Damas Andrea Mlaki1,2, Laila Asmal1, Stella-Maria Paddick3, William K Gray4, Catherine Dotchin4, Richard Walker3,4. 1. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box, 241, Cape Town, South Africa, 8000. 2. Mirembe Mental Health Hospital, P.O.BOx, 904, Dodoma, Tanzania. 3. Newcastle University, Newcastle upon Tyne, United Kingdom. 4. Northumbria Healthcare NHS Foundation Trust, United Kingdom.
Abstract
OBJECTIVES: Depression is the commonest mental disorder in older adults worldwide, affecting 7% of the world's older population and accounting for 5.7% of years lived with disability among adults aged over 60 years. We conducted a secondary data analysis to determine the point prevalence, associated risk factors and treatment gap for DSM-IV depression among older adults in the Hai District, rural Tanzania. METHODS: The primary data source was a cross-sectional two-stage community-based dementia study where older adults aged ≥70 years (n=296) were fully-assessed for dementia and depression in the second stage. Age-adjusted prevalence of depression was determined based on the WHO standard population using the Direct Method. Univariate and multivariate logistic regression models were performed. RESULTS: Of the 296 older adults assessed for depression, 48 were diagnosed with depression based on Diagnostic and Statistical Manual of Mental Disorders-IV criteria. The median (Inter Quartile Range) (IQR) age was 80 (75-88) years. Age-adjusted point prevalence of depression was 21.2% (95%CI: 16.6-21.9) and the treatment gap for depression was 100%. There was reduced odds of depression in older adults who rated their physical health as good or very good (AOR=0.22; 95%CI: 0.10-0.46; p<0.001), or moderate (AOR 0.26; 95%CI: 0.10-0.66; p=0.005). CONCLUSIONS: Depression in older adults is associated with physical health status and there is an alarmingly high treatment gap. Future research on depression in older adults should focus on effective interventions to address physical morbidity, psychosocial factors and the treatment gap. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
OBJECTIVES:Depression is the commonest mental disorder in older adults worldwide, affecting 7% of the world's older population and accounting for 5.7% of years lived with disability among adults aged over 60 years. We conducted a secondary data analysis to determine the point prevalence, associated risk factors and treatment gap for DSM-IV depression among older adults in the Hai District, rural Tanzania. METHODS: The primary data source was a cross-sectional two-stage community-based dementia study where older adults aged ≥70 years (n=296) were fully-assessed for dementia and depression in the second stage. Age-adjusted prevalence of depression was determined based on the WHO standard population using the Direct Method. Univariate and multivariate logistic regression models were performed. RESULTS: Of the 296 older adults assessed for depression, 48 were diagnosed with depression based on Diagnostic and Statistical Manual of Mental Disorders-IV criteria. The median (Inter Quartile Range) (IQR) age was 80 (75-88) years. Age-adjusted point prevalence of depression was 21.2% (95%CI: 16.6-21.9) and the treatment gap for depression was 100%. There was reduced odds of depression in older adults who rated their physical health as good or very good (AOR=0.22; 95%CI: 0.10-0.46; p<0.001), or moderate (AOR 0.26; 95%CI: 0.10-0.66; p=0.005). CONCLUSIONS:Depression in older adults is associated with physical health status and there is an alarmingly high treatment gap. Future research on depression in older adults should focus on effective interventions to address physical morbidity, psychosocial factors and the treatment gap. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.