Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study

BACKGROUND

Retirees face numerous challenges, including disassociation from persons in their social networks in Nigeria. Perceived social isolation or loneliness could impair the quality of life in old age, and lead to mental disorders. However, it is uncertain whether perceived loneliness has an independent association with depressive and anxiety symptoms and comorbid conditions in Nigerian retirees. Therefore, we aimed at examining the association between perceived loneliness, depressive and anxiety symptoms, including comorbid conditions among retirees in Northcentral Nigeria.

METHODS

This community-based cross-sectional study enrolled retirees aged 60 years and above in different pension zones from February 2019 to August 2019. A two-stage sampling procedure was used to select the study participants. Data on perceived loneliness, depressive, and anxiety symptoms were collected using the 8-item University of California, Los Angeles Loneliness Scale (ULS-8), and the DASS 21-depression and anxiety subscales, respectively. We collected information on the demographic characteristics using a well-validated structured questionnaire. Descriptive statistics, binary and multivariable logistic regression were used to examine the independent associations between loneliness, depression, anxiety, and anxious depression. P-values below 0.05 were considered statistically significant.

RESULTS

The mean age of participants was 71.3 (± 6.01) years, and 54.4% were men. The prevalence of loneliness, depression, anxiety, and anxious depression was 21.8, 52.0, 27.7, and 20.5%, respectively. Retirees with depression or anxiety symptoms perceived that they were lonelier than those without depression or anxiety. The multivariable logistic regression model showed that female gender (AOR 1.49; 95% CI (1.09, 2.00), having secondary education (AOR 2.24, 95% CI (1.40, 3.57) and having higher education (AOR 3.82, 95%CI (2.37, 6.16) were significantly associated with depression. Also, lonely retirees are 1.19 times (AOR 1.19; 95% CI (0.84, 1.69) more likely to be depressed compared to retirees that are not lonely, and the anxious depressed retirees are 314.58 times (AOR 314.58; 95% CI (508.05, 1941.70) more likely to be depressed than those without anxious depression.

CONCLUSION

The prevalence of loneliness, depression, anxiety, and anxious depression were relatively high among the older retirees. Female gender and advanced age were significantly associated with perceived loneliness, depression and anxiety.

Depressive and anxiety symptoms and associated factors among postnatal women in Enugu-North Senatorial District, South-East Nigeria: a cross-sectional study

BACKGROUND

Postnatal depression (PND) and anxiety (PNA) among women are prevalent and impairing health problems, with adverse outcomes for mothers and their infants. This study assessed the prevalence of depression, anxiety and associated factors in a sample of postnatal women.

METHOD

A community-based cross-sectional study was conducted on 270 postpartum women attending public health facilities in the study area. Postnatal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) and anxiety was measured using the Hospital Anxiety and Depression Scale (HADS-A). Data on maternal demographics, health characteristics, pregnancy-related characteristics, labor and birth characteristics, were collected via structured questionnaire. Binary Logistic and multinomial logistic regression analyses were carried out to identify the factors associated with depressive and anxiety symptoms in women.

RESULTS

The EPDS identified 92 women (34.6%) as possibly depressed (using a cut-off ≥13) while the HADS-A identified 89 women (33.3%) with anxiety symptoms (using a cut-off + 8). A total of 69 women were identified with symptoms of anxiety and depression (anxious-depression). The multinomial regression analysis (MLA) showed that the history of depression (AOR = 0.12, 95% (CI 0.02, 0.76), and being a mother aged 15-29 years (AOR = 10.31, 95% (CI 1.13, 94.11) had a significant effect on the development of anxiety symptoms in women. Although not significant, mother's income level (AOR = 1.53, 95% (CI 0.72, 3.25), and being a younger mother (AOR = 1.06, 95% (CI 0.21, 5.26) were more likely to predict depressive symptoms in postnatal women. Attendance at postnatal care services in the PHCs (AOR = 0.14, 95% CI (0.04, 0.48) was significantly associated with anxious-depressed in the studied postnatal women.

CONCLUSION

The findings of this study showed a direct association between depressive symptoms, anxiety and younger maternal age, rural residence, and low income. The higher prevalence of depressive and anxiety symptoms in this study is a call for postnatal care that is culturally sensitive, patient-centered, accessible and affordable by women, most importantly poor and rural women.

Effects of a health education intervention on hypertension-related knowledge, prevention and self-care practices in Nigerian retirees: a quasi-experimental study

BACKGROUND

Education is vital to increasing knowledge, improving prevention and self-care practices for hypertension in older adults. This study aimed to determine the effectiveness of a health education intervention in improving hypertension (HT) knowledge, prevention and self-care practices among retirees in Enugu State, South-east, Nigeria.

METHODS

In this quasi-experimental study, we enrolled 400 participants in Enugu and Nsukka cities in Enugu State, south-east Nigeria. Participants were assigned to the treatment and control groups. Participants in the intervention/treatment group (T-group) received the intervention provided by public health experts and nurses and participants in the control group (C-group) received health talk without the intervention. Data collected at baseline (before intervention), 16 weeks (4th month) and follow-up (5th month) included demographic variables, knowledge about hypertension, prevention and self-care practices. We used paired samples t-test, Chi-square test and one-way ANOVA repeated measures for data analyses.

RESULTS

The mean age of the participants was 65.9 (± 8.9) years, the mean SBP and DBP were 136.5 (± 13.3) and 87.9 (± 9.1) respectively. More than half of the participants were (50.3%) were males, and the mean BMI was 23.9 (± 5.1) kg/m2. The paired comparison analysis showed that the mean HT knowledge score significantly increased in the T-group between baseline and 1 month (4th month) post-intervention compared to those in the C-group (P < 0.0001). Also, PA (P = 0.007), sleep pattern and quality (P = 0.003), substance use abstinence (P = 0.000), healthy diet (P = 0.000), and medication adherence (P = 0.000) improved significantly in the T-group compared to the control between baseline and 1 month after intervention. The repeated measures analyses showed statistically significant effects (between-groups analysis) for all outcomes with small to large effect sizes. Similarly, the repeated measures ANOVA analyses showed significant time-by-group interaction effects (within-groups) for all the outcomes with small to large effect sizes.

CONCLUSION

Community-based health education intervention targeted at older adults can increase HT knowledge, improve prevention and self-care practices of hypertension at the population level.