1
|
Edwards N, Walker S, Paddick SM, Prina AM, Chinnasamy M, Reddy N, Mboya IB, Mtei M, Varghese M, Nakkasuja N, Guerra M, Sapkota N, Dotchin C. 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. J Affect Disord 2023; 325:656-674. [PMID: 36681304 DOI: 10.1016/j.jad.2023.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
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.
Collapse
Affiliation(s)
- N Edwards
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
| | - S Walker
- Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - S-M Paddick
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Population Health Sciences Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - A M Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Chinnasamy
- Bradford Primary Care NHS Foundation Trust, Bradford, UK
| | - N Reddy
- Newcastle University, Newcastle-Upon-Tyne, UK
| | - I B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Mtei
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Nakkasuja
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - M Guerra
- Memory and Depression Centre, Cayetano Heredia Peruvian University, Peru
| | - N Sapkota
- B.P Koirala Institute of Health Sciences, Dhahran, Eastern Nepal, Nepal
| | - C Dotchin
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| |
Collapse
|
2
|
Silva SPZ, Bocchi SCM. Measuring suicide risk in the elderly with non-institutionalized depression: an integrative review. Rev Bras Enferm 2020; 73:e20200106. [PMID: 33111806 DOI: 10.1590/0034-7167-2020-0106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/28/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Analyze the state of the art about instruments, at national and international levels, for assessing the risk of suicide in elderly people with depression assisted in the community. METHODS Integrative review of 38 complete articles, published in journals indexed in the databases: US National Library of Medicine (PubMed Central), Scopus, CINAHL and Web of Science, located using controlled descriptors combined with Boolean operators: elderly OR aged OR older OR elder OR geriatric AND depression AND suicide AND risk assessment. RESULTS Six instruments were found, all international and published in the English language, in order to identify suicidal behavior and ideation in the elderly. Of these, two are specific scales for assessing the risk of suicide in the elderly in the community: 5-item GDS subscale and Geriatric Suicide Ideation Scale. FINAL CONSIDERATIONS With the scarcity of national instruments to assess such risk, research is recommended to cross-culturally adapt one of these scales to the Brazilian Portuguese language.
Collapse
|