ORIGINAL ARTICLE

Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka

Corresponding Author

Onali B.W. Rajapakshe

[email protected]

orcid.org/0000-0002-9154-8930

National Dengue Control Unit, Ministry of Health, Narahenpita, Sri Lanka

Correspondence: Dr Onali B.W. Rajapakshe MBBS MSc MD, National Dengue Control Unit, Ministry of Health, Narahenpita, Sri Lanka. Email: [email protected]Search for more papers by this author

Sivagurunadan Sivayogan,

Sivagurunadan Sivayogan

Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

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Prasadi M. Kulatunga,

Prasadi M. Kulatunga

Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

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Onali B.W. Rajapakshe,

Corresponding Author

Onali B.W. Rajapakshe

[email protected]

orcid.org/0000-0002-9154-8930

National Dengue Control Unit, Ministry of Health, Narahenpita, Sri Lanka

Correspondence: Dr Onali B.W. Rajapakshe MBBS MSc MD, National Dengue Control Unit, Ministry of Health, Narahenpita, Sri Lanka. Email: [email protected]Search for more papers by this author

Sivagurunadan Sivayogan,

Sivagurunadan Sivayogan

Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

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Prasadi M. Kulatunga,

Prasadi M. Kulatunga

Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

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First published: 23 November 2018

https://doi.org/10.1111/psyg.12389

Citations: 26

Disclosure: The authors have no potential conflicts of interest to declare.

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Abstract

Aim

As the population ages, mental health issues among the elderly are becoming a major concern worldwide, including in Sri Lanka. With rapid globalization, the coping and adapting skills of elderly individuals are tested, potentially revealing predisposition to psychological disturbances. Previous studies have indicated a higher risk of depression among the elderly. The current study attempts to quantify the prevalence and associated factors of depression in a highly urbanized setting within Sri Lanka.

Methods

A community-based, cross-sectional analytical study was carried out in the urban areas of Colombo District. The subjects were young elders (60–74 years) who permanently reside in the area. Depression was assessed by the item Geriatric Depression Scale Sinhalese version (cut-off score ≥8) among 1283 subjects. Logistic regression analysis was used to assess the association of depression with sociodemographic and health-related variables.

Results

The prevalence of depression in the sample was 13.9% (mild depression: 11.2%; moderate to severe depression: 2.7%). Among the sociodemographic predictors, female sex (odds ratio (OR) = 10.60), being 60–64 years old (OR = 1.61), being unmarried, separated, divorced, or widowed (OR = 3.73), income ≤20 000 Sri Lankan rupees (OR = 2.27), and perceived financial burden (OR = 3.15) were significantly associated with clinically significant depression. Among the health-related variables, smoking (OR = 2.18), alcohol use (OR = 7.58), presence of chronic disease (OR = 1.51), limitation in performing one or more instrumental activities of daily living (OR = 1.73), unsatisfactory partner relationship (OR = 2.94), perceived inadequate social support (OR = 2.47), experiencing abuse (OR = 3.90), and experiencing major life events (OR = 2.11) were significantly related with depression.

Conclusion

Depression is an important issue among the elderly living in an urbanized environment in Sri Lanka.

REFERENCES

1 World Health Organization. Aging and health, 2018. [Cited 23 Feb 2018.] Available from URL: http://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Google Scholar
2De Silva WI. The age structure transition and the demographic dividend: an opportunity for rapid economic take-off in Sri Lanka. Sri Lanka J Adv Soc Stud 2012; 2: 3–46.
Google Scholar
3Mubeen SM, Henry D, Qureshi SN. Prevalence of depression among community dwelling elderly in Karachi, Pakistan. Iran J Psychiatry Behav Sci 2012; 6: 84–90.
PubMed Google Scholar
4Senarath U, Wickramage K, Peiris SL. Prevalence of depression and its associated factors among patients attending primary care settings in the post-conflict Northern Province in Sri Lanka: a cross-sectional study. BMC Psychiatry 2014; 14: 85.
10.1186/1471-244X-14-85
PubMed Web of Science® Google Scholar
5 United Nations. Vienna International Plan of Action on Aging. New York: The UN, 1983 [Cited 20 Oct 2017.] Available from URL: http://www.un.org/es/globalissues/ageing/docs/vipaa.pdf
Google Scholar
6 World Health Organization. Aging and life course, 2018. [Cited 23 Feb 2018.] Available from URL: http://www.who.int/ageing/en/
Google Scholar
7Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007; 370: 851–858.
10.1016/S0140-6736(07)61415-9
PubMed Web of Science® Google Scholar
8 World Health Organization. Depression and Other Common Mental Disorders. Global Health Estimates, 2017. [Cited 27 Oct 2018.] Available from URL: http://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=D3FC389B5C9606D7EC7509A5A0FBCBA1?sequence=1
Google Scholar
9Weisenbach SL, Kumar A. Current understanding of the neurobiology and longitudinal course of geriatric depression. Curr Psychiatry Rep 2014; 16: 463.
10.1007/s11920-014-0463-y
PubMed Web of Science® Google Scholar
10Grippo AJ, Johnson AK. Biological mechanisms in the relationship between depression and heart disease. Neurosci Biobehav Rev 2002; 26: 941–962.
10.1016/S0149-7634(03)00003-4
PubMed Web of Science® Google Scholar
11Joint KE, Whellan DJ, O'Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry 2003; 54: 248–261.
10.1016/S0006-3223(03)00568-7
PubMed Web of Science® Google Scholar
12 World Health Organization. Depression, 2018. [Cited 10 Apr 2018.] Available from URL: http://www.who.int/news-room/fact-sheets/detail/depression
Google Scholar
13Gallo JJ, Labowitz BD. The epidemiology of common late-life mental disorders in the community: themes for the new century. Aging Ment Health 1999; 50: 1158–1166.
CAS Google Scholar
14Dennis M, Kadri A, Coffey J. Depression in older people in the general hospital: a systematic review of screening instruments. Age Ageing 2012; 41: 148–154.
10.1093/ageing/afr169
PubMed Web of Science® Google Scholar
15Chiu E. Epidemiology of depression in the Asia Pacific region. Australas Psychiatry 2004; 12: 4–10.
10.1111/j.1039-8562.2004.02097.x-i1
PubMed Google Scholar
16Wada T, Ishine M, Sakagami T et al. Depression, activities of daily living, and quality of life of community-dwelling elderly in three Asian countries: Indonesia, Vietnam, and Japan. Arch Gerontol Geriatr 2005; 41: 271–280.
10.1016/j.archger.2005.03.003
PubMed Web of Science® Google Scholar
17Tsai YF, Yeh SH, Tsai HH. Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan. Int J Geriatr Psychiatry 2005; 20: 1097–1102.
10.1002/gps.1413
CAS PubMed Web of Science® Google Scholar
18Chiu HC, Chen CM, Huang CJ, Mau LW. Depressive symptoms, chronic medical conditions and functional status: a comparison of urban and rural elders in Taiwan. Int J Geriatr Psychiatry 2005; 20: 635–644.
10.1002/gps.1292
CAS PubMed Web of Science® Google Scholar
19Ball HA, Siribaddana SH, Kovas Y et al. Epidemiology and symptomatology of depression in Sri Lanka: a cross-sectional population-based survey in Colombo District. J Affect Disord 2010; 123: 188–196.
10.1016/j.jad.2009.08.014
PubMed Web of Science® Google Scholar
20Malhotra R, Chan A, Østbye T. Prevalence and correlates of clinically significant depressive symptoms among elderly people in Sri Lanka: findings from a national survey. Int Psychogeriatr 2009; 22: 227–236.
10.1017/S1041610209990871
PubMed Web of Science® Google Scholar
21Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001; 24: 1069–1078.
10.2337/diacare.24.6.1069
CAS PubMed Web of Science® Google Scholar
22Beekman ATF, Beurs E, Balkom AJLM, Deeg DJH, Dyck R, Tilburg W. Anxiety and depression in later life: co-occurrence and communality of risk factors. Am J Psychiatry 2000; 157: 89–95.
10.1176/ajp.157.1.89
CAS PubMed Web of Science® Google Scholar
23Lauber C, Falcato L, Nordt C, Rössler W. Lay beliefs about causes of depression. Acta Psychiatr Scand 2003; 108: 96–99.
10.1034/j.1600-0447.108.s418.19.x
Web of Science® Google Scholar
24Henriksson MM, Marttunen MJ, Isometsä ET et al. Mental disorders in elderly suicide. Int Psychogeriatr 1995; 7: 275–286.
10.1017/S1041610295002031
CAS PubMed Google Scholar
25Thombs BD, Bass EB, Ford DE et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 2006; 21: 30–38.
10.1111/j.1525-1497.2005.00269.x
PubMed Web of Science® Google Scholar
26Chou KL, Ho AHY, Chi I. Living alone and depression in Chinese older adults. Aging Ment Health 2006; 10: 583–591.
10.1080/13607860600641150
PubMed Web of Science® Google Scholar
27Dong X, Simon MA, Odwazny R, Gorbien M. Depression and elder abuse and neglect among a community-dwelling Chinese elderly population. J Elder Abuse Negl 2008; 20: 25–41.
10.1300/J084v20n01_02
PubMed Google Scholar
28Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity. A literature review. Arch Int Med 2003; 163: 2433–2445.
10.1001/archinte.163.20.2433
PubMed Web of Science® Google Scholar
29Lin JH, Huang MW, Wang DW et al. Late-life depression and quality of life in a geriatric evaluation and management unit: an exploratory study. BMC Geriatr 2014; 18: 1–7.
Google Scholar
30Yip PSF, Chi I, Yu KK. An epidemiological profile of elderly suicides in Hong Kong. Int J Geriatr Psychiatry 1998; 13: 631–637.
10.1002/(SICI)1099-1166(199809)13:9<631::AID-GPS836>3.0.CO;2-A
CAS PubMed Web of Science® Google Scholar
31Conwell Y, Orden KV, Caine ED. Suicide in older adults. Psychiatr Clin North Am 2011; 34: 451–468.
10.1016/j.psc.2011.02.002
PubMed Web of Science® Google Scholar
32 World Health Organization. Preventing suicide: a global imperative. Geneva: The WHO, 2014. [Cited 15 Oct 2017.] Available from URL: http://apps.who.int/iris/bitstream/10665/131056/1/9789241564779_eng.pdf?ua=1&ua=1
Google Scholar
33Kua EH, Ko SM, Ng TP. Recent trends in elderly suicide rates in a multi-ethnic Asian city. Int J Geriatr Psychiatry 2003; 18: 533–536.
10.1002/gps.868
CAS PubMed Web of Science® Google Scholar
34Rezaeian M. Age and sex suicide rates in the eastern Mediterranean region based on global burden of disease estimates for 2000. East Mediterr Health J 2007; 13: 953–960.
CAS PubMed Google Scholar
35Thalagala N. Suicide trends in Sri Lanka 1880-2006; social, demographic and geographical variations. J Coll Commun Phys Sri Lanka 2009; 14: 24–32.
10.4038/jccpsl.v14i1.2945
Google Scholar
36Bennett S, Woods T, Liyanage WM, Smith DL. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q 1991; 44: 98–106.
CAS PubMed Google Scholar
37Kulathunga M, Umayal S, Somaratne S, Srikanth S, Kathriarachchi S, De Silva KRD. Validation of the Geriatric Depression Scale for an elderly Sri Lankan clinic population. Indian J Psychiatry 2010; 52: 254–256.
10.4103/0019-5545.70979
CAS PubMed Google Scholar
38Barker DJP, Hall AJ. Practical Epidemiology. London: Churchill Livingstone, 1991.
Google Scholar
39Ayad M, Barrere B, Otto J. Demographic and Socio-economic Characteristics of Households, Demographic and Health Surveys Comparative Studies. Calverton, MD: Macro International, 1996.
Google Scholar
40Ferdinando KDAR. Prevalence and correlates of depression in adults of 25–45 years in Kalutara RDHS area [thesis]. Postgraduate Institute of Medicine, Colombo, Sri Lanka, 2006. Available from URL: http://pgimrepository.cmb.ac.lk:8180/
Google Scholar
41Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–186.
10.1111/j.1532-5415.2007.01590.x
CAS PubMed Web of Science® Google Scholar
42Shelkey M, Wallace M. Katz Index of Independence in Activities of Daily Living (ADL), 2012. [Cited 10 March 2014.] Available from URL: https://consultgeri.org/try-this/general-assessment/issue-2.pdf
Google Scholar
43Broadhead WE, Gehlbach SH, Gruy FV, Kaplan BH. The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients. Med Care 1988; 26: 709–723.
10.1097/00005650-198807000-00006
CAS PubMed Web of Science® Google Scholar
44Ellawala YG. Parenting stress, risk factors and coping strategies among mothers of adolescents aged 15 to 19 years in the District of Colombo [thesis]. Postgraduate Institute of Medicine, Colombo, Sri Lanka, 2013. Available from URL: https://libguides.murdoch.edu.au/Vancouver/theses
Google Scholar
45Samaraweera PC. Elderly abuse in a selected MOH area in the district of Colombo: prevalence and correlates of physical, emotional, financial abuse and neglect [thesis]. Postgraduate Institute of Medicine, Colombo, Sri Lanka, 2012. Available from URL: https://libguides.murdoch.edu.au/Vancouver/theses
Google Scholar
46Singh G, Kaur D, Kaur H. Presumptive stressful life events scale (PSLES)—a new stressful life events scale for use in India. Indian J Psychiatry 1984; 26: 107–114.
CAS PubMed Google Scholar
47 World Health Organization. Global status report on alcohol and health, 2018. [Cited 27 Oct 2018.] Available from URL: https://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf
Google Scholar

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Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka

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Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka

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