Independent Researcher

PhD Candidate

Sikkim-Manipal Institute of Medical Sciences (SMIMS)

Thesis Title: Prevalence of Depressive Disorders in Elderly: A Meta-analysis

About

Introduction:
The community-based mental health studies have revealed that the point prevalence of depressive disorders in the elderly population in India varies between 13 and 25 per cent. Though India is the second-most populated country in the world in terms of elderly population of sixty years and above, yet geriatric depression is not yet perceived as a public health problem in India.

Objectives:
(1)  To determine the Median Prevalence Rates of Depressive Disorders in elderly population of the world and India.
(2)  To conduct a Time-Trend Analysis on prevalence of Depressive Disorders in elderly population of the world.
(3) To study the socio-demographic correlates and chronic co-morbid conditions associated with depressive disorders in elderly population.

Materials & Methods:
Study Design:  Retrospective study based on Meta-analysis of various study reports. 
Setting: Community based mental health surveys on geriatric depressive disorders conducted in continents of Asia, Europe, Australia, North America, and South America.
Study Period: All the studies that constituted the sample were conducted between 1955 and 2005.
Sample Size: After applying the inclusion and exclusion criteria on published and indexed articles, 74 original research studies that surveyed a total of 4,87,275 elderly individuals in the age group of 60 years and above, residing in various parts of the world were included for the final analysis.
Inclusion Criteria: The researchers had included only community based cross-sectional surveys and some prospective studies that had not excluded depression on baseline. These studies were conducted on homogenous community of elderly population in the world, who were selected by simple random sampling technique.
Exclusion Criteria: All the unpublished reports and unavailable or unanalyzed or inaccessible articles from the internet were excluded from the study.
Statistical analysis: Median prevalence rate and its corresponding inter-quartile range, Chi-square test and Chi-square for Linear Trend were applied. P value <0.05 was considered as statistically significant.

Results & Conclusion:
The Median Prevalence Rate of depressive disorders in the world for the elderly population was determined to be 10.3% [Interquartile Range (IQR) = (4.7% - 16.0%)]. The Median Prevalence Rate of depression among elderly Indian population was determined to be 21.9% [IQR = (11.6% - 31.1%)]. Though there was a significant decrease trend in world prevalence of geriatric depression, but it was significantly higher among the Indians in recent years than the rest of the world.

The risk factors for depression in elderly were identified as older ager group, female gender, low socio-economic status, loss of spouse, living alone, chronic co-morbidities, cognitive impairment, bereavement and restricted Activities of Daily Living (ADL).

Key Words: Depressive Disorders, Prevalence, Elderly, Median, Time Trend Analysis

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