Depression, Prevalence and Some Risk Factors in Elderly Nursing Homes in Tehran, Iran

Article excerpt

Abstract

Background: The most common geriatric psychiatric disorder is depression, known to be a multi factorial disorder. However, the influence of common preventable factors is yet to be discovered. This study was designed to evaluate the prevalence of depression and some possible risk factors in elderly residents of nursing homes in Iran.

Methods: Data on demographic characteristics, nutritional and health status of 244 residents aged 60 years or older were collected from seventeen nursing homes in Tehran, Iran, during 2010 to 2012. Depression was assessed and classified according to the 15-item GDS. Univariate and then multivariate complex sample survey ordinal regression analysis was performed to investigate the association between depression and the risk factors.

Results: The average age of the 244 cases studied was 75.8 (±8.7) years, 53.3% were female (of whom 74.2% were housewives), 43.4% illiterate, and 32.0% were divorced or were living separately. The percentages of non-depressed, mild, moderate and severe depression were 9.8%, 50.0%, 29.5% and 10.7%, respectively. Multivariate analysis showed that dissatisfaction with personnel of nursing homes and food quality had odds ratios of 2.91 (1.33-6.36) and 2.64 (1.44-4.87), corresponding to greater odds of having a higher grade depression. Moreover, those who rested or walked had significantly higher risk of a more severe depression in comparison with those who did not (OR of 2.25 (1.50-3.38) and 1.98 (1.24-3.18), respectively), however, studying had a protective odds ratio of 0.17 (0.13-0.22).

Conclusion: Depression was very common in our sample and their lifestyle influenced its prevalence.

Keywords: Depression, Elderly, Nursing homes, Iran

Introduction

Depression is a major mental health problem in the elderly population (1-3). Despite considerable interest and the fact that depression is known to be highly prevalent in elderly nursing home (NH) residents, few studies exist on its incidence and risk factors. There is no consensus regarding the prevalence of depression in later life, which partly is due to a lack of diagnostic criteria for elderly.

Older people are prone to psychiatric disorders through vicissitudes of life such as social isolation, malnutrition, economic problems and emotional depression. The prevalence of depression in NH population is very high, no matter how depression was defined, and prevalence rates among NH residents were found to be up to three to four times higher than in community-dwelling elderly (4, 5). Also many illnesses that are common in older adults are known to be associated with depression symptoms (6). Studies on the relation between depression and diabetes have led to new conclusions such as, an association between clinical depression with a 65% increased risk of diabetes in elderly people (7). Major and minor depressions seem to be implicated in this relation (8).

In modern industrialized countries traditional forms of support for the elderly are often replaced by new formal and informal support systems. This shifthappened as a consequence of demographic and social changes in the 19th and 20th centuries (9) and is accompanied by an increase of the proportion of elderly in especially industrialized societies. United Nations' estimates show that in 2000, individuals aged 60 years or older represented 10% of the world's population (about 600 million people), and by the year 2050, with more than 2 billion people, this group will represent 22% of the world's population. Furthermore, the population of individuals aged 80 years or older is projected to more than triple during the 2000-2050 periods (10).

High rates of depression among American longterm NH residents, at admission and during the first year, indicate a need to monitor and treat large numbers of elderly for depression (11). It is not known if depression has the same high prevalence in NHs in Iran or not.

Our country (Iran) has undergone a period of rapid demographic transitions that increased the proportion of older people in the society. …