Abstract
BackgroundThere is lack of information on the magnitude of depression among elderly population in India. This systematic review and meta-analysis aimed to estimate the prevalence of depression among elderly population in India.MethodsPubMed, Scopus, Web of Science, Embase, PsycINFO, IndMed, and Google Scholar were searched to identify articles reported community-based prevalence of depression among elderly population using screening tools. This study included the articles published during the years 1997 to 2016. Studies conducted in the special population groups, hospitals, reported only a subcategory of depression, and not specified the screening tool were excluded. Data were extracted from published reports and any missing information was requested from authors. Estimates were pooled using random-effects meta-analyses. Subgroup and sensitivity analysis were performed. The publication bias was evaluated by using Egger’s test and visual inspection of the symmetry in funnel plots.ResultsFifty-one studies from 16 States of India were included as 56 datasets, which estimated the prevalence of depression among Indian elderly population as 34.4% (95% CI: 29.3–39.7). In sub-group analysis, the pooled prevalence was higher among females, rural populations, and in the eastern part of the country. Studies using non-probability sampling, and GDS and CES-D screening tool showed higher prevalence. Exclusion of the studies with sample size less than 100 and low-quality studies (score < 5/8) had no effect on the estimate of the prevalence. The studies that excluded dementia before assessment of depression had lower prevalence.ConclusionAbout one third elderly population of India suffered from depression with female preponderance. The estimates varied with type of study tool, geographic region, sampling methods, and presence of dementia. The pooled estimate should be interpreted with caution as the studies included in this review had varied methodological approach and screening tools.
Highlights
There is lack of information on the magnitude of depression among elderly population in India
Pooled prevalence estimates for Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Public Health Questionnaire (PHQ), and Hamilton Depression Rating Scale (HDRS) were 39.5%, 37.9%, 19.7%, and 10.2%, respectively
We divided the states into Empowered Action Group (EAG) states, South, and Others, and found the pooled prevalence of depression as 11.3%, 39.8%, and 34.3%, respectively (Additional file 3: Figure S6)
Summary
There is lack of information on the magnitude of depression among elderly population in India. Depression among elderly population is likely to be a major cause of disease burden in the future. Chronic diseases, restricted mobility, bereavement, elderly abuse, isolation, and loss of income are major risk factors for depression, in addition to common risk factors in all age groups [4]. Depression in the elderly persons may have a varied presentation and may be difficult to diagnose [5]. It has devastating consequences and contributes significantly to misery in this phase of life [6]. Depression decreases the quality of life and influence prognosis of other chronic diseases that further aggravates disability [8]. Healthcare systems in low and middle income countries like India are not resilient enough to deal with mental health problems including depressive disorders [10]
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