem among older adults.

Prevalence of depressive symptoms and their associated factors among older adults in Yirgalem town, Southern Ethiopia: A community-based cross-sectional study

Background

Depression is a serious mental health issue and the largest contributor to disability worldwide. Elderly people with depression are significantly more likely to experience negative outcomes such as poor physical health, strained social relationships, and decreased quality of life. Studies on geriatric depression are limited in developing nations like Ethiopia.

Objectives

The purpose of this study was to determine the prevalence of depressive symptoms and associated factors among older adults in Yirgalem, Southern Ethiopia, in 2022.

Methods

A community-based cross-sectional study was conducted on a sample of 628 older adults in Yirgalem town from May 15 to June 15, 2022. The study subjects were selected using a multi-stage systematic sampling technique. Data were collected using the 15-item Geriatric depression scale through face-to-face interviews. The collected data were edited, cleaned, coded, and entered into Epi data version 4.6 software and analyzed using STATA version 14. Bivariable and multivariate logistic regression analysis was computed to identify factors associated with depression, and statistical significance was declared at a 95% confidence interval with a P-value less than 0.05.

Results

A total of 620 older adults were included in the study, with a response rate of 97.8%. The prevalence of depressive symptoms among older adults was 51.77% (95% CI: 47.83-55.69). Being a woman (AOR = 2.3, 95% CI: 1.56-3141); being of more advanced age: 70-79 years old (AOR = 1.92, 95% CI: 1.20-3.07), 80-89 years old (AOR = 2.15, 95% CI: 1.27-3.65), 90 and older (AOR = 3.77, 95% CI: 1.95-7.79); living alone (AOR = 1.99, 95% CI = 1.17-3.41); having a chronic illness (AOR = 3.24, 95% CI: 1.06-4.46); having anxiety (AOR = 3.40; 95% CI: 2.25-5.14); and having poor social support (AOR = 3.56, 95% CI: 2.09-6.04) were statistically associated with depressive symptoms at a P-value of less than 0.05.

Conclusion

This study found that depression affects more than half of the elderly residents in the study area. More advanced age, being a woman, living alone, having a chronic illness, having anxiety, and having poor social support were all strongly linked to depression. There is a need to integrate counseling and psychiatric services into the community healthcare system.

Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

BACKGROUND

Depression is among the common mental health problems in late-life and an important public health problem. Studies from both middle- and high-income countries have shown that depression is more common among older people than in adolescents. Many older people with depression are overlooked, and fewer efforts are made to mitigate their suffering. Despite depression being a major public health problem among older adults, its overall magnitude, and its main predictors were not determined for the development of appropriate measures. Hence, the objective of this study was, therefore, to estimate the overall prevalence of depression and identify its predictors among older adults in Ethiopia.

METHODS

Available articles were searched by means of different databases using the PRISMA guideline. The quality of the included studies was assessed using a JBI quality appraisal tool. STATA version 14.0 (STATA Corporation, College Station, Texas, USA) statistical software was used to analyze the eligible studies. Subgroup and sensitivity analyses were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots.

RESULT

In this meta-analysis, we included 11 articles that assessed 6521 older adults. The overall prevalence of depression among older adults in Ethiopia was 41.85 (33.52, 50.18). The finding was higher in the Oromia region with a prevalence of 48.07% (95% CI: 35.62, 60.51). The finding also demonstrated that being female (AOR = 1.76, 95% CI: 1.17, 2.63), no formal education (AOR = 1.82, 95% CI: 1.03, 3.19), with chronic diseases (AOR = 2.46, 95% CI: 1.00-6.06), and no social support (AOR = 2.01, 95% CI: 1.06, 3.83) were found to be independent predictors of depression in older Ethiopian adults.

CONCLUSION

Our systematic review and meta-analysis showed that almost two out of five older adults had depression. Female sex, no formal education, having chronic diseases, and no social support were the independent predictors of depression among older adults in Ethiopia. The study emphasizes that depression among older adults in Ethiopia calls for appropriate screening and interventions to reduce the occurrence and its overwhelming consequences.

Estimate of the prevalence of depression among older people in Africa: a systematic review and meta-analysis

OBJECTIVE

The current systematic review and meta-analysis aimed to estimate the pooled prevalence of depression among elderly people in Africa.

METHOD

We have searched CINAHIL, PubMed, SCOPUS and Psych-INFO databases to identify important observational studies which reported the prevalence of depression among the elderly. We used a random-effects model due to reported heterogeneity among the included studies. The publication bias was examined by using Egger's test, visual inspection of the symmetry in funnel plots and adjusted using Duval and Tweedie's Trim and Fill analysis. We have meta-analysed the pooled estimates of depression from primary studies by adjusting for publication bias. We used Cochran's Q and the I²-tests to measure heterogeneity across the studies.

RESULT

A total of 23 studies conducted in Africa were included in the current systematic review and meta-analysis, representing a total of 14, 350 elderly population. The pooled prevalence of depression among elderly people in Africa was estimated to be 26.3% (95% CI; 22.2, 30.4%). The estimated pooled prevalence of depression among the elderly in Africa was much higher (43.1%) in studies that used a screening tool to measure depression when compared to studies that used a diagnostic tool (24.2%). Also, the prevalence of depression among female elderly participant (43.10%) was higher than that of male elderly participant (30.90%).

CONCLUSION

One in five elderly population in Africa were depressed, which poses serious health concerns. Timely and targeted screening of depression among the elderly and evidence-based interventions were highly recommended.

Prevalence of Mental Disorders in the WHO Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Objectives: To synthesize the prevalence of mental and substance use disorders in countries of the Eastern Mediterranean Region (EMR) of the World Health Organization. Methods: The literature search was conducted across several databases in two phases. First, we searched for systematic reviews and/or meta-analyses published before 2014, reporting prevalence estimates for mental disorders in the EMR. Then, we identified new primary cross-sectional or longitudinal studies published between 2014 and 2020. Studies were included if they had a sample size of ≥ 450 and were conducted among the general adult population. Current, period and lifetime prevalence estimates for each disorder were pooled using random-effects meta-analyses, and subgroup analyses and meta-regressions were conducted. Findings: Prevalence estimates were extracted from 54 cross-sectional studies across 15 countries within the EMR. Pooled analyses of current, period and lifetime prevalence showed the highest prevalence for depression (14.8%, 95% confidence interval, CI: 10.7-20.1%), followed by generalized anxiety disorder (GAD) (10.4%, 95% CI: 7.1-14.7%), post-traumatic stress disorder (7.2%, 95% CI: 2.9-16.6%), substance use (4.0%, 95% CI: 3.1-5.2%), obsessive compulsive disorder (2.8%, 95% CI: 1.6-4.9%), phobic disorders (1.8%, 95% CI: 1.1-2.8%), panic disorders (1.1%, 95% CI: 0.6-2.2%), bipolar disorders (0.7%, 95% CI: 0.3-1.6%), and psychosis (0.5%, 95% CI: 0.3-0.9%). Populations exposed to adverse events had higher prevalence of mental disorders than the general population. Period and lifetime prevalence showed little difference across mental disorders. More pronounced differences in prevalence were seen for depression and GAD, specifically between current and lifetime prevalence (depression: current prevalence 20.5% (95% CI: 14.9-27.4%), vs. lifetime prevalence: 4.2% (95%CI: 1.8-9.6%); GAD: current prevalence 10.3% (95% CI: 6.1-17.0), vs. lifetime prevalence: 4.5% (95% CI: 2.4-8.3%). Differences between current and lifetime prevalence of mental disorders may be due to the use of different screening instruments and thresholds being applied. Conclusion: The prevalence of mental and substance use disorders in the EMR is high. Despite substantial inter-survey heterogeneity, our estimates align with previous global and regional data on mental disorders. Our meta-review provides new evidence on the burden of mental health problems in the EMR. Systematic Review Registration: PROSPERO, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020187388.

Prevalence of Mental Disorders, Cognitive Impairment, and Dementia Among Older Adults in Egypt: Protocol for a Systematic Review

Background

In Egypt, the population of older adults is rapidly growing. The last census in 2017 indicated that older adults numbered 94.8 million, which is a 2.56% increase from the 2006 census. There is growing evidence that the older population is at greater risk for some forms of mental disorders such as depression, dementia, and many more.

Objective

This study aims to review the current evidence regarding the prevalence of mental disorders among older adults in Egypt. This will be achieved by estimating the current prevalence of mental disorders and identifying any sociodemographic correlations with mental disorders.

Methods

An electronic search of 5 key databases (MEDLINE, PsycINFO, EMBASE, AMED, and PubMed) from their date of inception was conducted. In addition, scans of reference lists and searches of key journals, citations, and relevant internet resources were conducted. Studies were included if they were published in English, point prevalence studies, conducted with older Egyptians aged ≥60 years, and conducted using a validated diagnostic tool to ascertain mental disorders. Studies that did not meet any of these criteria were excluded.

Results

This systematic review started in November 2018. The literature search of the 5 databases revealed 343 papers. After screening titles and abstracts, scanning citations and reference lists, and searching internet sources, a total of 38 full-text articles were accessed, of which 16 studies met the eligibility criteria and were included. We are currently in the process of data extraction and synthesis.

Conclusions

This research will help bring the scale of mental disorders among older adults in Egypt to the forefront. This may help ensure evidence-based initiatives are established and that priority is given to resource allocation for geriatric mental health in Egypt.

Trial Registration

PROSPERO International Prospective Register of Systematic Review CRD42018114831; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=114831

International Registered Report Identifier (IRRID)

DERR1-10.2196/14637

Dissatisfaction with life and absence of leisure time activity: clues to overt depression and occult suicide risk in elderly individuals without significant disabling disease

BACKGROUND

Depression is a major public health problem in all ages. Besides other chronic physical diseases, it is one of the most common psychiatric disorders observed in the elderly. In this study, it was aimed to determine the prevalence of depressive symptoms and related factors and to draw attention to occult suicide probability in elderly people without significant disabling disease.

METHODS

Individuals aged 65 and over, who were randomly selected from a family healthcare centre, were enrolled into the study. Geriatric Depression Scale (GDS) was used to assess prevalence of depression and Suicide Probability Scale (SPS) for risk of suicide.

RESULTS

There were 323 elderly (F/M: 150/173). Mean age was 73.3 ± 6.1 years. The majority had chronic physical illnesses (77.7%). Mean GDS and SPS scores were 11.07 ± 4.6 and 62.91 ± 8.24, respectively. Prevalence of depression was 27.6%. In multivariable logistic regression analysis, living without a spouse (P = 0.047, Exp(B) = 1.744, 95% CI = 1.008-3.01), dissatisfaction with life (P ˂ 0.001, Exp(B) = 5.327, 95% CI = 3.02-9.36) and having no leisure time activity (P = 0.047, Exp(B) = 1.846, 95% CI = 1.009-3.37) were found to be the independent predictors of presence of depression, as indicated by GDS. In logistic regression analysis, dissatisfaction with life (P ˂ 0.001, Exp(B) = 2.631, 95% CI = 1.53-4.50) was found to be an independent predictor of high SPS scores.

CONCLUSION

In elderly individuals without overt disabling disease, dissatisfaction with life, absence of leisure time activities, and a life without a partner seem to significantly increase the likelihood of overt depression. On the other hand, there is occult increase in suicide risk in the presence of dissatisfaction with their lives in the elderly.

Ageing of the Diaphragm Muscle

The diaphragm muscle is the most important contractile district used for breathing. Like other muscles in the human body, it is subject to ageing and sarcopenia. Sarcopenia can be classified as primary (or age-related) when there are no local or systemic pathologies that cause a functional and morphological detriment of skeletal musculature. Secondary sarcopenia occurs when there is a cause or more pathological causes (illness, malnutrition, immobility) related or unrelated to ageing. In the elderly population, transdiaphragmatic pressure (Pdi) decreases by 20-41%, with a decline in the overall strength of 30% (the strength of the expiratory muscles also decreases). The article discusses the adaptation of the diaphragm muscle to ageing and some other ailments and co-morbidities, such as back pain, emotional alterations, motor incoordination, and cognitive disorders, which are related to breathing.

Occurrence of mood disorders among educationally active older adults in Bialystok, Poland: a cross-sectional study

BACKGROUND

Mood disorders in older people are an increasingly serious health and social problem, and their prevalence increases with age. The most common mood disorders are bipolar disorder, which is the occurrence of mania and hypomania, and depressive disorders. The aim of this study was to determine the prevalence of mood disorders in a group of educationally active elderly people living in Bialystok, Poland.

METHODS

The study included a total of 162 people-residents of Bialystok-aged 60 or older; 135 women (83.33%) and 27 men (16.67%). The study used five standardized psychometric scales: The Mood Disorder Questionnaire (MDQ), Hypomania Check List (HCL-32), Geriatric Depression Scale (GDS) and The Zung Self-Rating Depression Scale (Zung SDS).

RESULTS

Nearly 90.00% of the respondents obtained GDS scores indicating the presence of mild depressive symptoms; however, on the Zung SDS, which also evaluates depression symptom levels, the result obtained in almost the same number of respondents showed an absence of these symptoms. A similar percentage of respondents also obtained values on the MDQ that allow to determine a lack of bipolar disorder characteristics in the studied population. Over half of the respondents (58.02%) did not show symptoms of hypomania using the HCL-32. There was a significant correlation between the results of the GDS and Zung SDS, the HCL-32 and MDQ, as well as the HCL-32 and Zung SDS in the total studied group.

CONCLUSIONS

Mood disorders, particularly depression, constitute a significant social and health problem in the group of educationally active older adults living in Bialystok. In light of the obtained research results, it is recommended to conduct and improve already realized health education programs for the elderly on the subject of mood disorder prevention and their impact on quality of life. There is a need for further research on mood disorders in the elderly to determine their prevalence on a national scale.

Correlation Between Depressive Symptoms And Quality Of Life, And Associated Factors For Depressive Symptoms Among Rural Elderly In Anhui, China

Purpose

We aimed to assess the current status of depressive symptoms and quality of life (QoL) among rural elderly in central China (Anhui Province) and explore their correlation and associated factors for depressive symptoms.

Methods

A multi-stage random sampling method was used to obtain 3349 participants (aged ≥60): 1206 poor and 2143 non-poor. The 30-item Geriatric Depression Scale (GDS-30) and five-dimensional European quality of health scale (EQ-5D) were employed to evaluate depressive symptoms and QoL, respectively.

Results

The prevalence of depressive symptoms was 52.9%, and that in the poor group (62.3%) was significantly higher than the non-poor group (47.6%). The GDS-30 score was 12.40 ± 7.089, and the poor group scored significantly higher (14.045 ± 6.929) than the non-poor group (11.472 ± 7.011). The EQ-5D score was 0.713 ± 0.186, and the poor group (0.668 ± 0.192) scored significantly lower than the non-poor group (0.738 ± 0.178). There was a significant negative correlation between depressive symptoms and QoL (r = −0.400, P-value <0.05). The following factors were associated with depressive symptoms: poverty, low EQ-5D score, female gender, older age, illiteracy, unemployed, chronic diseases, and hospitalization in previous year.

Conclusion

Rural elderly in central China have a high prevalence of depressive symptoms and low QoL. Poverty was associated with a higher prevalence of depressive symptoms and lower QoL.