Abstract
The growth of the older adult population in Africa demands more knowledge about their chronic health problems, such as depression. The aim of this paper is to estimate depression prevalence and identify correlates of depression among older adults in Ghana and South Africa. The WHO Study on global AGEing and adult health (SAGE study) was conducted in Ghana and South Africa from 2007 to 2009 by the World Health Organization, using a standardized questionnaire among an adult population. Our analyses included 4289 adults aged 50 and above in Ghana and 3668 in South Africa. Depression was measured using self-reported symptoms over the last 12 months according to ICD-10 criteria. The prevalence of mild depression was 6.7% and 2.7% in Ghana and South Africa, respectively (p<.001), with a gender difference only in Ghana. Factors independently associated with depression among women in Ghana were migration and lack of current work.. Similarly, higher age, lack of current work and lower quality of life were independently associated with depression among women in South Africa, whereas higher age and lower quality of life were associated with depression among men in South Africa. Ghana had a higher depression rate than South Africa and we identified different factors associated with depression among men and women in these two countries. Our finding underscores the need for culture- and gender-sensitive approaches for the prevention and management of depression among the older adult population in Ghana and South Africa.
Highlights
Despite setbacks in life expectancy due largely to the HIV epidemic, the median age of some African state populations is increasing due to improvements in food security and health care [1,2]
Factors independently associated with depression among women in Ghana were migration and lack of current work
Higher age, lack of current work and lower quality of life were independently associated with depression among women in South Africa, whereas higher age and lower quality of life were associated with depression among men in South Africa
Summary
Despite setbacks in life expectancy due largely to the HIV epidemic, the median age of some African state populations is increasing due to improvements in food security and health care [1,2]. Depression is common among middle aged and older adults [7], and can increase the likelihood of negative outcomes when concurrent with other mental and somatic disorders [8,9,10]. The population-based World Mental Health Survey Initiative (WMHS) carried out in Nigeria reported lifetime and 12 month major depression at 3.1% and 1.1%, respectively. The majority of the data on depression in Africa is often from younger or special populations, such as persons living with HIV, and is not generalizable to older, community-based adults [6,17]. The growth of the older adult population in Africa requires more knowledge about their burden of mental illness, in particular depressive disorders as these are likely to emerge as an important public health challenge [18]
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