Depression and Associated Factors in the Elderly Cadres in Fuzhou, China: A Community-based Study

Determinants of Depression in Caregivers of Geriatric Patients in Jeddah, Saudi Arabia: A Cross-Sectional Study

Background and Objectives: Caregiving for geriatric patients is essential for ensuring the well-being and quality of life of older adults. Family caregivers play a crucial role, but they often face a significant burden that can lead to adverse mental health outcomes, including depression. This study aimed to estimate the prevalence of depression among caregivers of geriatric patients in Jeddah, Saudi Arabia, and to analyze its association with caregiver burden and various socio-demographic and caregiving parameters. Methods: A cross-sectional study was conducted in Jeddah, Saudi Arabia, between January and March 2024. Adult caregivers of geriatric patients were recruited through various social media platforms. Data were collected via an electronic questionnaire that included demographic information, caregiving parameters, the Patient Health Questionnaire-9 (PHQ-9) for depression screening, and the Zarit Burden Interview (ZBI-12) for caregiver burden assessment. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. Results: Of the 269 participants, the average age was 32 years, and the gender distribution was nearly balanced. The prevalence of depression (PHQ-9 score ≥ 10) among caregivers was 45.4% (95% CI: 39.3, 51.5%). Significant factors associated with higher depression scores included younger age, female gender, single status, being a student, low income, and caregiving burden. In the multivariate analysis, female gender (OR 2.50, 95% CI 1.30-4.80) and caregiving burden (mild-to-moderate burden: OR 6.18, 95% CI 2.94-13.00; high burden: OR 22.75, 95% CI 8.75-59.13) were independent predictors of depression. Conclusions: The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers.

Loneliness, Psychological Well-being, Depression, and Social Participation in the Older Persons: Rural and Urban Differences

INTRODUCTION

The purpose of this study is to compare the loneliness, psychological well- being, depression, and social participation of elderly people living in Turkish society between rural and urban areas. The sample group of the study, in which a correlational survey model was used, consisted of 610 elderly adults.

METHOD

The study population consists of two groups: the first group consists of individuals over 65 years of age living in the city (Istanbul) (n= 291), and the second group consists of individuals over 65 years of age living in rural areas (rural areas of Ordu) (n= 319). Socio-demographic Information Form, Loneliness in the Elderly Scale, Geriatric Depression Scale, Psychological Well-Being in the Elderly Scale, and Social Inclusion Scale were applied online. Statistical analyses of the study were conducted using SPSS 27.00, and the Independent Samples t-test and ANOVA test were used.

RESULTS

According to the findings of this study, statistically significant results were found in psychological well-being, social inclusion, social relations, loneliness and depression, and place of residence. It was observed that the social isolation and social acceptance levels of those living in urban areas were higher than those living in rural areas. Social, loneliness, and depression scores of those living in the village/town were found to be higher than those living in the city centre. Furthermore, the social relationship scores of those living in the village/town were found to be higher than those living in the city centre.

CONCLUSION

The increasing elderly population worldwide has become an issue that requires global measures. Place of residence is one of the factors thought to affect older people's health and well- being. It is thought that the study data will contribute to new policies that will ensure the protection and promotion of elderly health and those working in this field. In addition, the study, which provides information about Turkish culture, will also enable intercultural comparisons.

Urban-rural and gender differential in depressive symptoms among elderly in India

Background

To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly.

Methods

This study used data from Longitudinal Ageing Study in India (LASI) Wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women.

Results

Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly.

Conclusion

Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

Geriatric depression: prevalence and its associated factors in rural Odisha

The world's population is aging rapidly, and the epidemiological transition has led to increased mental disorders worldwide. Geriatric depression is masked by multiple comorbidities or the natural process of aging. Our study aims to estimate the prevalence of geriatric depression and find the risk factors associated with geriatric depression in rural Odisha. The study was a multistage cross-sectional study conducted in the Tangi block, district Khordha, Odisha, from August 2020 to September 2022, among 520 participants selected by probability proportional to size sampling. From the selected participants, eligible 479 older adults were interviewed using a semi-structured interview schedule, Hindi Mini Mental Scale, Geriatric Depression Scale-15, and Hamilton Depression Rating Scale. The step forward multivariable logistic regression was used to assess the associated factors of depression among older adults. Among our participants, 44.4% (213) of older adults were depressed. Substance abuse in family members [AOR: 16.7 (9.1-30.9)], history of elder abuse [AOR: 3.7 (2.1-6.7)], physical dependency [AOR: 2.2 (1.3-3.6)], and financial dependency [AOR: 2.2 (1.3-3.6)] are significant independent risk factors associated with geriatric depression. Living with children [AOR: 0.33 (0.18-0.59)] and recreational activity [AOR: 0.54 (0.34-0.85)] are significant protective factors of geriatric depression. Our study found that geriatric depression is highly prevalent in rural Odisha. Poor quality of family life and physical and financial dependency was found to be the most significant risk factor for geriatric depression.

The prevalence and correlates of depression among older adults in greater kumasi of the ashanti region

BACKGROUND

Approximately two million Ghanaians suffer from mental disorders including depression. The WHO defines it as an illness characterized by constant sadness and loss of interest in activities that a person usually enjoys doing and this condition is the leading cause of mental disorders; however, the burden of depression on the aged population is fairly unknown. A better appreciation of depression and its predictors is necessary to design appropriate policy interventions. Therefore, this study aims to assess the prevalence and correlates of depression among older people in the Greater Kumasi of the Ashanti region.

METHODS

A cross-sectional study design with a multi-stage sampling approach was employed to recruit and collect data from 418 older adults aged 60 years and above at the household level in four enumeration areas (EAs) within the Asokore Mampong Municipality. Households within each EAs were mapped and listed by trained resident enumerators to create a sampling frame. Data was collected electronically with Open Data Kit application over 30 days through face-to-face interaction using the Geriatric Depression Scale (GDS). The results were summarized using descriptive and inferential statistics. A multivariable logistics regression using a forward and backward stepwise approach was employed to identify the predictors of depression in the study sample. All analyses were performed using STATA software version 16, and the significance level was maintained at a p-value < 0.05 and presented at a 95% confidence interval.

RESULTS

The study achieved a response rate of 97.7% from the estimated sample size of 428 respondents. The mean age was 69.9 (SD = 8.8), and the distribution was similar for both sexes (p = 0.25). The prevalence of depression in this study was 42.1% and dominated by females, older adults (> 80 years), and lower economic class respondents. The rate was 43.4% for both consumers of alcohol and smokers with a history of stroke (41.2%) and taking medication for chronic conditions (44.2%). The predictors of depression in our study were being single, low class [aOR = 1.97; 95% CI = 1.18-3.27] and having other chronic conditions [aOR = 1.86; 95% CI = 1.59-4.62], and the inability to manage ones' own affairs [aOR = 0.56; 95% CI = 0.32-0.97].

CONCLUSION

The study provides data that can inform policy decisions on the care of the elderly with depression in Ghana and other similar countries, confirming the need to provide support efforts towards high-risk groups such as single people, people with chronic health conditions, and lower-income people. Additionally, the evidence provided in this study could serve as baseline data for larger and longitudinal studies.

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.

Depression and Associated Factors Among the Elderly Population in an Urban Tertiary Geriatric Hospital in Bangladesh

Background: Geriatric depression becoming a serious concern worldwide, but no studies addressed depression among patients attending outpatient department of a tertiary geriatric care hospital in Bangladesh. Methods: This cross-sectional study was conducted in face-to-face interview using the Geriatric Depression Scale (GDS-15) to measure depression among 230 elderly outpatients (60-80 years old) who visited the hospital for medical reasons in Dhaka city; a variety of socio-demographic, behavioral, and psycho-social variables as well as history of chronic diseases were assessed to detect factors associated with depression. Results: The prevalence of depression was 81.7%; 52.6%, 25.2%, and 3.9% showed mild, moderate and severe depression (the GDS scores 5-8, 9-11, and 12-15), respectively. In logistic regression models, the associated factors included marital status, occupational status, educational status, physical activity, and history of cerebrovascular diseases or stroke. The prevalence of depression was generally higher than other reports elsewhere, and the reason behind this may include the use of the GDS-15 and the setting to carry out this study. Conclusion: Nationally representative investigations are warranted to further address depression among the elderly in Bangladesh; these findings would be helpful for future studies and intervention programs.

Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors

Background

Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life.

Objective

The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia.

Methods

Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors.

Results

The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults.

Conclusion

Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.

Mobile phone addiction and depression among Chinese medical students: the mediating role of sleep quality and the moderating role of peer relationships

The literature has shown that mobile phone addiction is an important risk factor for depression. However, the internal mechanisms of mobile phone addiction leading to depression are still not clear. This study examined the mediating role of sleep quality and moderating role of peer relationships in the association between mobile phone addiction and depression. A sample of 450 Chinese medical students were recruited to complete measures of mobile phone addiction, depression, sleep quality and peer relationships. In this study, SPSS 25.0 and macro PROCESS were used to conduct statistical analysis on the collected data. The results showed that sleep quality partially mediated the association between mobile phone addiction and depression. Moreover, the effect of sleep quality on depression was moderated by peer relationships. The present study can advance our understanding of how and when mobile phone addiction leads to depression. Limitations and implications of this study are discussed.

Effects of Group Music Intervention on Depression for Elderly People in Nursing Homes

Depression is the most common mental problem among the elderly, especially in long-term care facilities. The purpose of the present study was to examine the effects of group music intervention on depression for elderly people in nursing homes. Methods: A randomized control trial consisting of sixty-three elderly participants randomly and blindly assigned to a music group or control group was utilized. The music group received 20 sessions of group music intervention (two 30-min sessions per week for 10 weeks), and the control group received usual care with no music intervention. The Geriatric Depression Scale—Short Form (GDS-SF) and salivary cortisol at baseline, 5 weeks, and 10 weeks were collected for analysis. Results of the GEEs (generalized estimating equations) analysis indicated that after 20 sessions for 10 weeks of group music intervention, the groups showed a statistically significant difference in depression at 5 weeks and 10 weeks. There was no significant difference in the salivary cortisol concentration between the two groups. The results show that the group music intervention may effectively reduce the depression scores for elderly people in nursing homes. Conclusion: The group music intervention has positive effects on depression.

Estructura factorial y datos normativos del Inventario de Depresión de Beck (BDI-II) en población general peruana

El objetivo principal de este estudio fue analizar la dimensionalidad del BDI-II, así como demostrar la invarianza según el sexo y construir datos normativos en población general peruana. Para ello, se contó con la participación de 1665 personas (51.83 % mujeres) procedentes de diferentes regiones del Perú (75.92 % de Cajamarca, 11.05 % de Lima, 6.42 % de La Libertad y 2.62 % de Lambayeque), con un rango de edad de 18 a 54 años (M = 24.99; DE = 8.73), a quienes se les administró el BDI-II. Mediante un análisis factorial confirmatorio se probaron catorce modelos basados en estudios previos. Los resultados indicaron que los modelos bifactor y de segundo orden tenían problemas de convergencia, mientras que los bidimensionales y el unifactorial presentaban adecuados índices de ajuste. Se seleccionó el modelo unidimensional debido a su coherencia teórica, pues los creadores del BDI-II señalan que la prueba se debe interpretar de manera global, sumando los 21 ítems, y desaconsejan la interpretación mediante el cálculo de puntajes separados por dimensiones. Incluso, los antecedentes indican que la varianza explicada del segundo factor es muy baja, por lo cual dicha práctica estaría injustificada. Además, los estudios previos han señalado correlaciones interfactoriales muy altas. Finalmente, se demostró invarianza según el sexo, y los datos normativos, calculados mediante percentiles, mostraron que las puntuaciones superiores a 11 serían clínicamente relevantes. En conclusión, el BDI-II muestra buenas propiedades psicométricas en una estructura unidimensional con 21 ítems, la cual es invariante según el sexo y tiene datos normativos adecuados para población general peruana.

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.

Malnutrition and other risk factors of geriatric depression: a community-based comparative cross-sectional study in older adults in rural Bangladesh

BACKGROUND

Malnutrition and depression are highly prevalent in older adults and can lead to disparaging outcomes. Analytical studies on geriatric depression (GD) and its association with malnutrition are very scarce in Bangladesh, although the size of the older population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in rural older adults.

METHODS

A community-based comparative cross-sectional study was conducted in 600 older adult residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. The study enrolled two groups of participants; 300 depressed as cases and another 300 non-depressed older adults as a comparison group matching their age and living area. We used a semi-structured questionnaire to collect data through a face-to-face interview. Geriatric Depression Scale-15 was used to determine depression, and a score of ≥5 was considered as depressed. We used the Bangla version of the Mini-Nutritional Assessment-Short Form to assess nutritional status, which comprised questions related to appetite, weight loss, mobility, recent illness/stress, dementia/depression, and BMI, and considered a score of 0-7 as the cutoff score for malnutrition. Measures included baseline and personal characteristics, malnutrition, GD, and its associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.

RESULTS

The study found no significant difference in gender (male Vs. female) between depressed (44.0% Vs. 56.0%) and non-depressed (46.0% Vs. 54.0%) older individuals. The study revealed that malnutrition was significantly (p < 0.01) higher in depressed (56.0%) than in non-depressed (18.0%) rural older adults. The malnourished older adults had around three times (AOR = 3.155; 95% CI: 1.53-6.49, p = 0.002) more risk of having depression than the well-nourished older individuals. Older adults who were unemployed (AOR = 4.964; 95% CI: 2.361-10.440; p = 0.0001) and from lower and middle class (AOR = 3.654; 95% CI: 2.266-7.767; p = 0.001) were more likely to experience depression. Older adults having a 'poor diet' were more likely to experience depression (AOR = 3.384; 95% CI: 1.764-6.703; p = 0.0001). The rural older adults who were single (AOR = 2.368; 95% CI: 1.762-6.524; p = 0.001) and tobacco users (AOR = 2.332; 95% CI: 1.663-5.623; p = 0.003) were found more likely to experience depression.

CONCLUSIONS

A significant association between malnutrition and depression was evident by the current study in the rural older individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in providing universal health care for better health and well-being of the rural older populations.

Gender convergence or divergence in the relationship between late-life depression and multiple stressors: evidence from a national survey in China

This study aimed to investigate gender convergence or divergence among older adults in China, a Confucian society with strong persistence of gender role differentiation. We examined how multiple stressors influence depression simultaneously, with gender comparison approach. The data were drawn from the China Longitudinal Aging Social Survey study (N = 8,097). Results indicated that older women reported significantly higher levels of depression than men, yet overall depressive symptoms showed many gender similarities. Surprisingly, our analyses supported the hypothesis of gender convergence in stressors predicting late-life depression. Recommendations for practice and further research priorities based on findings are discussed.

Prevalence of depression and associated factors among elderly people in Womberma District, north-west, Ethiopia

BACKGROUND

Depression is a common mental disorder that suffers many elderly people who are neglected, their problems are overlooked, and no efforts are made to mitigate their suffering. It is a mental health problem which is both underdiagnosed and under treated in primary care settings. This study was aimed to assess the prevalence and associated factors of depression among elderly people in Womberma District, Ethiopia.

METHODS

A community based cross-sectional study was conducted from March 10/2020 - April 08/2020. From a 2269 study population, 959 study participants were selected by using computer-generated simple random sampling techniques from selected kebeles. Data were collected using Geriatric depression scale item 15 through face-to-face interviews. Then, entered into EpiData version 3.1 and then exported to SPSS version 23.0 for analyses. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of depression. An adjusted odds ratio with 95% confidence interval was reported and statistical significance was declared at P-values < 0.05.

RESULTS

The prevalence of depression among elderly people was 45% [95% CI: 41.7-48.5%]. Being female [AOR = 1.60, 95% CI [(1.15-2.23)], (age > =75 years [AOR = 7.95, 95% CI (4.98-12.68)], age 70-74 years [AOR = 5.52, 95% CI (3.52-8.66)], age 65-69 years [AOR = 2.39,95% CI (1.54-3.70)]; divorced [AOR = 2.53, 95% CI (1.59-4.03)], widowed [AOR = 2.65, 95% CI (1.61-4.34)]; poor social support [AOR = 3.32, 95% CI (1.77-6.23)] and presence of known chronic disease [AOR = 1.91, 95% CI (1.30-2.81)] were significantly associated factors with depression.

CONCLUSIONS

In this study, the prevalence of depression among elderly people was high compared with previous studies done in other parts of Ethiopia. Older age, being female, marital loss, presence of known chronic disease, and poor social support were contributing factors for depression among elders. Early screening and co-morbidity management of depression should be comprised in basic primary health care packages. And also, ensuring adequate social support by establishing the Geriatrics care center could play a crucial role to mitigate the suffering of the elders from marital loss provoked loneness and depression.

Prevalence and related influencing factors of depression symptoms among empty-nest older adults in China

BACKGROUND

The phenomenon of empty-nest older adults has raised growing concerns in contemporary Chinese society. In this study, we examined the prevalence and related influencing factors of depression symptoms among empty-nest older adults in China at a national level.

METHODS

The database of the 2015 China Health and Retirement Longitudinal Study (N = 8549, aged ≥ 60) was used. The 10-item version of the Centre for Epidemiologic Studies Depression Scale was employed to measure depression symptoms.

RESULTS

The prevalence of depression symptoms was 34.7 % for empty-nest respondents, 32.2 % for respondents living with a spouse only and 43.4 % for those living alone. Multivariable logistic regression indicated that, compared with the non-empty-nest respondents, older adults living alone were more susceptible to depression symptoms (OR 1.194, 95 %CI 1.016-1.405) whereas older adults living with a spouse only were not exposed to an elevated probability of being depressed (OR 0.945, 95 %CI 0.847-1.055). Multivariable logistic regression also suggested that empty nesters who were female, lived in rural areas, had a lower frequency of children's visits, had lower socioeconomic status and had worse physical health conditions were more vulnerable to depression symptoms.

CONCLUSIONS

The association between empty-nest status and later-life depression is mixed. More concerns should be raised about the mental health of empty nesters living alone. Increased attention should also be paid to empty nesters who are female, rural residents and have low contact frequency with their children, disadvantaged socioeconomic status and poor physical health conditions.

Adding life to years: Role of gender and social and family engagement in geriatric depression in rural areas of Northern India

Background:

Depression among elderly population is a major public health issue affecting nearly 5% to 7% of the world's elderly. In the coming years, a major share will be contributed by developing countries like India. In the rural areas of Allahabad district of Uttar Pradesh, there is scarce data on the depression.

Methodology:

A community-based cross-sectional study was conducted in rural Allahabad. A total of 411 elderly persons were selected from 2 blocks—Jasra and Bahadurpur—through multistage random sampling method. Short form of geriatric depression scale (GDS) was used to assess depression.

Results:

The prevalence of depression among elderly was 19.7%. On binary logistic regression, depression had significant association with female sex [aOR = 2.4, 95% CI 1.1–5.1], having less-than-good relationship with family members [aOR = 2.7, 95% CI 1.2–6.0], not being cared for during illness by family members [aOR = 3.9, 95% CI 1.2-12.9], not being involved in leisure time activities [aOR = 2.5, 95% CI 1.3–4.9], and not regularly meeting relatives and friends [aOR = 4.7, 95% CI 1.9–11.6].

Conclusions:

The prevalence of depression in elderly was high in rural areas of Allahabad. Female sex and social and family engagement are the important predictors of depression among them.

Depression Prediction by Using Ecological Momentary Assessment, Actiwatch Data, and Machine Learning: Observational Study on Older Adults Living Alone

BACKGROUND

Although geriatric depression is prevalent, diagnosis using self-reporting instruments has limitations when measuring the depressed mood of older adults in a community setting. Ecological momentary assessment (EMA) by using wearable devices could be used to collect data to classify older adults into depression groups.

OBJECTIVE

The objective of this study was to develop a machine learning algorithm to predict the classification of depression groups among older adults living alone. We focused on utilizing diverse data collected through a survey, an Actiwatch, and an EMA report related to depression.

METHODS

The prediction model using machine learning was developed in 4 steps: (1) data collection, (2) data processing and representation, (3) data modeling (feature engineering and selection), and (4) training and validation to test the prediction model. Older adults (N=47), living alone in community settings, completed an EMA to report depressed moods 4 times a day for 2 weeks between May 2017 and January 2018. Participants wore an Actiwatch that measured their activity and ambient light exposure every 30 seconds for 2 weeks. At baseline and the end of the 2-week observation, depressive symptoms were assessed using the Korean versions of the Short Geriatric Depression Scale (SGDS-K) and the Hamilton Depression Rating Scale (K-HDRS). Conventional classification based on binary logistic regression was built and compared with 4 machine learning models (the logit, decision tree, boosted trees, and random forest models).

RESULTS

On the basis of the SGDS-K and K-HDRS, 38% (18/47) of the participants were classified into the probable depression group. They reported significantly lower scores of normal mood and physical activity and higher levels of white and red, green, and blue (RGB) light exposures at different degrees of various 4-hour time frames (all P<.05). Sleep efficiency was chosen for modeling through feature selection. Comparing diverse combinations of the selected variables, daily mean EMA score, daily mean activity level, white and RGB light at 4:00 pm to 8:00 pm exposure, and daily sleep efficiency were selected for modeling. Conventional classification based on binary logistic regression had a good model fit (accuracy: 0.705; precision: 0.770; specificity: 0.859; and area under receiver operating characteristic curve or AUC: 0.754). Among the 4 machine learning models, the logit model had the best fit compared with the others (accuracy: 0.910; precision: 0.929; specificity: 0.940; and AUC: 0.960).

CONCLUSIONS

This study provides preliminary evidence for developing a machine learning program to predict the classification of depression groups in older adults living alone. Clinicians should consider using this method to identify underdiagnosed subgroups and monitor daily progression regarding treatment or therapeutic intervention in the community setting. Furthermore, more efforts are needed for researchers and clinicians to diversify data collection methods by using a survey, EMA, and a sensor.

Risk factors of geriatric depression among elderly Bangladeshi people: A pilot interview study

Globally, geriatric depression (GD) has been recognized to be one of the most prevalent problems among the elderly. However, there is an only one previous Bangladeshi study addressing the issue. Consequently, the present study investigated GD and its associated risk factors. A semi-structured face-to-face interview was conducted among 168 self-reported healthy elderly residents (59.5% female) aged 60-80 years in Patuakhali city and the neighboring village. Measures included the Geriatric Depression Scale-15, socio-demographic variables, psychosocial factors, physical health-related factors, lifestyle factors, and dietary factors. Results showed the GD prevalence rate was 36.9% (n = 62). Risk factors for GD included living in a rural area, having no history of chronic disease, having a history of previous personal and/or family depression, not engaging in daily life activities, not exercising regularly, having no hobbies, having a poor diet, and not engaging in religious practices regularly. The GD prevalence rate was generally higher compared to previous studies in other countries. This may have been due to the inclusion criterion of selecting self-reported healthy elderly individuals. It is recommended that a nationally representative study is carried out to assess the actual figure of GD in Bangladesh. The findings are helpful for depression-reducing intervention programs.

Investigating the effect of multisensory stimulation on depression and anxiety of the elderly nursing home residents: A randomized controlled trial

PURPOSE

The aim was to determine the effect of multisensory stimulation (MSS) on the depression and anxiety status among nursing home-dwelling elderly people in Ahvaz, Iran.

DESIGN AND METHODS

This clinical trial study conducted on 28 old people living in nursing homes in Ahvaz, who were divided into two groups of intervention and control. The interventions included sensory stimulations of touch, sound, and sight for 4 weeks and 3 sessions weekly and 25 min per each session.

FINDINGS

The mean depression and anxiety scores of the intervention group before and after the intervention were 14.5 ± 5.5 and 10.1 ± 5.3 and, 9.6 ± 8.1 and 6.1 ± 6.2, respectively.

PRACTICE IMPLICATIONS

MSS could improve the condition of depression and anxiety in the elderly nursing home residents.

Bidirectional association between obstructive sleep apnea and depression: A population-based longitudinal study

An association may exist between obstructive sleep apnea (OSA) and depression. However, results regarding this association are inconsistent, and the direction of the association between OSA and depression remains unknown. Therefore, we used the Taiwan National Health Insurance Research Database to investigate the bidirectional association between OSA and depression.A total of 6427 OSA patients and 32,135 age and sex-matched control subjects were enrolled to analyze the risk of depression among patients with OSA, where 27,073 patients with depression and 135,365 control subjects were enrolled to address the risk of OSA among patients with depression. All subjects were followed to identify their outcomes of interest from January 1, 1997 to December 31, 2012.Cox proportional-hazards models, after adjusting for potential confounders, demonstrated that patients with OSA had an increased risk (adjusted hazard ratio 2.48, 95% confidence interval 2.20-2.79) of developing depression, whereas those with depression were associated with an increased risk of future OSA (adjusted hazard ratio 2.30, 95% confidence interval 2.11-2.50).Our results suggested that a strong bidirectional relationship exists between OSA and depression, with each disease influencing the development of the other. Health providers are recommended to ensure the early detection and management of depression among patients with OSA and vice versa.