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      Prevalence and Predictors of Depression in Community-Dwelling Elderly in Rural Haryana, India

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          Abstract

          Background:

          Depression in the elderly has been emerged as a serious public health challenge in the developing countries. Elderly population with depression is on rise in India, but is not adequately addressed. This study was planned to ascertain the prevalence of depression among elderly in a rural population of Haryana and assess its socio-demographic correlates.

          Methods:

          This study was a community based, cross sectional study, which was conducted in Community Health Centre (CHC), Chiri of Rohtak district (Haryana, India). Of total 124 Anganwadi centres in study area, 10 were randomly selected. A total 500 elderly persons aged 60 years and above were randomly screened for depression. Long form of Geriatric Depression Scale (GDS- 30) was used with cut off score at 22. The Pearson’s Chi-squared test, student’s t test, and multiple logistic regression were used to assess the association of depression in the elderly with its risk factors.

          Result:

          In our study, the prevalence of depression in the elderly was 14.4% (95% CI: 11.6- 17.8). Mean age of study population was 68.5 ± 7.7 years. Depression in the elderly had significant association with female gender [OR=2.7 (95% CI 1.4- 5.0)], not being consulted for major decisions [OR=2.7 (95% CI 1.5- 4.7)], presence of any chronic morbidity [OR=2.4 (95% CI 1.3- 4.5)], spending day without doing any activity, work or hobby [OR=3.8 (2.1- 7.1)], and death of any close relative in the last 1 year [OR=2 (1.1- 3.7)] after adjustment of various factors.

          Conclusion:

          Our study revealed that the prevalence of depression in the elderly was 14.4% in a rural community of north India.

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          Most cited references42

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          Epidemiology and treatment of depression in patients with chronic medical illness

          There is a bidirectional relationship between depression and chronic medical disorders. The adverse health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications associated with chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical costs, poor adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical disorders. Depression may worsen the course of medical disorders because of its effect on proinflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic factors, in addition to being associated with a higher risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant medication are efficacious treatments for depression. Collaborative depression care has been shown to be an effective way to deliver these treatments to large primary care populations with depression and chronic medical illness.
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            Risk factors for depression among elderly community subjects: a systematic review and meta-analysis.

            The goal of this study was to determine risk factors for depression among elderly community subjects. MEDLINE and PsycINFO were searched for potentially relevant articles published from January 1966 to June 2001 and from January 1967 to June 2001, respectively. The bibliographies of relevant articles were searched for additional references. Twenty studies met the following six inclusion criteria: original research reported in an English or French publication, study group of community residents, age of subjects 50 years or more, prospective study design, examination of at least one risk factor, and use of an acceptable definition of depression. The validity of studies was assessed according to the four primary criteria for risk factor studies described by the Evidence-Based Medicine Working Group. Information about group size at baseline and follow-up, age, proportion of men, depression criteria, exclusion criteria at baseline, length of follow-up, number of incident cases of depression, and risk factors was abstracted from each report. Follow-up of the inception cohort was incomplete in most studies. In the qualitative meta-analysis, risk factors identified by both univariate and multivariate techniques in at least two studies each were disability, new medical illness, poor health status, prior depression, poor self-perceived health, and bereavement. In the quantitative meta-analysis, bereavement, sleep disturbance, disability, prior depression, and female gender were significant risk factors. Despite the methodologic limitations of the studies and this meta-analysis, bereavement, sleep disturbance, disability, prior depression, and female gender appear to be important risk factors for depression among elderly community subjects.
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              Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study.

              The EURO-D, a12-item self-report questionnaire for depression, was developed with the aim of facilitating cross-cultural research into late-life depression in Europe. To describe the national variation in depression symptoms and syndrome prevalence across ten European countries. The EURO-D was administered to cross-sectional nationally representative samples of non-institutionalised persons aged > or =50 years (n=22 777). The effects of age, gender, education and cognitive functioning on individual symptoms and EURO-D factor scores were estimated. Country-specific depression prevalence rates and mean factor scores were re-estimated, adjusted for these compositional effects. The prevalence of all symptoms was higher in the Latin ethno-lingual group of countries, especially symptoms related to motivation. Women scored higher on affective suffering; older people and those with impaired verbal fluency scored higher on motivation. The prevalence of individual EURO-D symptoms and of probable depression (cut-off score > or =4) varied consistently between countries. Standardising for effects of age, gender, education and cognitive function suggested that these compositional factors did not account for the observed variation.
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                Author and article information

                Journal
                Indian J Community Med
                Indian J Community Med
                IJCM
                Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0970-0218
                1998-3581
                Jan-Mar 2017
                : 42
                : 1
                : 13-18
                Affiliations
                [1]Department of Community Medicine School of Public Health, PGIMER, Chandigarh, India
                [1 ]Centre for Health Systems & Policy Research and Institute of Health Management Research, IIHMR University, Jaipur, India
                [2 ]Department of Psychiatry, Pt. B D Sharma PGIMS, Rohtak, India
                [3 ]Department of Community Medicine, Pt. B D Sharma PGIMS, Rohtak, India
                Author notes
                Address for correspondence: Dr. Manju Pilania, Department of Community Medicine School of Public Health, PGIMER Chandigarh, India. E-mail: drmanjupilania@ 123456gmail.com
                Article
                IJCM-42-13
                10.4103/0970-0218.199792
                5348997
                28331248
                31ca1fed-d063-4e37-ab4d-8fdc7be6abfc
                Copyright: © 2017 Indian Journal of Community Medicine

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 03 July 2015
                : 26 July 2016
                Categories
                Original Article

                Public health
                depression,elderly,prevalence,rural
                Public health
                depression, elderly, prevalence, rural

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