Author Login

Authors: AKassaw Belay Shiferaw^1*, Ermias Solomon Yalew¹, Ashenafi Zemed¹, Samuel Teferi Chanie¹, Gebreeyesus Abera zeleke², Melisew Mekie Yitayal¹, Molla Fentanew¹ 

1. Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
2. Department of Surgical Nurse, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract:

Background :
Depression is one of the most frequent mental health disorders in the world among the elderly, and it is a serious public health concern because it affects so many people. The global rise in the aging population has sparked concerns about the mental well-being of older individuals. Most studies on mental disorders among older people have been conducted in high-income countries, with similar studies less common in developing countries. This study aimed to determine the prevalence and associated factors of depression among community-dweller older adults living in Gondar town, Northwest Ethiopia. Method :
A community-based cross-sectional study was conducted in Gondar town. Depression was measure by Geriatric Depression Scale-15. Eight hundred and twenty five community dweller older adults were participated in this study. A multistage sampling technique was used to select the study participants. Statistical Package of Social Science version 25 software was used to analyze the data. In the multivariable logistic regression analysis model, adjusted OR (AOR) with a 95% CI and p value0.05 were used to identify the associated factors with depression. Results :
The prevalence of depression was 53.4% (95% CI: 49.8, 57.0). Being female (AOR: 5.758, 95% CI: 1.078–30.765), having an elderly occupation like a housewife (AOR: 4.174, 95% CI: 1.539–11.319), and being retired (AOR: 2.532, 95% CI: 1.104-5.806). Older adults perceived poor social support (AOR: 11.3785, 95% CI: 0.01-25.835), moderate social support (AOR: 2.966, 95% CI: 1.454-6.051), and physical inactivity (AOR: 12.042, 95% CI: 1.580-31.959) as strongly associated with depression. Conclusion :
The prevalence of depression in Gondar town was high. Being female, divorce, housewives, retirees, poor social support, and low physical activity were significantly associated with depression. Depressive symptoms among the elderly must be diagnosed earlier, and proper treatment should be given to increase quality of life and prevent mental health disorders. Keyword :
depression, prevalence, older adults, associated factors, Ethiopia

BACKGROUND: 
The aging of the world population has become a major demographic trend in the twenty-first century. This increase in the aging population presents challenges and opportunities for countries in terms of healthcare and overall well-being for older citizens (1). Depression is one of the most frequent mental health disorders among the elderly in the world, and it is a serious public health concern because it affects many people (2). Depression in older adults often goes untreated because people typically think that it is a normal component of the aging process and a natural reaction to chronic diseases (3). The burden of depressive disorders affects 10 to 20% of older individuals globally, affecting over 300 million people in 2015, as reported by the World Health Organization (4). It also has an economic impact on older adults due to its significant contribution to the rise of direct annual livelihood costs (5) In addition, the aging population is rising in many countries around the world. By 2050, it is anticipated that 80% of the world’s older adults will live in low and middle-income nations, with the number of individuals aged 60 and above reaching 390 million (6). The older population in Ethiopia also increased, approximately 6.1 million people are over the age of 60, and the country is projected to have a total population of almost 115 million in 2022 (7). Older people are more likely to face significant challenges in terms of financial loss, social deprivation, loss of self-worth, and functional limitations when compared to their younger counterparts (8). The usage of health services by older adults increases as a result of depression, putting additional strain on the already overburdened healthcare system. The global rise in the aging population led to a higher prevalence of mental health disorders among the elderly (9). Research indicates that over 20% of adults aged 60 and above grapple with a mental disorder, including depression, dementia, and anxiety (10). Mental health issues in older adults are linked to higher mortality rates, increased suicide risk, and cognitive disorders, all of which have adverse effects on their overall well-being and quality of life (11). A European study found that the lifetime prevalence of any mental disorder among individuals over 65 years was 47.0%, with 35.2% experiencing a mental disorder within the past year (12). In Western countries, the prevalence of mental disorders among older adults was 16.5% (13), while a meta-analysis in China revealed a 38.6% prevalence of depressive symptoms (14). Depression among elders causes significant problems it may accelerate the course of concurrent illness and amplify cognitive impairment and functional disability. The prevalence of depression in the Nepal systematic review reported a range of 25.5% to 60.6% among community-dwelling older adults (15). More recent cross-sectional studies also reported a higher prevalence of depressive symptoms (29%) in Europe (16), 41.8% in Ambo town (17), 45% in womberma district (18),57.9 in Bahir Dar city (19), in Nepal 49.2% (20), all using the GDS-15. Various factors were reported to be associated with the development of depression. Being female, elderly, marital status, presence of a known chronic disease, poor social support, lack of formal education, lower income, substance abuse, employment status, physical inactivity, and overweight or obesity, were contributing factors for depression (18, 21, 22, 23, 24, 25). According to a population-based study, depression amplifies the functional disabilities caused by physical illness, interferes with treatment and rehabilitation, and further contributes to a decline in the physical and cognitive functioning of a person (26). Studies conducted at the community level showed that older adults experienced depression-related complications, especially in low-income countries like Ethiopia (17, 18). Despite the priority of launching a national mental health policy in Ethiopia, interventions against the problem are still limited. In addition, compared with other health services, evidence of depressive disorders tends to be relatively poor. Thus, the level of its burden among older adults is not well addressed in Gondar town, Ethiopia. Lack of adequate evidence about depression in older adults may be a factor that contributes to poor or inconsistent mental health care at the community level (27). Therefore, this study was aimed at determining the prevalence of depression and identifying the contributing factors among older adults in Gondar town, Amhara Region, Ethiopia.

Citation:

Kassaw Belay Shiferaw. Depression and its associated factors among community dweller older adults in Gondar town, Northwest Ethiopia: A cross-sectional study. Journal of Psychiatry Research 2024.