Depression In Geriatric Population Research Articles

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BACKGROUND:In India,elderly persons constitute 8.6% of total population which is projected to reach 19% by 2050.There is lack of information on the magnitude of depression among elderly population in India.Depression is among the leading causes of disability adjusted life years in the world and a serious health problem among older adults.AIM AND OBJECTIVES:To study the prevalence of depression in geriatric patients and to assess the severity and risk factors for depression in geriatric population.METHODOLOGY;This is a cross-sectional study done in 150 geriatric patients attending Geriatric OPD in Government Rajaji Hospital,Madurai who are above 65 years in three months study period and are assessed using Semi-structured proforma to collect information regarding socio-demographic profile,Mini Mental status examination,Geriatric Depression Scale and Presumptive Stressful life events scale and ICD-10 diagnostic criteria to diagnose depression.RESULTS:Prevalence of depression was 29% of which 20% are mildy depressed.Older adults are less likely to endorse cognitive –affective symptoms of depression including dysphoria,worthlessness and guilt.Sleep disturbance ,fatigue,loss of interest ,hopelessness,poor memory are more common.CONCLUSION:The study revealed high prevalence of depression among geriatric patients attending tertiary care hospitals,Sociodemographic,clinical and psychosocial variables as risk factors for depression.But its undiagnosed and overlooked.Prevention of risk factors and early diagnosis may reduce the morbidity ,mortality and improve quality of life.

Magnitude of Neurocognitive Impairment and Severity of Depression in Geriatric Population

<p>Background and Objective:  With the increasing life expectancy of the populations and rising prevalence of depressive and neurocognitive disorders, there is a need to address the association between the two in terms of magnitude of the neurocognitive disorders and the severity of depression. The current study addresses this issue and aims to observe the association between the two.</p>
 <p>Methods:  This cross-sectional descriptive study was conducted from September 2014 to March 2015 at the Institute of Psychiatry at Benazir Bhutto Hospital, Rawalpindi, Pakistan where consecutive patients aged ≥ 65 years were screened for depression using Geriatric Depression Scale (GDS). Neurocognitive impairment was assessed using Mini Mental State Examination (MMSE). -square test was used to compute the association between depression severity and neurocognitive deficit.</p>
 <p>Results:  There was approximately equal gender distribution with a mean age of 63.6 ± 9.68 years. Eighty six percent of the study population was found to be suffering from clinical depression while seventy percent had neurocognitive deficit. The severity of depression came out to be directly proportional to the magnitude of the neurocognitive disorder (P = 0.000) with 68.8% of the patients with severe depression having moderate to severe neurocognitive deficit.</p>
 <p>Conclusions:  Depression is associated with significant neurocognitive impairment in elderly in the local population; higher the severity of depression more the magnitude of cognitive impairment.</p>

Magnitude of Neurocognitive Impairment and Severity of Depression in Geriatric Population

Background and Objective: With the increasing life expectancy of the populations and rising prevalence of depressive and neurocognitive disorders, there is a need to address the association between the two in terms of magnitude of the neurocognitive disorders and the severity of depression. The current study addresses this issue and aims to observe the association between the two. Methods: This cross-sectional descriptive study was conducted from September 2014 to March 2015 at the Institute of Psychiatry at Benazir Bhutto Hospital, Rawalpindi, Pakistan where consecutive patients aged ≥ 65 years were screened for depression using Geriatric Depression Scale (GDS). Neurocognitive impairment was assessed using Mini Mental State Examination (MMSE). -square test was used to compute the association between depression severity and neurocognitive deficit. Results: There was approximately equal gender distribution with a mean age of 63.6 ± 9.68 years. Eighty six percent of the study population was found to be suffering from clinical depression while seventy percent had neurocognitive deficit. The severity of depression came out to be directly proportional to the magnitude of the neurocognitive disorder (P = 0.000) with 68.8% of the patients with severe depression having moderate to severe neurocognitive deficit. Conclusions: Depression is associated with significant neurocognitive impairment in elderly in the local population; higher the severity of depression more the magnitude of cognitive impairment.

Prevalence and factors associated to depression among geriatric population in a rural area of Kanyakumari district Tamil Nadu

Background: Aging is a universal process. It has been documented that elderly are more prone to psychological problems and depression is the commonest geriatric psychiatric disorder. In India the prevalence of depression among elderly population between 13% and 25%. Depression usually becomes unnoticed and untreated in the elderly. Depression in late life is associated with significant morbidity including deficits in a range of cognitive functions, functional impairment, decreased quality of life, increased rate of suicide. The objectives of this study was to find out the prevalence of depression and its risk factors in geriatric population.Methods: This cross-sectional study was conducted from March 2017 to August 2017 among 75 elderly people who were attending the rural health centre Marappadi were included for the study. Depression was assessed by Geriatric Depression Scale (GDS).Results: The mean age of the participants were 72.63. Majority of them were females (56%). Most of them had middle school education (48 %) and 77.3% belong to joint family. The overall prevalence of depression in the study population was 76%. 30.7% of the elderly had severe depression and 16% are having moderate depression. There is significant association between depression with female sex, primary education, marital status, lower socio-economic status and presence of chronic illness.Conclusions: This study indicates high prevalence of depression in elderly population. Female sex, unemployment, marital status as married and joint family are the risk factors of depression in geriatric population.

The prevalence and associated factors influencing depression in the geriatric population: A cross-sectional study in Ban Nayao, Chachoengsao Province, Thailand

Background Depression is a major burden disease. Geriatric depression is not well recognize and cannot be treated adequately. In rural community, various socio-demographic factors are responsible for the depression among older adults. Methods This cross-sectional study aims to evaluate the prevalence and associated factors of depression in the geriatric populations (age > 60 years) in Ban Nayao, Chachoengsao Province, Thailand. A total of 433 elderly populations were interviewed using Thai geriatric depression scale (TGDS), 16-item family relationship questionnaire and Barthel Index of ADL. We excluded those who had visual and auditory disabilities and cognitive impairment using Thai mini-mental status examination (T-MMSE). Multivariate logistic regression was used to evaluate the associated factors for depression in geriatric population. Results Of 416 participants were enrolled; 225 (50.1%) were female. Mean age was 69.3 ± 7.0 years; 412 (99.1%) were independence ADL status by using Barthel Index (mean score 19.6 ± 1.6), and 206 (54.1%) were imbalance family by using 16-item family relationship questionnaire. The prevalence of depression was 18.5%. The associated factors of moderate to severe depression were female gender (adjusted OR = 3, 95% CI = 1.2–7.5, P-value = 0.017), illiterate (adjusted OR = 2.4, 95% CI = 1.0–5.5, P-value = 0.041), current smoker (adjusted OR = 4, 95% CI = 1.0–9.9, P-value = 0.002) and imbalance family type with low attachment, low co-operation and poor alignment between each members (adjusted OR = 4.3, 95% CI = 1.8–7.5, P-value = 0.001). Conclusion The prevalence of depression was high in our population. Additionally, female gender, illiterate, current smoker and imbalance family type were the associated factors of depression in geriatric population in the rural community.

A cross sectional study on the prevalence and factors associated with geriatric depression in an urban slum of Davangere city

Background: Various community-based studies have revealed that the prevalence of depression in geriatric population in India varies between 13% and 25%. In spite of the magnitude of this problem there are very few studies from India investigating geriatric depression and its associated risk factors. This study aims to establish the prevalence, socio- demographic correlates and factors associated with geriatric depression in an urban slum of Davangere city. Objective of the study was to estimate the prevalence of depression and its association with socio- demographic factors among the geriatric population in an urban slum of Davangere city.Methods: A community based cross sectional study was conducted from June to November 2016, among the geriatric people residing in an urban slum (Mustafanagar) of Davangere city. A house to house survey was done and all the geriatric people willing to participate in the study were selected and assessed for depression using the Geriatric Depression Scale.Results: In this study the prevalence of depression was found to be 39% among the elderly, of which 33% had mild depression and 6% had severe depression.Conclusions: In this study it was found that the prevalence of depression was higher among those who were widowed and those who were living alone. It was also more among the people belonging to Class V Socio-economic status (Modified B.G Prasad Classification) and people suffering from a chronic illness.

Prevalence of Depression among Geriatric Population in Block Hazratbal, District Srinagar

Background: Elderly population aged 60 years and above in the world will reach 1.2 billion by the year 2025, the majority of whom will be in developing countries. Major health problems which are faced in this age group are hypertension, CAD, atherosclerosis, strokes, DM, obesity, cancers, cataracts, osteoarthritis, osteoporosis, chronic obstructive airway disease, benign hyperplasia of prostate, Alzheimer's disease, Parkinson's disease, senile Dementia and depression. Objective: To estimate the prevalence of depression among geriatric population in block Hazratbal, district Srinagar. Methodology: The 496 elderly subjects were interviewed in their local/Urdu language and they were examined by using a pre-tested, pre-structured study questionnaire. The questionnaire was divided into two parts. The first part comprised of the socio-demographic information which covered a diverse set of parameters such as age, sex, marital status, education, socio-economic status, Non-communicable diseases, living conditions, economic dependency and the dependency for the activities of daily living, impact of turmoil caused due to conflict in the state. In second part Geriatric Depression Scale (GDS 30-item) was used to measure depression in geriatric population in the selected sample population. Results: In the present study, it was found that 31.5% of elderly were suffering from depression. 27.2% of elderly had Mild depression, whereas only 4.2% had severe depression as males (31.5%) p<0.001. Both the categories of depression were found to be more in elderly females. Prevalence of severe depression in elderly females (7.1%). Conclusion: Overall prevalence of depression was fairly high among the elderly subjects in this part of the world. Depression was more common in females as compared to males. Advanced age, illiteracy, occupations, marital status, socio-economic class, family pattern, economic dependence, dependence for activities of daily living, children dependency, expected care givers, relationship with spouse are the strong predictors on the prevalence of depression in the elderly.

Elderly depression: unnoticed public health problem in India- a study on prevalence of depression and its associated factors among people above 60 years in a semi urban area in Chennai

Background: Worldwide proportion of elderly population is expected to double from current 12% to 22% by 2050. This growth in elderly population inevitably leads to increase in age related diseases such as depression and serious constrains on quality of life among them. As depression frequently manifest with somatic symptoms like tension, headache and heaviness, etc., most of the elderly persons visit non psychiatry outpatient services seeking relief for their symptoms.Methods: A cross sectional study was done in the field practice area of Saveetha Medical College and Hospital. Geriatric depression scale (GDS) short form was used to measure the level of depression in geriatric population. Structured questionnaire was used in order to assess their physical health, socio-demographic data and social support. Elderly mobility scale was used to measure the level of physical dependency. Proportion and chi-square were used for analysis.Results: Prevalence of depression was found to be 76%. Among depressed elderly 47% had mild depression, 28% had moderate depression and 25% were suffering from severe depression. Severity of depression was also found to be significantly more among those who had lost their life partner and those who were physically dependent on others.Conclusions: Prevalence of depression in the elderly was found to be high moreover none of the elderly were diagnosed to be depressed. Steps like screening for depression among elderly should be undertaken to diagnose the cases of depression, they should be treated and also be given proper counseling sessions to reduce their levels of depression.

Study of Depression in Geriatric Population: Old Age Home and Community in Lucknow India.

Study of Depression in Geriatric Population: Old Age Home and Community in Lucknow India.

Correlation between Self Efficacy and Depression in Geriatric Population having Osteoarthritis of Knee

Correlation between Self Efficacy and Depression in Geriatric Population having Osteoarthritis of Knee

Randomised controlled trial of group cognitive behavioural therapy for comorbid anxiety and depression in older adults

Anxiety and depression are commonly comorbid in older adults and are associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments. However, little research has examined the effectiveness of psychological programs to treat comorbid anxiety and depression in older adults. Sixty-two community dwelling adults aged over 60 years with comorbid anxiety and depression were randomly allocated to group cognitive behavioural therapy or a waitlist condition and were assessed immediately following and three months after treatment. After controlling for cognitive ability at pre-treatment, cognitive behaviour therapy resulted in significantly greater reductions, than waitlist, on symptoms of anxiety and depression based on a semi-structured diagnostic interview rated by clinicians unaware of treatment condition. Significant time by treatment interactions were also found for self-report measures of anxiety and depression and these gains were maintained at the three month follow up period. In contrast no significant differences were found between groups on measures of worry and well-being. In conclusion, group cognitive behavioural therapy is efficacious in reducing comorbid anxiety and depression in geriatric populations and gains maintain for at least three months.

Relationship of Vitamin D3 Deficiency to Depression in Older Adults: A Systematic Review of the Literature From 2008-2013

In 2009, the seminal integrative literature review on vitamin D and the occurrence of depression included 17 studies on older adults and determined the relationship between vitamin D and depression to be largely circumstantial. Since this publication, 10 studies have assessed the relationship of vitamin D status/supplementation to depression in elders. Six studies indicated a link between vitamin D deficiency, depressive symptoms, and overall psychological health, and 4 studies highlight vitamin D supplementation and the effect on depressive symptoms. More studies are needed to confirm a definitive relationship between vitamin D status, supplementation, and effect on depression in geriatric populations.

English

BACKGROUND: Depression is the most common psychiatric disorder among the elderly which can manifest as major or minor depression. The community-based studies have revealed that the prevalence of depression in geriatric population in India varies between 13% and 25%. In spite of quantum of this problem there are very few studies from India investigating geriatric depression and its associated risk factors. This study aimed to establish the prevalence, sociodemographic correlates and factors associated with geriatric depression in urban slum and rural communities in Chennai. METHODS: This study was done as a cross sectional study in the urban and rural field practice areas of ACS Medical College and Hospital among 60 years and above age group by house to house survey method using Geriatric Depression Scale during July and August 2011.All the houses in the urban and rural field practice areas were surveyed and those who fulfilled the eligibility criteria were interviewed after getting informed consent. The results were expressed in percentages and chi-square test was done to find out the association. RESULTS: Totally 173 study participants were interviewed and the prevalence was found to be 41.1% and 45.8% in urban and rural communities respectively. Geriatric depression is significantly associated with female sex, living without spouse, illiteracy, time spent with children and grand children and dietary habits in both communities but money dependence and health problems were strongly associated with depression in urban community. CONCLUSION: The prevalence of depression in the elderly population in our study was moderately high in both areas and a cause of concern.

Depression and associated socio-demographic factors among Geriatrics-An Experience from a tertiary Hospital.

Depression in old age is associated with genetic susceptibility, chronic disease and disability, pain, frustration with limitations in activities of daily living. The present study was undertaken to find out the prevalence of depression and associated socio-demographic factors among geriatric patients attending a tertiary care hospital by Geriatric Depression Scale. 65.3% of the study population had depression (mild- 36.2%, severe-29.1%) and the association of this depression with age (p<.001), gender (p<.001), residence (p=.027), marital status (p=.004), education (p<.001), occupation (p<.001), family type (p<.001) and economic dependency (p=.002), living condition (p<.001) was statistically significant. Social support group, local clubs and respective families should address the issue of depression among elderly. 1 The population aged 60 years and above will grow from 77 million in 2001(7.4%) to 150 million (14.41%) in 2020. 2 Age is an important determinant of mental illness. The overall prevalence of mental and behavioural disorders tends to increase with age due to the normal ageing of the brain, deteriorating physical health and cerebral pathology. 3 Lack of family support and restricted personal autonomy are other important contributing factors. Mental health of the elderly is an important concern and depression accounts for the greatest burden among them. It is expected to become the leading cause of disability by year 2020 closely following ischemic heart disease. 4 Globally, prevalence of depression in geriatric population varies from 10% to 20%, while in India; it is even higher varying from 13% to 25%. 5 Depression in old age is associated with genetic susceptibility, chronic disease and disability, pain, frustration with limitations in activities of daily living, personality trait (dependent, anxious or avoidant), adverse life events and lack of adequate social support. In a hospital-based study, Abhay et al. 6 found that nearly 52.5% of the patients with chronic medical illness suffer from psychiatric illness, depression being the most common. Uwakwe et al 7 evaluated all the patients aged more than 60 years, who were admitted in non-psychiatric wards in a teaching hospital and observed that 45.3% of the patients had psychiatric illness, with depression being the commonest, followed by organic disorders, adjustment disorder, and generalized anxiety disorder. Only 2.8% of the mental disorders could be recognized by the physicians. This reflects the need for psychological assessment among the geriatric patients. With this background, we have conducted this study with the following objectives: 1. To find out the prevalence of depression among elderly patients attending a tertiary care hospital. 2. To assess the socio demographic factors affecting depression among them.

An epidemiological study on Depression and related factors among Geriatrics in a tertiary care Hospital.

Depression in old age is associated with genetic susceptibility, chronic disease and disability, pain, frustration with limitations in activities of daily living. The present hospital based cross sectional study was undertaken on 306 patients selected by systemic consecutive sampling from Geriatric O.P.D of Institute of Psychiatry, Kolkata to find out the prevalence of depression and associated factors among geriatric patients. 65.3% of the study population had depression (mild-36.2%, severe-29.1%) and the association of this depression with age (p<.001), gender (p<.001), residence (p=.027), marital status (p=.004), education (p<.001), occupation (p<.001), family type (p<.001) and economic dependency (p=.002), living condition (p<.001) was statistically significant. Social support group, local clubs and respective families should address the issue of depression among elderly. Family counselling for old age care, creation of a viable family and social environment will go a long way to improve the mental health of the elderly. aged 60 years and above will grow from 77 million in 2001(7.4%) to 150 million (14.41%) in 2020 and 2050 it will touch 300 million being 2 nd largest geriatric population in the world.. 2 Geriatric populations comprises 7.2% of total population of West Bengal. Age is an important determinant of mental illness. The overall prevalence of mental and behavioural disorders tends to increase with age due to the normal ageing of the brain, deteriorating physical health and cerebral pathology. 3 Lack of family support and restricted personal autonomy are other important contributing factors .Geriatrics are more prone to infections and injuries and they have increased risk of disease, disability and death. Mental health is an important concern and depression accounts for the greatest burden among them, expected to become the leading cause of disability by year 2020 closely following ischemic heart disease. 4 Globally, prevalence of depression in geriatric population varies from 10% to 20%, while in India; it is even higher varying from 13% to 25%. 5 Depression in old age is associated with genetic susceptibility, chronic disease and disability, pain, frustration with limitations in activities of daily living, personality trait (dependent, anxious or avoidant), adverse life events and lack of adequate social support. In a hospital-based study. 6 it was found that nearly 52.5% of the patients with chronic medical illness suffer from psychiatric illness, depression being the most common. Uwakwe et al 7 evaluated all the patients aged more than 60 years, who were admitted in psychiatric wards in a teaching hospital and observed that 45.3% of the patients had psychiatric illness, with depression being the commonest followed by organic disorders, adjustment disorder, and generalized anxiety disorder. Only 2.8% of the mental disorders could be recognized by the physicians. This reflects the need for psychological assessment among the geriatric patients. With this background, we have conducted this study with the following objectives: 1. To find out the prevalence of depression among elderly patients attending geriatric O.P.D of Institute of Psychiatry, Kolkata. 2. To assess the related socio demographic factors affecting depression among geriatric patients.

Socio-demographic Factors of Geriatric Depression

Background:Depression is a common mental health problem in geriatric population and the overall prevalence rate of depression in this age group varies between 10 and 20%.Objective:To study the socio-demographic factors associated with depression in geriatric population.Materials and Methods:A systematic review was done on 74 community-based mental health surveys on depression in geriatric population, which were conducted in the continents of Asia, Europe, Australia, North America, and South America. All the studies were conducted between 1955 and 2005. The researchers had included only community-based cross-sectional surveys and some prospective studies that had not excluded depression on baseline. These studies were conducted on homogenous community of geriatric population in the world, who were selected by simple random sampling technique. A qualitative analysis was conducted to study the socio-demographic factors of depression.Results and Conclusion:The two non-modifiable risk factors found to be significantly associated with depression in geriatric population were “older age group” and “female gender”. However, the potentially modifiable risk factors for depression in the geriatric population were identified as low socioeconomic status, loss of spouse, living alone, chronic co-morbidities, cognitive impairment, bereavement and restricted activities of daily living (ADL).

Discontinuation of Lithium Augmentation in Geriatric Patients with Unipolar Depression: A Systematic Review

Lithium is an augmentation strategy for unipolar depression in geriatric populations. This review outlines the evidence in the literature regarding risk of relapse when lithium is discontinued in geriatric patients. Articles were selected based on selection criteria for relevance and design quality (original studies, French or English, patients older than 65 years, patients with an episode of major depressive disorder, meeting DSM-III or greater criteria, and patients who had been successfully treated to remission with lithium augmentation of an antidepressant, then withdrawn from lithium augmentation treatment). Three articles were found. Overall rate of relapse could not be clearly established but a rate of 50% relapse over about 6 months follow-up could be surmised from the study results. There is a risk of relapse in elderly patients whose lithium augmentation treatment for unipolar depression is discontinued. More studies with a randomized control trial design are required to provide more definitive information on this topic.

Managing Depression in Geriatric Populations

Late life depression is an increasingly acute public health concern due to the quickly expanding population of elderly in the US. The last few years has witnessed an explosion in the research literature changing our understanding of this disease. Published studies over the past decade focusing on the epidemiology, phenomenology, comorbidity, and treatment of depression in the elderly were reviewed. The prevalence and phenomenology of depression in late-life varies with age. It remains highly prevalent in the elderly population, and certain vulnerable populations of older adults are at special risk. Further, the morbidity of late-life depression on physical health, social support systems, and overall functioning is considerable, making depression a leading cause of disability in elderly adults and a risk factor for mortality and suicide as well. Findings suggest a heterogeneity in etiology and in treatment response among older adults with depression, and differences from younger adults as well. This paper reviews our current understanding of late life depression and the implications for treatment and prevention. In addition, we review current research questions and future considerations in this field.

The validation of the short form of the Geriatric Depression Scale (GDS) in Greece.

The Geriatric Depression Scale-15 (GDS-15) is a short, 15-item instrument specifically designed to assess depression in geriatric populations. Its items require a yes/no response. The Geriatric Depression Scale was first introduced by Yesavage et al. in 1983, and the short form (GDS-15) was developed by Sheikh and Yesavage in 1986. The aim of the current study was the standardization of the GDS-15 for use in Greece. Subjects were divided into Group A: 168 control subjects, and Group B: 103 patients suffering from clinically diagnosed depression. All were over 65 years of age. A score of 6/7 on the GDS-15 was found to be the best cut-off point for diagnosing depression in an elderly Greek population, with Sensitivity = 92.23 and Specificity = 95.24. GDS-15 manifests high internal consistency with Cronbach's alpha = 0.94, and all items seem to be equivalent. Factor Analysis of the GDS-15 revealed 4 factors: a cognitive (thought content), an affective, a functional, and a factor that reflects helplessness and fear for the future. The two diagnostic groups differed on all 4 factors scores at p-value <0.001.