Prevalence of geriatric depression in a community sample in Ghana: Analysis of associated risk and protective factors

KNUST aging and human immunodeficiency virus outcomes-Study protocol

INTRODUCTION

Globally, 7 million people with HIV (PWH) aged over 50 years exist. 5 million of them live in sub-Saharan Africa, the epicenter of the HIV epidemic. In Ghana, every 1 in 6 PWH is aged over 50 years. However, access to geriatric health care is grossly limited in Ghana and the sub-Saharan Africa region. This has resulted in a lack of focus on geriatric syndromes, a multi-factorial clinical condition common in older PWH, that do not fit discrete disease categories. Consequently, this gap threatens the life expectancy for aging PWH, necessitating the need to promptly fill it. The KNUST Aging and HIV Outcomes (KAHO) study will help identify priorities and opportunities for developing an effective integrated model of HIV and geriatric healthcare in Ghana.

METHODS AND ANALYSIS

The KAHO study will recruit 151 PWH aged 50 years and older at the Infectious Disease Unit (IDU) of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST). The study will be conducted over a 2-year period and participants will be seen at months 0, 6 and 12. Participants at each visit will be taken through assessments and questionnaires on geriatric health, cognition, social vulnerability, HIV-related conditions and they will provide biospecimens for laboratory testing. We will also conduct semi-structured qualitative interviews of PWH, healthcare providers, policy makers and study research assistants. Quantitative data will be analyzed using one sample proportion test and linear regression models appropriately. The Levesque's framework will be used as a guide to analyze qualitative data.

An analysis of the influencing factors of depression in older adults under the home care model

Objectives

To explore and analyze the influencing factors of depression in older adults living at home, so as to propose suggestions for improving the quality of older adults living at home.

Methods

We conducted a cross-sectional study on 498 older adults living at home based on questionnaire survey on the general information, daily living ability, health status, and care perception (including self-care, care for cohabitants, and care for non-cohabitants) of older adults living at home, as well as their willingness to help each other, and analyzed the influencing factors of depression among older adults living at home.

Results

The results showed a willingness to help older adults, self-care, and total activities of daily living (ADL), health status was an influential factor for depression in older adults (p < 0.05).

Conclusion

It aims to take targeted measures, such as encouraging older adults at home to actively participate in mutual assistance activities for older adults and care for themselves, so as to prevent and reduce the occurrence of depression in older adults.

Childhood abuse as a mediator of the relationship between early family socio-economic status and geriatric depression: A population-based study in China

Previous studies have suggested that childhood socioeconomic status (SES) is linked to geriatric depressive symptoms in many developed countries. However, the potential pathways of the relationship between childhood SES and geriatric depressive symptoms need to be further explored. This study aimed to assess the mediating effect of being abused during childhood on the association between childhood SES and geriatric depressive symptoms, using evidence from a longitudinal study in China. The study cohort included 8137 individuals. Childhood abuse was defined as experiences related to parental violence, sibling abuse, school violence, community violence, and parental quarrel. Results indicated poor childhood SES was associated significantly with geriatric depressive symptoms. The indirect effect of poor childhood SES to high geriatric depressive risk through community violence, sibling abuse, school violence, and parental quarrel were 0.02, 0.01, 0.02, and 0.01, respectively. Our findings shed new light on the literature regarding the impact of childhood SES on elderly depressive symptoms. Furthermore, childhood SES demonstrated a significant correlation with geriatric depressive symptoms through bullying behaviors. The findings highlight the need to promote both childhood social welfare and psychological well-being within the elderly population.

Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey

BACKGROUND

Household food insecurity is the situation where individuals and families have limited/uncertain access to nutritionally adequate and safe foods for healthy living. Family size is the number of persons in the family. Household food insecurity and family size are risk factors for depression. However, their synergistic and/or multiplicative effect on depression is not well investigated. This study investigated/examined household food insecurity, family size and their interaction on depression prevalence among teenaged pregnant girls in Ghana.

METHODS

Population based cluster survey was conducted among 225 teenaged pregnant girls in 20-electoral areas at Twifo-Atti-Morkwa district in the central region of Ghana. Simple random sampling was used to recruit study participants and structured questionnaire used to collect demographic variables. Household Food Insecurity Access Scale (HFIAS) and Revised Children's Anxiety and Depression Scale (RCADS-25) were used to collect data. Multinomial logistic regression models were used to analyzed the data.

RESULTS

Moderate and high depression prevalence reported among teenaged pregnant girls in Twifo-Atti-Morkwa district were 35.1(28.1-42.1) and 33.5 (26.5-40.5) respectively. Moderate family size (AOR = 1.08, 95%CI = 1.17-3.71) and large-family-size (AOR = 2.78, 95%CI = 3.98-10.19) were significant for depression. Moderate food insecurity (AOR = 0.12, 95%CI = 0.41 - 0.35) and high food insecurity (AOR = 0.27, 95%CI = 0.11-0.71) were significant for depression. Interaction between moderate food insecurity and moderate family size (AOR = 1.69, 95%CI = 2.79-17.51), interaction between high food insecurity and low family size (AOR = 1.24, 95%CI 1.57-11.41) and interaction between high food insecurity and large family size (AOR = 1.01, 95%CI = 1.72-14.57) were significant for depression among teenaged pregnant girls.

CONCLUSION

There is moderate and high depression prevalence among teenaged pregnant girls in Twifo-Atti-Morkwa district. Interaction between household food insecurity and family size are the major predictors for depression among the teenaged girls in the district. We therefore recommend that public health officers should be up with health education campaigns in the district to create awareness on the depression prevalence among teenaged girls, and urge them to come out and seek support to prevent the catastrophic effect of depression.

Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis

BACKGROUND

There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted.

METHODS

Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression.

RESULTS

One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings.

LIMITATIONS

The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis.

DISCUSSION

A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.

Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys

BACKGROUND

The reported prevalence of depressive symptoms (depression hereafter) among older adults varied widely across different studies. This was a meta-analysis to systematically examine the global prevalence of depression among older populations and its associated factors.

METHODS

A systematic literature search was performed in PubMed, EMBASE, PsycINFO, and Web of Science. Due to the differences in demographic and clinical characteristics between studies, random-effects model was used to calculate the pooled prevalence of depression and its 95% confidence interval (95% CI).

RESULTS

In total, 55 studies with 59,851 individuals met the study criteria and were included in the analyses. The overall prevalence of depression was 35.1% (95%CI: 30.2-40.4%). Subgroup analyses revealed that different sampling methods (Q=10592.49, p = 0.037), Geriatric Depression Scale versions (Q=13712.55, p < 0.001) and income levels (Q=14.028, P < 0.001) were significantly associated with the pooled prevalence of depression in older adults. In the meta-regression analyses, time of survey (B=0.012, z = 2.30, p = 0.029) was positively associated, and mean age (B=-0.018, z = 2.10, p = 0.044) was negatively associated with the prevalence of depression in older populations. The funnel plot and Egger's test did not reveal any significant publication bias (Egger's test: t = 1.93, p = 0.059).

CONCLUSION

This meta-analysis found that over a third of older populations globally had depression. Effective preventive measures, regular screening and timely interventions are needed to address this highly prevalent public health problem among older adults.

Prevalence of depressive symptoms and their associated factors among older adults in Yirgalem town, Southern Ethiopia: A community-based cross-sectional study

Background

Depression is a serious mental health issue and the largest contributor to disability worldwide. Elderly people with depression are significantly more likely to experience negative outcomes such as poor physical health, strained social relationships, and decreased quality of life. Studies on geriatric depression are limited in developing nations like Ethiopia.

Objectives

The purpose of this study was to determine the prevalence of depressive symptoms and associated factors among older adults in Yirgalem, Southern Ethiopia, in 2022.

Methods

A community-based cross-sectional study was conducted on a sample of 628 older adults in Yirgalem town from May 15 to June 15, 2022. The study subjects were selected using a multi-stage systematic sampling technique. Data were collected using the 15-item Geriatric depression scale through face-to-face interviews. The collected data were edited, cleaned, coded, and entered into Epi data version 4.6 software and analyzed using STATA version 14. Bivariable and multivariate logistic regression analysis was computed to identify factors associated with depression, and statistical significance was declared at a 95% confidence interval with a P-value less than 0.05.

Results

A total of 620 older adults were included in the study, with a response rate of 97.8%. The prevalence of depressive symptoms among older adults was 51.77% (95% CI: 47.83-55.69). Being a woman (AOR = 2.3, 95% CI: 1.56-3141); being of more advanced age: 70-79 years old (AOR = 1.92, 95% CI: 1.20-3.07), 80-89 years old (AOR = 2.15, 95% CI: 1.27-3.65), 90 and older (AOR = 3.77, 95% CI: 1.95-7.79); living alone (AOR = 1.99, 95% CI = 1.17-3.41); having a chronic illness (AOR = 3.24, 95% CI: 1.06-4.46); having anxiety (AOR = 3.40; 95% CI: 2.25-5.14); and having poor social support (AOR = 3.56, 95% CI: 2.09-6.04) were statistically associated with depressive symptoms at a P-value of less than 0.05.

Conclusion

This study found that depression affects more than half of the elderly residents in the study area. More advanced age, being a woman, living alone, having a chronic illness, having anxiety, and having poor social support were all strongly linked to depression. There is a need to integrate counseling and psychiatric services into the community healthcare system.

Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

BACKGROUND

Depression is among the common mental health problems in late-life and an important public health problem. Studies from both middle- and high-income countries have shown that depression is more common among older people than in adolescents. Many older people with depression are overlooked, and fewer efforts are made to mitigate their suffering. Despite depression being a major public health problem among older adults, its overall magnitude, and its main predictors were not determined for the development of appropriate measures. Hence, the objective of this study was, therefore, to estimate the overall prevalence of depression and identify its predictors among older adults in Ethiopia.

METHODS

Available articles were searched by means of different databases using the PRISMA guideline. The quality of the included studies was assessed using a JBI quality appraisal tool. STATA version 14.0 (STATA Corporation, College Station, Texas, USA) statistical software was used to analyze the eligible studies. Subgroup and sensitivity analyses were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots.

RESULT

In this meta-analysis, we included 11 articles that assessed 6521 older adults. The overall prevalence of depression among older adults in Ethiopia was 41.85 (33.52, 50.18). The finding was higher in the Oromia region with a prevalence of 48.07% (95% CI: 35.62, 60.51). The finding also demonstrated that being female (AOR = 1.76, 95% CI: 1.17, 2.63), no formal education (AOR = 1.82, 95% CI: 1.03, 3.19), with chronic diseases (AOR = 2.46, 95% CI: 1.00-6.06), and no social support (AOR = 2.01, 95% CI: 1.06, 3.83) were found to be independent predictors of depression in older Ethiopian adults.

CONCLUSION

Our systematic review and meta-analysis showed that almost two out of five older adults had depression. Female sex, no formal education, having chronic diseases, and no social support were the independent predictors of depression among older adults in Ethiopia. The study emphasizes that depression among older adults in Ethiopia calls for appropriate screening and interventions to reduce the occurrence and its overwhelming consequences.

Associations between water, sanitation, and depression among older people in Ghana: empirical evidence from WHO-SAGE Wave 2 survey

BACKGROUND

While depression is the most frequent psychiatric disorder among the older adults, the use of water and sanitation has been associated with both physical and psychological adverse outcomes. We investigated the associations of water and sanitation with depressive symptoms among older adults in Ghana.

METHODS

The study used data from 4,735 participants in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 2 of adults aged ≥50 years. Major depressive episode (MDE) was assessed using the World Mental Health Survey version of the Composite International Diagnostic Interview and we classified water and sanitation sources based on the Joint Monitoring Program. Multivariate logistic regressions evaluated the associations.

RESULTS

Approximately 7.3% of respondents reported a MDE, 90% and 78% used improved water sources and sanitation facilities respectively, and 77% shared sanitation facilities. Individuals who used unimproved water sources and unimproved sanitation were 1.6 and 1.3 times more likely to report MDE respectively. Also, sex-based analysis showed that the effect of the use of unimproved water and sanitation on depression was much appreciable and more substantial among women compared to men.

CONCLUSIONS

The findings suggest the importance of water and sanitation to the well-being of older people, particularly among women. Policies targeted at improving the mental health in old age should include water and sanitation.

Estimate of the prevalence of depression among older people in Africa: a systematic review and meta-analysis

OBJECTIVE

The current systematic review and meta-analysis aimed to estimate the pooled prevalence of depression among elderly people in Africa.

METHOD

We have searched CINAHIL, PubMed, SCOPUS and Psych-INFO databases to identify important observational studies which reported the prevalence of depression among the elderly. We used a random-effects model due to reported heterogeneity among the included studies. The publication bias was examined by using Egger's test, visual inspection of the symmetry in funnel plots and adjusted using Duval and Tweedie's Trim and Fill analysis. We have meta-analysed the pooled estimates of depression from primary studies by adjusting for publication bias. We used Cochran's Q and the I²-tests to measure heterogeneity across the studies.

RESULT

A total of 23 studies conducted in Africa were included in the current systematic review and meta-analysis, representing a total of 14, 350 elderly population. The pooled prevalence of depression among elderly people in Africa was estimated to be 26.3% (95% CI; 22.2, 30.4%). The estimated pooled prevalence of depression among the elderly in Africa was much higher (43.1%) in studies that used a screening tool to measure depression when compared to studies that used a diagnostic tool (24.2%). Also, the prevalence of depression among female elderly participant (43.10%) was higher than that of male elderly participant (30.90%).

CONCLUSION

One in five elderly population in Africa were depressed, which poses serious health concerns. Timely and targeted screening of depression among the elderly and evidence-based interventions were highly recommended.

Prevalence and determinants of depression among old age: a systematic review and meta-analysis

BACKGROUND

Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric psychiatric disorders and a major risk factor for disability and mortality in elderly patients. Even though depression is a common mental health problem in the elderly population, it is undiagnosed in half of the cases. Several studies showed different and inconsistent prevalence rates in the world. Hence, this study aimed to fill the above gap by producing an average prevalence of depression and associated factors in old age.

OBJECTIVE

This study aims to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression and its determinants among old age.

METHOD

A comprehensive search of PubMed, Scopus, Web of sciences, Google Scholar, and Psych-info from database inception to January 2020. Moreover, the reference list of selected articles was looked at manually to have further eligible articles. The random-effects model was employed during the analysis. Stata-11 was used to determine the average prevalence of depression among old age. A sub-group analysis and sensitivity analysis were also run. A graphical inspection of the funnel plots and Egger's publication bias plot test were checked for the occurrence of publication bias.

RESULT

A search of the electronic and manual system resulted in 1263 articles. Nevertheless, after the huge screening, 42 relevant studies were identified, including, for this meta-analysis, n = 57,486 elderly populations. The average expected prevalence of depression among old age was 31.74% (95% CI 27.90, 35.59). In the sub-group analysis, the pooled prevalence was higher among developing countries; 40.78% than developed countries; 17.05%), studies utilized Geriatrics Depression Scale-30(GDS-30); 40.60% than studies that used GMS; 18.85%, study instrument, and studies having a lower sample size (40.12%) than studies with the higher sample; 20.19%.

CONCLUSION

A high prevalence rate of depression among the old population in the world was unraveled. This study can be considered as an early warning and advised health professionals, health policymakers, and other pertinent stakeholders to take effective control measures and periodic care for the elderly population.

The global prevalence of major depressive disorder (MDD) among the elderly: A systematic review and meta-analysis

BACKGROUND

Major depressive disorder is characterized by a depressed mood or feeling of sadness, loss of interest or pleasure in everyday activities. Depressed individuals have a cognitive impairment, low self-esteem, difficulty making decisions, feeling helpless and hopeless. The factors that have been associated with depression include the lack of social support, living in rural areas, suffering from chronic diseases, smoking, and alcohol abuse. This study aimed to investigate the global prevalence of major depressive disorder in the elderly.

METHOD

The electronic database such as Web of Science (WoS), Scopus, SID, PubMed, Google Scholar, Mag Iran, and IranDoc were systematically searched for studies reporting the prevalence of major depressive disorderin the elderly published up to March 2021. Meta-analysis was performed using Comprehensive Meta-Analysis (CMA) software. Heterogeneity between the studies was evaluated using the I² index. Begg and Mazumdar rank correlation test was used to assess publication bias.

RESULT

A total of 20 studies involving 18953 participants were included in this study. The global prevalence of major depression in the elderly was 13.3 % (95 % CI: 8.4-20.3 %). In the subgroup analysis, the prevalence of major depression in elderly women was 11.9 % (95 % CI: 7.6-18.6) and men 9.7 % (95 % CI: 5.2-17.3). No comparison was made between the two sexes, but based on the confidence intervals and large overlap, the two groups are not statistically different. Among continents, Australia had the highest prevalence of major depression in the elderly at 20.1 % (CI: 14.5-27.2 %). This was followed by Europe at 12.9 % (95 % CI: 5.1-28.9 %).

CONCLUSION

Major depressive disorder has a growing trend in the elderly population of the world. The prevalence of major depression in the elderly depends on various clinical and demographic factors such as age and gender. Therefore, mental health and the quality of life (QoL) of the elderly are important. The present study emphasizes the importance of social support in mental health that can reduce depression in the elderly.

Prevalence and associated factors of depression among older adults in rural Tanzania

OBJECTIVES

Depression is the commonest mental disorder in older adults worldwide, affecting 7% of the world's older population and accounting for 5.7% of years lived with disability among adults aged over 60 years. We conducted a secondary data analysis to determine the point prevalence, associated risk factors and treatment gap for DSM-IV depression among older adults in the Hai District, rural Tanzania.

METHODS

The primary data source was a cross-sectional two-stage community-based dementia study where older adults aged ≥70 years (n = 296) were fully-assessed for dementia and depression in the second stage. Age-adjusted prevalence of depression was determined based on the WHO standard population using the Direct Method. Univariate and multivariate logistic regression models were performed.

RESULTS

Of the 296 older adults assessed for depression, 48 were diagnosed with depression based on Diagnostic and Statistical Manual of Mental Disorders-IV criteria. The median (Inter Quartile Range; QR) age was 80 (75-88) years. Age-adjusted point prevalence of depression was 21.2% (95% CI: 16.6-21.9) and the treatment gap for depression was 100%. There was reduced odds of depression in older adults who rated their physical health as good or very good (adjusted odds ratio [AOR] = 0.22; 95%CI: 0.10-0.46; p < 0.001), or moderate (AOR 0.26; 95%CI: 0.10-0.66; p = 0.005).

CONCLUSIONS

Depression in older adults is associated with physical health status and there is an alarmingly high treatment gap. Future research on depression in older adults should focus on effective interventions to address physical morbidity, psychosocial factors and the treatment gap.

Exploring the influencing factors of quality of life among the empty nesters in Shanxi, China: a structural equation model

Background

As China’s aging trend intensifies and the proportion of empty nests increases, the health-related quality of life of the elderly is the focus of social attention. Previous studies focused on the quality of life of the elderly, rather than empty nesters, and lacked the discussion of the mechanism of influencing factors. Thus, this study aimed to explore the influencing factors of the quality of life (QOL) and interaction mechanisms among empty nesters in Shanxi Province, China, so as to provide practical reference for improving the QOL of empty nesters.

Methods

A total of 4901 empty nesters in Shanxi Province, China, were selected using multi-stage random cluster sampling method in this cross-sectional study. The quality of life was assessed with the Short Form 36 Health Survey (SF-36). Multiple linear regression analysis (stepwise) was performed to examine the factor associated with QOL. Structural equation model (SEM) approach was conducted to test the direct and indirect association between QOL influencing factors with QOL.

Results

The average QOL score of empty nesters was 63.34 (SD = 17.23). The multiple linear regression revealed that gender, age, education, monthly income, drinking status, exercise frequency, physical examination frequency, attention to daily nutritional health, relationship with a spouse and relationship with children were significant predictors of the empty nester’s QOL (P < 0.05) (R² = 0.128). SEM showed that behavioral lifestyle had a direct effect on QOL (β = 0.446, P < 0.001). Socio-economic status had an indirect effect (β = 0.288, P < 0.001) on QOL through behavioral lifestyle. The family relationship had an indirect effect (β = 0.115, P < 0.001) on QOL.

Conclusion

Behavioral lifestyle was the strongest influencing factor in the quality of life among empty nesters, followed by socio-economic status and family relationships. Thus, maintaining a healthy behavioral lifestyle was important to improve the QOL of the empty nesters. Our findings provide a concrete and strong reference for the formulation of targeted intervention strategies.

Old age and depression in Ghana: assessing and addressing diagnosis and treatment gaps

Background: There is limited evidence about the prevalence of depression among older people in sub-Saharan Africa, about access to treatment or the potential efficacy of community-based interventions.

Objective: Using nationally representative data from the WHO SAGE survey, we examine the prevalence of and factors associated with depression among people aged 50 and over in Ghana. Compare self-reported diagnosis and a symptom algorithm to assess treatment gaps and factors associated with the size of gap. Assess the feasibility of a small community-based intervention specifically for older people.

Method: Prevalence and treatment data were taken from the WHO SAGE 2007 survey in Ghana, including 4,725 people aged 50 or over. Outcomes of interest were self-reported depression and diagnosis of depression derived from a symptom-based algorithm. The data were subjected to bivariate and multivariate analysis. In parallel, a pilot intervention was conducted with 35 older people, which included screening by a trained psychiatrist and follow-up group sessions of psychotherapy.

Results: The symptomatic algorithm reported an overall rate of 9.2 per cent for the study population, with associations with female sex and older age. The treatment gap for these cases was found to be 83.0 per cent. The implementation of the pilot study was perceived as effective and replicable by stakeholders and there was some evidence of enhanced outcomes for people with mild depression.

Conclusions: Large numbers of older people in Ghana experience depression, but very few have access to treatment. There is an urgent need to develop and validate community-based services for older people experiencing this condition.

Risk factors for mild depression in older women with overactive bladder syndrome-A cross sectional study

Background

Studies demonstrate an association between severe depression and overactive bladder syndrome (OAB). However, mild depression is constantly overlooked. The aim of this study was to evaluate the clinical and sociodemographic factors associated with mild depression in women with OAB.

Methods

Cross-sectional study involving 241 women over 60 years old in Brasilia, Brazil. All patients were subjected to an interview followed by questionnaires and physical examination. The clinical and sociodemographic variables analyzed were age, body mass index, physical activity level, OAB symptoms, presence of gynecological surgery, fecal incontinence, systemic arterial hypertension, Diabetes Mellitus, anxiety (Beck Anxiety Scale). The Geriatric Depression Scale-15 (GDS-15) was used to identify depression. Univariate logistic regression was used to assess the correlation between mild depression and the variables chosen. Variables with a p-value less than 0.2 were included in the multivariate logistic regression analysis. The level of confidence was set at 95%.

Results

121 volunteers suffered from mild depression. The multivariate analysis demonstrated that gynecological surgery (p < .001) and anxiety (p < .001) are factors associated with mild depression. Older women with a history of gynecological surgery and a GDS-15 score of 2.04 were 1.08 times more likely to develop mild depression compared to older women with no history of gynecological surgery.

Conclusion

Anxiety and a history of gynecological surgery are factors that need to be taken into account and may influence the development of mild depression in older women with OAB. Psychological treatment should be considered an important adjunct in the treatment of women with symptoms of Overactive Bladder Syndrome.

Occurrence of mood disorders among educationally active older adults in Bialystok, Poland: a cross-sectional study

BACKGROUND

Mood disorders in older people are an increasingly serious health and social problem, and their prevalence increases with age. The most common mood disorders are bipolar disorder, which is the occurrence of mania and hypomania, and depressive disorders. The aim of this study was to determine the prevalence of mood disorders in a group of educationally active elderly people living in Bialystok, Poland.

METHODS

The study included a total of 162 people-residents of Bialystok-aged 60 or older; 135 women (83.33%) and 27 men (16.67%). The study used five standardized psychometric scales: The Mood Disorder Questionnaire (MDQ), Hypomania Check List (HCL-32), Geriatric Depression Scale (GDS) and The Zung Self-Rating Depression Scale (Zung SDS).

RESULTS

Nearly 90.00% of the respondents obtained GDS scores indicating the presence of mild depressive symptoms; however, on the Zung SDS, which also evaluates depression symptom levels, the result obtained in almost the same number of respondents showed an absence of these symptoms. A similar percentage of respondents also obtained values on the MDQ that allow to determine a lack of bipolar disorder characteristics in the studied population. Over half of the respondents (58.02%) did not show symptoms of hypomania using the HCL-32. There was a significant correlation between the results of the GDS and Zung SDS, the HCL-32 and MDQ, as well as the HCL-32 and Zung SDS in the total studied group.

CONCLUSIONS

Mood disorders, particularly depression, constitute a significant social and health problem in the group of educationally active older adults living in Bialystok. In light of the obtained research results, it is recommended to conduct and improve already realized health education programs for the elderly on the subject of mood disorder prevention and their impact on quality of life. There is a need for further research on mood disorders in the elderly to determine their prevalence on a national scale.

Prevalence of major depressive disorder in the general population of Iran: A systematic review and meta-analysis

Background: Major depressive disorder (MDD) is the most common psychological disorder and affects many people worldwide. Surveying the prevalence of mental disorders, especially general disorders, such as major depressive disorder, is highly important for health professionals and policymakers. Due to a wide variation of studies concerning the prevalence of major depressive disorder in Iran, the present study was conducted to integrate such results. Methods: To conduct this study, English (PubMed/Medline, Scopus and Web of Science) and Persian (MHRN, Noormgs, Magiran, Iran-Medex, Irandoc, and SID) databases, from 1990 to 2018, were explored. All articles related to the point prevalence of depressive disorders in the general population of Iran were reviewed. The inclusion criteria of the present study were as follow: cross sectional studies based on general populations; the expression of the point prevalence rate and incidence of major depressive disorder for people over 15 years; and the use of a structured or semi-structured clinical interview for diagnosis of the disorder. Studies that were not original (such as review studies) and those that did not represent general populations were excluded from the study. To analyze the data obtained from this study, the second version of Comprehensive Meta-Analysis (CMA) software was used. The total point prevalence was calculated using the meta-analysis method, and the I2 index was used to measure the heterogeneity of the studies. Results: Of 6734 studies, 30 studies with a total sample size of 37 867 were finally included based on proposed inclusion and exclusion criteria. The sample included 20641 women (55%), and 17 226 (45%) men. In the present meta-analysis study, due to significant heterogeneity (I=97.1%, p=0.001) among studies, the randomized method was used, and the total point prevalence was 4.1% (CI: 3.1% 5.5%). The overall point prevalence of major depressive disorder was 4.8% (CI: 3.6% -5.6%) in women and 2.3% (CI: 1.6% -3.6%)in men, which indicated that the incidence of this disorder was 1.95 times more in women than in men. Conclusion: This meta-analysis study found a considerable prevalence of major depressive disorder among Iranian participants and revealed that the point prevalence of the disease was more than two-fold in women compared to men. Considering these findings and the high burden of this disorder for communities, the need to formulate and implement prevention and treatment programs is highly required.