Depressive symptomatology among Turkish older adults with low incomes in a rural community sample

Prevalence of common mental disorders in widowhood: A systematic review and meta-analysis

BACKGROUND

Widowed people have a high risk of common mental disorders, however no summary estimates of the prevalences exist. The aim of this study was to conduct a systematic review and meta-analysis of the prevalence of common mental disorders in widowed people in the community.

METHODS

MEDLINE, Embase and PsycInfo were searched for papers reporting on prevalence of common mental disorders and widowhood. Eligible studies were included in random effects meta-analyses of the prevalence of depression and anxiety disorders. Subgroup analyses were performed on method of assessment of depression and age and sex.

RESULTS

The literature search identified 13,781 titles of which 42 were eligible for meta-analysis. The pooled prevalence of depression in studies using a screening scale was 40.6% (33.6%-47.6%) (n = 30). For studies using full diagnostic criteria the pooled prevalence of depression was 19.2% (13.4%-25.0%) (n = 12). Subgroup analyses of age (≥ or < 65) and sex did not show any differences regarding depression. Five studies reported the prevalence of anxiety disorders. The pooled prevalence estimate was 26.9% (8.1%-45.7%).

LIMITATIONS

The prevalence estimates in this study are summary estimates of prevalences from existing literature. Although the reporting bias assessment showed no evidence, there could be some reporting bias, as studies might only present results if there is a high prevalence.

CONCLUSIONS

Widowed people have a high prevalence of depression and anxiety disorders. The high prevalence of depression was independent of age and sex. The study identifies a population group at high risk needing special attention in clinical practice.

Prevalence and risk factors of depression among community dwelling elderly

Depression in the elderly is associated with increased morbidity and mortality. The purpose of this study was to determine the prevalence and risk factors of depression among community-dwelling older population in an urban setting in Turkey. This cross-sectional study was conducted among 482 elderly individuals 65 years and over in an urban area. Cluster sampling method was used for sample size. Depression in the elderly had been diagnosed by a clinical interview and Geriatric Depression Scale. Data were collected by door-to-door survey. Chi square test was used for statistical analysis. P value, which was calculated by the results of chi square test and coefficient of phi (φ), below 0.05 was included in the analysis of logistic regression. Depression was significantly associated with female gender, being single or divorced, lower educational status, low income, unemployment, and lack of health insurance. However, logistic regression analysis revealed higher depression rates in the elderly with chronic obstructive pulmonary disease, psychiatric disease, cerebrovascular disease, low income and being dependent. Depression is common among community-dwelling older people in an urban area of Izmir, Turkey. Older adults living in community should be cautiously screened to prevent or manage depression.

Gender differences in the relationship between physical functioning and depressive symptoms in low-income older adults living alone

This study examined gender differences in the relationship between physical functioning and depressive symptoms in low-income older adults living alone in Korea, and the variables influencing these symptoms. Data from a total of 317 older adults in the 2011 Korean National Survey were used. Upper limb mobility, lower limb mobility, activities of daily living, instrumental activities of daily living, and depressive symptoms were measured. Data were analyzed using multiple regression analysis. Low-income older men and women living alone experienced depressive symptoms. Regression analysis showed that lower limb mobility and age together explained 35.4% of the variance in depressive symptoms in men. Subjective health status explained 16.7% of the same in women. These findings suggest that low-income older adults living alone should be carefully monitored by public healthcare managers to improve their physical and mental health, considering gender-specific elements.

Training unemployed women for adult day care in Izmir, Turkey: a program evaluation

The proportion of older people in Turkey is increasing steadily with a subsequent growth of long-term care (LTC) needs. There is a scarcity of formal care provisions for residential and particularly nonresidential settings. Thus, formal caregiving is not meeting LTC needs nor attracting workers as a labor option. The authors examine the hypothesis that LTC may offer work opportunities for women unfamiliar with caregiving as an occupation, and also examine the need and acceptance of different types of LTC beyond residential care. The authors evaluate an innovative project introducing these two elements to 76 women in İzmir, Turkey, using an analysis framework that incorporates factors related to applications and progression; management assessment; trainees' self-assessment reflecting on their views on aging; and older people's perception of the experience and its impact on their well-being. Trainees reported a major positive shift in their attitudes toward working in LTC and toward the aging process. Users reported discovering a new dimension to care, which directly affected their quality of life. Overall, this community-based initiative appeared effective in enhancing the awareness of the concept of adult day centers providing a social model of care, and appears promising in addressing the growing need for formal LTC in Turkey.

Factors associated with depressive symptoms among older adults living alone: an analysis of sex difference

OBJECTIVES

The aim of this study was to explore the prevalence of depressive symptoms and the risk factors that correlated with depressive symptoms among elders living alone.

METHODS

A cross-sectional design was implemented. The sample consisted of 117 women and 75 men aged 65 and older who living alone in Tainan, Taiwan. The Chinese version of Center for Epidemiological Studies Depressive Symptoms Scale was adopted to assess depressive symptoms. Logistic regression analyses were employed to determine the risk factors of depressive symptoms in the elderly women and men living alone.

RESULTS

Results of this study showed that the elderly women had a 1.6-fold greater prevalence of depressive symptoms than did men. Women who were aged 85 and above, and less social support, had a significantly higher occurrence rate of depressive symptoms. The risk factors for depressive symptoms in elderly men living alone included educational level, religious beliefs, self-rated health status, number of chronic illnesses, and social support.

CONCLUSIONS

Healthcare providers should reflect the sex difference on risk factors of depressive symptoms when planning mental health services for the elderly population.

Cognitive Impairment and Depression in Community-Dwelling Older Korean Women

Cognitive impairment and depression were investigated in older Korean women. 143 Korean women ( M age = 75.8) attending four senior service community centers in Seoul participated. 27% scored as possibly demented and 15% as demented on the Korean version of the Mini-Mental State Examination. 57% scored as depressed on the Korean Geriatric Depression Scale. Younger elderly women (ages 65–74 years) displayed less cognitive impairment than older women. Older elderly Korean women (> 75 yr.) who lived with their spouses scored as more cognitively stable than those who lived without spouses. Those with inadequate income scored higher on Depression, which was inversely correlated with cognitive function in the entire sample. Dementia and depression were found to be more frequent in this elderly sample than previously reported by the Korean government.

Depression morbidity in later life: prevalence and correlates in a developing country

OBJECTIVE

To investigate the one-month prevalence of depression morbidity and its association with sociodemographic characteristics, health and functional status, and use of health services in community residents aged 60 years and over in Brazil.

METHODS

This study used a cross-sectional design of face-to-face interviews (N = 7,040) in Rio Grande do Sul State, Brazil. Participants were household residents aged 60 years and older. Measurements included the Short Psychiatric Evaluation Schedule (six-item version) and questionnaire that assessed sociodemographic characteristics, self-reported health status, systemic illnesses, activities of daily living (ADL), use of medical services, and social support.

RESULTS

The overall prevalence of depression morbidity was 22% (men: 18%, women: 25.2%). In controlled analyses, younger age, low income, rural origin, never or no longer married, poor self-rated health, presence of systemic illnesses, visual, hearing, or ADL impairments, hospitalization in the past 12 months, and lack of exercise or employment were significantly associated with depression morbidity, whereas living alone was nearly so associated. Gender, education, minority race, or outpatient visits in the previous six months were not associated with depression morbidity.

CONCLUSION

The overall prevalence of depression morbidity was among the highest previously reported for older persons. In controlled analyses, prevalence declined as age increased, and rates were higher for those with lower income and poorer social, health, and functional status, but did not differ significantly by gender, education, or race/ethnicity. Increased attention should be paid to identifying depression morbidity in those with adverse circumstances and to identifying ameliorating interventions.

Depressive symptoms among older residents at nursing homes in Taiwan

AIMS AND OBJECTIVES

To examine the depressive symptoms of older residents at nursing homes and the relationship between their depressive symptoms and certain selected variables.

BACKGROUND

Depression has become a major healthcare concern among the older people, but nursing home-based studies on risk factors of depression have still hardly been well performed in Taiwan.

DESIGN

A cross-sectional design was developed and implemented.

METHODS

A research sample of 138 older residents was recruited from eight nursing homes located in southern Taiwan. During face-to-face interviews, the Center for Epidemiological Studies Depression Scale, Social Support Scale, Chronic Condition Checklist and Socio-demographic Inventory were used for data collection.

RESULTS

The results showed that 81.8% of those residents were identified as being depressed. It was further discovered that the length of residency, number of chronic conditions, perceived health status and the amount of social support from their family and relatives could explain 38.8% of the total variances in depressive symptoms.

CONCLUSIONS

Our study suggests that, in Taiwan, older people who live in nursing homes suffer from more depressive symptoms than those in community dwellings. To maintain and improve the health status for the elderly as much as possible, it is suggested that healthcare providers at nursing homes should develop an effective health promotion program for these older peoples.

RELEVANCE TO CLINICAL PRACTICE

There exists a high rate of depressive symptoms among older residents at nursing homes. It is imperative that a proper identification and its correspondent treatment for this health problem on the older residents are required. In late life, to maintain a higher level of quality of life, it is important to suggest that the health providers should regularly screen older people to increase the likelihood of diagnosis and improved treatment of late-life depressive symptoms.