Thai Geriatric Depression Scale Research Articles

Factors Influencing Low Muscle Strength among Community-Dwelling Older Adults with Non-Communicable Diseases

Introduction The presence of low muscle strength serves as a major indicator of sarcopenia and health status in older adults with non-communicable diseases (NCDs), leading to increased morbidity and mortality among them. Objective 1) To describe the prevalence of low muscle strength, and 2) To investigate personal and health factors predicting low muscle strength in community-dwelling older adults with NCDs Design This study employed a correlational predictive design, guided by physiological theory and literature as its conceptual framework. Methodology The participants consisted of 192 community-dwelling older adults diagnosed with non-communicable diseases in Samut Prakan province. Purposive sampling was employed according to the inclusion and exclusion criteria. Data were collected using the Global Physical Activity Questionnaire (GPAQ) version 2, the Thai Geriatric Depression Scale (TGDS-15), and nutritional and muscle strength assessments. Data were then analyzed using descriptive statistics and logistic regression analysis. Results Most of the participants were female (65.1%), with a mean age of 69.60 years (SD = 7.60). The prevalence of low muscle strength among older adults with non-communicable diseases was 54.17%. Personal and health factors including age (OR= 3.47, 95% CI = 1.91-6.33), weight loss (OR= 4.05, 95% CI = 1.11-14.70), physical activity (OR= 0.37, 95% CI = .19-.73), and depression (OR= 3.06, 95% CI = 1.16-8.03) were significantly predicted low muscle strength. Multiple logistic regression analysis revealed that age (OR= 3.02, 95%CI = 1.63-5.59) and physical activity (OR= 0.48, 95%CI = 0.24-0.97) together could predict low muscle strength among older adults with NCDs, accounting for 14.3% of the variance. Recommendation This study demonstrates that age and physical activity significantly predict low muscle strength among older adults with NCDs in the community. Therefore, health promotion programs addressing physical activity should be developed to reduce risk factors and to prevent and delay sarcopenia particularly in older adults of advanced age with NCDs.

Prevalence and Factors Associated with Depression Among Older Adults During the COVID-19 Pandemic: A Cross-Sectional Study in Urban Areas in Thailand.

This study examined the prevalence of and factors associated with depression symptoms among Thai older adults during the COVID-19 pandemic. A cross-sectional survey was conducted among older adults in urban areas in Bangkok, Thailand, between July and October 2021. The 15-item Thai Geriatric Depression Scale (TGDS-15) was used to determine the prevalence of depression symptoms, and multiple logistic regression was conducted to identify the associated factors. A total 156 older adults survey responses were received. The largest group of participants (80.8%) was aged below 70, women (50.6%), married (67.9%), retired (41%), having sufficient income (67.9%), living with their families (89.1%). More than half (71.8%) had an underlying disease, with hypertension being the most common (39.1%). In addition, 17.3% of the participants had received compulsory COVID-19 vaccination. Only 0.6% had a history of COVID-19 infection. The prevalence of depression among Thai older adults was 20.5%. Univariate analysis demonstrated occupation and income sufficiency was associated with depression symptoms. The results of the multivariate analysis found that the "non-worker" group was 3.54 times more likely to experience depression symptoms than the reference group (OR = 3.54, 95% CI = 1.25-10.02, p = 0.018) when controlling for the confounding factors. This study highlights the importance of addressing depression symptoms among Thai older adults, in which occupation and income sufficiency were the main variable factors for depression. Our study further suggested that the importance of interventions such as increasing job availability and establishing financial aid policies may ameliorate depression symptoms among older adults, especially in high-risk groups during the pandemic situation such as the COVID-19.

Cooking Groups for Older Adults: Implications for Functional Abilities

ABSTRACT Occupational therapists utilize cooking groups to optimize intrinsic capacity and functional ability, but there is a lack of scientific evaluation. This quasi-experimental study aimed to investigate the effect of a cooking group on cognitive, emotional, psychomotor, and interpersonal performance in older adults. Nineteen participants with chronic conditions were recruited to attend ten consecutive cooking sessions. Large Allen Cognitive Level Screen-5 (LACLS-5), Thai Geriatric Depression Scale (TGDS-15), psychomotor speed test and interpersonal communication observation were used. The results showed significant improvement in the study outcomes. Therefore, the cooking groups have improved cooperative capacity through engaging the older adults’ functional abilities.

The Geriatric Depression Scale Predicts Glycemic Control in Older Adult with Type 2 Diabetes Mellitus: A Longitudinal Study.

The presence of comorbid depression and diabetes is associated with worse glycemic control, higher complication and greater mortality risk than expected by each condition alone. The association between various levels of severity of depressive symptoms and glycemic control over time among type 2 diabetic older patients was unclear. This study aimed to investigate a longitudinal association between depression and HbA1c among type 2 diabetic older patients. Type 2 diabetes patients aged 60 years and above with normal cognition were recruited from the outpatient department from 1 June 2020 to 1 July 2021. The Thai Geriatric Depression Scale (TGDS) and HbA1c were assessed at five time points (baseline and every 12 weeks) for 1 year. A linear mixed effect model was used. Of the 161 enrolled participants, 146 completed the study. At baseline, 14% were susceptible to depression or having depression (TGDS score 6 and above), and there was a significant correlation between HbA1c and depression (r = 0.26, p ≤ 0.01). The longitudinal analysis indicated that TGDS was a significant predictor of HbA1c in the next visit, and the relationship was J-shaped. A TGDS below 5 was associated with decreasing HbA1c in the next visit, but the association became positive at a TGDS score at 5 or higher. The presence of significant symptoms of depression was associated with glycemic control in the next 3-month interval OPD visit event, although major depressive disorder has not yet been established.

Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression.

Background: Globally, population aging is happening more quickly than in the past, and Thailand ranks the world’s number three among the rapidly aging countries. Age-related decline in physical and mental health would impact depression among older adults. We aimed to determine the depression among the community-dwelling Thai older adults in Chiang Mai, Thailand. Methods: The baseline data, collected by door-to-door household visits of an intervention arm from a cluster randomized controlled trial (Community-Integrated Intermediary Care (CIIC): TCTR20190412004), were included in this cross-sectional study. Descriptive analysis and binary logistic regression were applied. Results: The mean age was 69.31 ± 7.10 years and 23.8% of study participants were older than 75 years. The Thai geriatric depression scale showed 6.5% had depression. Adjusted risk factors for depression were older age, being single, drinking alcohol daily, having diabetes, having experience of a fall last year, self-rated health as neutral, poor/very poor, and moderate/severe dependency by ADL scoring. Conclusion: Our findings highlighted the potentially modifiable risk factors in addition to the common predictors affecting depression among community-dwelling older adults. Fall prevention programs and public health interventions to prevent diabetes are recommended. Furthermore, self-rated health and Barthel’s ADL scoring would be simple tools to predict risk factors for geriatric depression.

Factors Associated with Depressive Symptoms in Elderly Individuals Living in Urban Communities.

BackgroundDepression is one of the most significant mental illnesses in the elderly population. Societal and economic changes in the social structure, particularly in urban communities, have led to a tendency toward depression in the elderly. Therefore, understanding the factors associated with depression among the elderly living in urban areas in Thailand is important to prevent and mitigate depression.ObjectiveTo investigate the proportion of depression and its associated factors in the elderly living in Bangkok.Materials and MethodsThis was a cross-sectional descriptive study with a sample size of 888 people living in Thai urban communities, including those in slum, urban, suburban, and high-rise building areas. A two-parts questionnaire was used: 1) the Thai Geriatric Depression Scale (TGDS) to assess depression and 2) associated factors.ResultsThe overall percentage of depression in the sample population was 7.3%, and the proportion of depression was associated with community density (p = 0.031). The factors significantly associated with depression in the elderly included anxiety about an underlying disease [adjusted odds ratio (AOR) = 7.51; 95% CI 3.47–16.27], family conflict (AOR = 6.30; 95% CI 1.34–29.55), family history of psychiatric illness (AOR = 5.78; 95% CI 2.35–14.21), financial problems (AOR = 3.81; 95% CI 2.08–6.98), living separately from a spouse (AOR = 3.31; 95% CI 1.22–8.98), and less or no activity participation (AOR = 3.09; 95% CI 1.32–7.26 and AOR = 3.02; 95% CI 1.29–7.09).ConclusionTo mitigate depression in the elderly, attention should be given to any underlying medical disease. The community also should promote more activities accessible to the elderly, especially income-earning activities. These activities might promote better relationships or ease conflict among elderly and other family members.

Factors Predicting Spiritual Well-Being among Dependent Older People

Spiritual well-being is a deep feeling within the mind that represents peacefulness and the inner strength of individuals, resulting from an understanding of the nature of life and acceptance of changes occurring to themselves. Spiritual well-being is; therefore, very important to dependent older people. The objectives of this study were to identify the levels of spiritual well-being of dependent older people, to examine the relationships between religious belief, religious practice, self-esteem, social support, depression, and spiritual well-being, and to examine the ability of those factors to predict spiritual well-being among dependent older people. The study sample were 395 of people aged 60 years and above who are dependent and live in three provinces in southern Thailand. Data were collected using questionnaires, including the Spiritual Well-Being Scale for Dependent Older People, Thai version of the Rosenberg Self-Esteem Scale, Thai version of the Multidimensional Scale of Perceived Social Support, Thai Geriatric Depression Scale, the Religious Practices Questionnaire, and the Buddhist Belief Questionnaire. Data were analyzed using descriptive statistics, Spearman’s rank correlation coefficient, and multiple regression analysis. The study results were as follows: 1) The spiritual well-being among dependent older people was at a moderate level (x̅ = 46.97, SD = 7.22). 2) Religious belief, religious practice, self-esteem, and social support significantly related positively to spiritual well-being (p < 0.01), while depression significantly related negatively to spiritual well-being (p < 0.01). 3) Religious belief, self-esteem, and social support together could explain 46.00 % of the variance in spiritual well-being. The results of this study can be used by nurses and health care providers to determine interventions for enhancing spiritual well-being in this particular group of older people.
 HIGHLIGHTS
 
 Spiritual well-being is one of the important dimensions of holistic care. Spiritual well-being has a positive effect on physical, mental and social health
 The conceptual framework is guided by the Buddhism Principles
 Religious belief, self-esteem, and social support together could explain 46.00 % of the variance in spiritual well-being

The Prevalence and Associated Factors of the Fear of Falling in Elderly Patients at the Primary Care Clinic of Songklanagarind Hospital

Objective: The fear of falling (FOF) is defined as low perceived self-efficacy at avoiding falls during the nonhazardous activities of daily life. The FOF can lead to negative consequences including the physical change, and it might decrease the quality of life of the elderly. The aim of study was to assess the prevalence of FOF and identify the associated factors among Thai elderly patients. Methods: A cross-sectional study was performed. A total of 101 participants 60 years or older were recruited from October to November 2017. The data obtained through questionnaires, face-to-face interviews, and gait and balance tests that were measured by the researchers. The structured questionnaire included demographic data, history of falls, the Thai geriatric depression scale (TGDS), the Falls Efficacy Scale-International (FES-I), and the Thai mental state examination (TMSE). The balance and gait tests were conducted using the timed up and go (TUG) test and the Berg balance scale. Results: The prevalence of FOF was 70.3%. The logistic regression analysis showed a significant association between FOF and female gender (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.63-10.46), whereas factors were not associated with FOF included age, living status, education, number of underlying disease, comorbidities, number of drugs used, history of fall, consequences of falls, visual acuity, TGDS, TMSE, TUG, and Berg balance test. In the multivariate model, the factors associated with the FOF were gender (OR, 4.28; 95% CI, 1.58-12.14) and hypertension (OR, 3.46; 95% CI, 1.11-11.72). Conclusion: The prevalence of FOF was high among Thai elderly patients. The present findings may help health care providers identify individuals who have FOF. These people could benefit from interventions, which focus on gender differences and hypertension aimed at reducing the FOF.

Health Literacy and Long-Term Care Needs among Thai Elderly in Rural Communities

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community

Effectiveness of Behavioral Activation in Treating Thai Older Adults with Subthreshold Depression Residing in the Community.

BackgroundIn recent years, behavioral activation (BA) has attracted increased interest as an effective depression treatment. However, empirical evidence supporting its effectiveness in non-Western countries is currently limited.ObjectiveTo examine the effectiveness of BA in reducing depressive symptoms, stress, and anxiety among Thai older adults with subthreshold depression.Methods and SubjectsA clustered randomized controlled trial was conducted in two health promoting hospitals (HPHs) in the Samut Songkhram province of Thailand. One hospital was used for the intervention (BA+usual care group) and the other for the control (usual care-only group). Each HPH randomly selected 41 eligible older adults residing in their jurisdictions to take part in the study. Mental health outcomes were assessed using the Thai Geriatric Depression Scale (TGDS) and Depression Anxiety Stress Scales (DASS). The BA effectiveness was evaluated using generalized estimating equations (GEE) at a group level and the reliable change index (RCI) at the individual level.ResultsOver 9 months, the adjusted mean change in depression (TGDS) scores [−2.47 (95% CI: −3.84, −1.00)], mental health status (DASS), specifically depression and stress score [−1.47 and −1.87 (95% CI: −2.43, −0.50 and −2.94, −0.79, respectively)], improved significantly in the BA+usual care group compared to the usual care-only group, whereas anxiety score improved significantly only at 6 months [−0.87 (95% CI: −1.52, −0.23)]. Additional RCI analysis showed that BA was directly associated with 14.63 to 24.39% points increase in the reliable improvement of depressive outcome compared to the usual care-only group.ConclusionThis study showed that the BA effectively improved depression, stress, and anxiety in older adults with subthreshold depression in a Thai community setting. Future research should evaluate the longer-term effectiveness of BA in diverse population groups.

Effectiveness of a Qigong program on sleep quality among community-dwelling older adults with mild to moderate depression

PurposeThe purpose of this study was to determine the effectiveness of a Qigong program on older adults in the Thai community suffering from mild to moderate depression.Design/methodology/approachA randomized controlled trial study was conducted in a public health service (PHS) center setting. Sixty-six older adults aged 60–90 years with mild to moderate depressive symptoms measured by the Thai Geriatric Depression Scale (TGDS: scores 13–24) were recruited and randomly allocated into two groups. The subjective sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (TPSQI). The Qigong program group was given 12 weeks of Qigong training including three sessions per week, while the control group followed normal PHS activities (singing and praying). The outcome measure was the change in the TGDS from baseline to 12 weeks.FindingsParticipants in the Qigong program group had a significantly improved TPSQI global score (p < 0.001), subjective sleep quality (p < 0.001), and sleep latency (p < 0.05) after 12 weeks of intervention, while those in the control group showed no significant difference in sleep quality. Compared with the control group, the Qigong program group reported significantly better sleep quality throughout the 12-week period. The prevalence of poor sleep quality in this population was 82 percent.Originality/valueThis study confirmed that the Qigong program could improve sleep quality in older adults with mild to moderate depressive symptoms as the Qigong program conferred more significant improvements than the usual program.

Prevalence and associated factors influencing depression in older adults living in rural Thailand: A cross-sectional study.

Depression is a major disease burden in Thailand. In rural areas, young adults will leave home to work in cities, and older adults are left behind. Loneliness and comorbidities can lead to depression in older adults. The present study aimed to evaluate the prevalence and associated factors for geriatric depression. A cross-sectional study was carried out. Questionnaires including the Thai Geriatric Depression Scale and family relationship were obtained by healthcare professions by face-to-face interviews of 584 older people aged ≥60 years in Ban Nayao community, Chachoengsao Province, Thailand. Geriatric depression can be defined as depressive syndromes that arise in adults aged ≥60 years. We excluded those who had visual or auditory disabilities or did not pass the Thai Mini-Mental Status Examination. The prevalence and associated factors for geriatric depression were obtained. Associated factors were analyzed by multivariate logistic regression. A total of 433 older people were eligible. The prevalence of geriatric depression was 18.5%. Of the participants, 54.1% lived in an imbalanced family type. Multivariate analysis showed the significance for female sex (adjusted OR 2.78, 95% CI 1.54-7.49, P = 0.01), illiteracy (adjusted OR 2.86, 95% CI 1.19-6.17, P-value 0.04), current smoker (adjusted OR 4.25, 95% CI 2.12-10.18, P = 0.009) and imbalanced family type (low attachment, low cooperation and poor alignment between each member; adjusted OR 4.52, 95% CI 2.14-7.86, P < 0.001) as risk factors for depression. The prevalence of geriatric depression in rural Thailand is high. Imbalanced family type is an important risk factor for geriatric depression in the rural community. Geriatr Gerontol Int 2019; 19: 1248-1253.

Psychological factors associated with functional recovery among patients with a peripheral arterial disease after lower extremity bypass

Functional recovery, described by walking ability, is one of the significant outcomes for patients with peripheral arterial disease (PAD) after lower extremity bypass. Little is known about associated factors that help to improve this outcome. The purpose of this study was to examine factors associated with functional recovery among patients with PAD after lower extremity bypass, such as postoperative period, social support, and depression. Data were collected in a University Hospital in Bangkok, Thailand. A sample of 77 patients with PAD receiving lower extremity bypass treatment was recruited into the study. The interview questionnaires consisted of demographic characteristics, Medical Outcome Study social survey, Thai Geriatric Depression Scale, and Walking Impairment Questionnaire. Reliability of each instrument was 0.97, 0.87, and 0.92, respectively. Pearson's correlation was performed to identify the factors associated with functional recovery. The mean values of age, postoperative period, and walking ability score were 63.92years (standard deviation [SD]=11.21), 4.19years (SD=3.52), and 62.52 (SD=13.83). Functional recovery and social support were significantly associated with depression (r=-0.272, P<.05; r=-0.463, P<.01, respectively). The postoperative period was also significantly associated with social support (r=0.247, P<.03).In conclusion, psychological factors were significantly related to functional recovery among patients with PAD after lower extremity bypass. Therefore, health-care providers should consider these factors during discharge planning, and screening depression score as baseline should be performed.

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.

The effectiveness of a cognitive training program in people with mild cognitive impairment: A study in urban community.

To assess the effectiveness of a cognitive training program on global cognition among people with mild cognitive impairment. In this experimental study, using purposive sampling, 60 participants age 50 years and over who complained of subjective memory impairment were screened in their communities by public health volunteers with the Abbreviated Mental Test. Those with dementia were excluded as well as those with depression, which were screened out by the Thai Geriatric Depression Scale (TGDS-15). Mild cognitive impairment was diagnosed and confirmed by the Montreal Cognitive Assessment (MoCA) and joint agreement between a psychiatrist and a neurologist. The participants were alternately assigned to receive a cognitive training program (intervention group) while the other half received their normal usual therapy (control group). The program involved training of 4 aspects of cognition through 6 sessions; 2 sessions per month for 3 months. The MoCA and TGDS-15 scales were given at baseline and again at week 13, and at months 6 and 9. Independent t-tests were used to compare changes in global cognition among the two groups. MoCA scores at 9 months were significantly higher than at baseline in both groups. However, the mean difference in intervention group was significantly higher than control group. TGDS-15 scores at 6 months was significantly lower than at baseline among the intervention group but not the control group. This cognitive training program helped to improve global cognition and reduce depressive symptoms.

DUPLICATE: The effectiveness of a cognitive training program in people with mild cognitive impairment: A study in urban community.

To assess the effectiveness of a cognitive training program on global cognition among people with mild cognitive impairment. In this experimental study, using purposive sampling, 60 participants age 50 years and over who complained of subjective memory impairment were screened in their communities by public health volunteers with the Abbreviated Mental Test. Those with dementia were excluded as well as those with depression, which were screened out by the Thai Geriatric Depression Scale (TGDS-15). Mild cognitive impairment was diagnosed and confirmed by the Montreal Cognitive Assessment (MoCA) and joint agreement between a psychiatrist and a neurologist. The participants were alternately assigned to receive a cognitive training program (intervention group) while the other half received their normal usual therapy (control group). The program involved training of 4 aspects of cognition through 6 sessions; 2 sessions per month for 3 months. The MoCA and TGDS-15 scales were given at baseline and again at week 13, and at months 6 and 9. Independent t-tests were used to compare changes in global cognition among the two groups. MoCA scores at 9 months were significantly higher than at baseline in both groups. However, the mean difference in intervention group was significantly higher than control group. TGDS-15 scores at 6 months was significantly lower than at baseline among the intervention group but not the control group. This cognitive training program helped to improve global cognition and reduce depressive symptoms.

Physical activity and depression in older adults with and without cognitive impairment.

ABSTRACTLow physical activity and depression may be related to cognitive impairment in the elderly.Objetive:To determine depression and physical activity (PA) among older adults with and without cognitive impairment.Methods:156 older adults, both males and females, aged ≥60 years, were asked to complete the Thai Mini-Mental State Examination (Thai-MMSE), a global cognitive impairment screening tool. Seventy-eight older adults with cognitive impairment and 78 older adults without cognitive impairment were then separately administered two questionnaires (i.e., the Thai Geriatric Depression Scale; TGDS and Global Physical Activity Questionnaire; GPAQ). Logistic regression analysis was used to determine the risk of developing cognitive impairment in the groups of older individuals with and without cognitive impairment.Results:A cross-sectional study of elderly with a mean age of 74.47 ± 8.14 years was conducted. There were significant differences on the depression scale and in PA between older adults with and without cognitive impairment. Further, participants with low PA and high level of depressive symptoms had an increased risk of cognitive impairment (Odds ratio = 4.808 and 3.298, respectively).Conclusion:Significant differences were noted in PA and on depression scales between older adults with and without cognitive impairment. Therefore, increased PA and decreased depressive symptoms (i.e., having psychological support) are suggested to reduce the risks of cognitive impairment in older adults.

Predictors of depressive symptoms in older adults living in care homes in Thailand

Thai culture traditionally abhors elders living in care homes due to the belief that this represents a dereliction of filial piety by their children, thus care homes are stigmatized as the domain of poor older adults with no family. This may impact negatively on psychological wellbeing of residents, although little is known about the key factors influencing depressive symptoms. Therefore, this study explores factors associated with depressive symptoms, internalised stigma, self-esteem, social support and coping strategies among older adults residing in care homes in Thailand. A cross-sectional questionnaire study was conducted with 128 older residents recruited from two care homes in Northeast Thailand. Data were collected using the 15-Item Thai Geriatric Depression Scale, Internalised Stigma of Living in a Care Home Scale, Thai Version of Rosenberg Self-Esteem Scale, Thai Version of Multidimensional Scale of Perceived Social Support and the Coping Strategies Inventory Short-Form. Depressive symptoms were significantly correlated with internalised stigma, self-esteem and social support (r=0.563, -0.574 and -0.333) (p<0.001), respectively. Perceived internalised stigma of living in a care home was the strongest predictor of care home residents reporting depressive symptoms (odds ratio=9.165). Older adults who perceived high internalised stigma of living in a care home were over nine times as likely to report experiencing depressive symptoms. Efforts to decrease or prevent perceived internalised stigma might help to reduce depressive symptoms. Interventions might include media collaboration, educational interventions in the care home setting and organising social activities for residents and their families.

Factors Related to Depression among Older People Living in Homes for the Aged of the Western Part of Thailand

# Introduction: Geriatric depression is one of the significant mental health issues for older people. This descriptive study aimed to investigate the correlation between selected factors and depression among older people, living in homes for the aged in the western part of Thailand. # Methods: 107 older people, living in two homes for the aged of the western part of Thailand were recruited to the study, using cluster sampling. Three questionnaires, including the Barthel Index Activity of Daily living (BADL), the Thai Geriatric Depression Scale (TGDS), and personal characteristics, perceived health status, chronic diseases, family relationship, and recent grief and loss experience were used. The quality of all questionnaires, especially the reliability of BADL, TGDS, and selected factors (e.g., health factors) were 0.95, 0.93, and 0.72 respectively. After finishing data collection, percentages, medians, and Spearman's rank correlation and Mann-Whitney U were used to analyze the data. # Results and discussion: The results revealed that nearly half (41.1%) of older people suffered from depression. Furthermore, income, perceived health status, and Barthel ADL index were significantly negatively associated with depression at p\<0.01; whereas, the number of chronic diseases was significantly positively associated with depression at p\<0.05. # Conclusion: results on the correlation may guide the practice in the future. For example, the officers or health care providers in homes for the aged should encourage older people to be independent, improve their perceived health status, increase health promoting behaviors to prevent or delay chronic illnesses, or increase older people incomes by promoting the appropriate occupation.

Quality of Life among Community-Dwelling Stroke Survivors

Background: The prevalence of stroke has been increasing. Post-stroke survivors often have deformities which impact their quality of life. Objective: To examine the relationship between demographic data, ability of daily living, depression, social supports.and quality of life in post-stroke survivors. Methods: A cross-sectional, descriptive correlational design was used in the study. One hundred and three stroke survivors were selected from Saraburi hospital by using purposive sampling technique, and completed Socio-demographic characteristics, Barthel Activity of daily Living index, Thai Geriatric Depression Scale, Social Support Measure, and World Health Organization Quality of Life in Brief version. The overall reliability was 0.93. Data analysis: Data were analyzed by using percentage arithmetic means, standard deviation, Chi-square, and Pearson’s Product Moment Correlation Coefficient. Results: Most of participants were males (56.3%), and married (63.1%), primary school educated (71.8%). Participants were, on average 62.59 years old and 54.01 months post-stroke. Average monthly income was 2231.07 bath. The major symptoms were hemiparesis (100%), imbalance movement (39.8%), aspirate and constipation (20.4%) respectively. Moreover, the majority showed depression at a normal level (65%), were able to perform their daily living activities (75.7%), the mean overall social support score was moderate level (M = 87.35, SD = 19.61), especially material and financial support (M =18.37, SD = 4.32). Regarding the quality of life, most participants perceived their quality of life either overall or individual dimension at a moderate level (M = 78.59, SD = 15.2). Chi-square and Pearson’s Product Moment Correlation Coefficient were conducted to explore the relationships between those variables and quality of life. The results showed that social support, ability of daily living, and educational level were statistically significant positive relationships with the quality of life (r=0.74, p<0.01, r=0.27, p<0.01, r=0.28, p<0.01) respectively. In addition, there was statistically significant negative relationships between length of diagnosis with stroke, depression level and quality of life (r= -0.21, p<0.05, r = -0.23, p<0.05). These results implied that the participants who had received more social support, more independence to perform their daily living, higher education, lower depression level, and shorter periods of stroke diagnosis were more likely to have a better quality of life. Conclusion: This finding will guide health care professionals to strengthen social support for improving quality of life in community- dwelling stroke survivors