Skip to main content
Top
Published in: BMC Psychiatry 1/2020

01-12-2020 | Mood Disorders | Research article

Socio-demographic characteristics, lifestyle factors, multi-morbid conditions and depressive symptoms among Nepalese older adults

Authors: Uday Narayan Yadav, Tarka Bahadur Thapa, Sabuj Kanti Mistry, Roshan Pokhrel, Mark Fort Harris

Published in: BMC Psychiatry | Issue 1/2020

Login to get access

Abstract

Background

Depressive symptoms (DS) are a well-recognized public health problem across the world. There is limited evidence with regard to DS and its associates, such as socio-demographic characteristics, lifestyle factors and chronic conditions in low-income countries like Nepal. In this study, we aimed to assess the level of DS and its relationship with socio-demographic characteristics, lifestyle factors and chronic disease conditions among community dwelling older people in Nepal.

Methods

We conducted a cross-sectional study of 794 older adults aged 60 or above residing in the rural setting of the Sunsari and Morang districts of eastern Nepal between January and April 2018. Multi-stage cluster sampling was adopted to select the study participants. Data included socio-demographics, lifestyle factors, self-reported chronic disease conditions and the Geriatric depression scale. On Geriatric depression scale, an older adult with a test score greater than five were defined as having depressive symptoms. Determinants of DS were estimated through the generalized estimating equation (GEE) approach by considering exchangeable correlation structure among clusters.

Results

In our study samples, nearly 55.8% of the older adults were found to be suffering from DS. We found a significant association between DS and being female (aOR: 1.25, 95% CI: 0.89–2.09), Buddhism (aOR: 1.95, 95% CI: 1.58–2.42), Dalits (aOR: 2.60, 95% CI: 1.19–5.65), unemployed, low family income (aOR: 1.77, 95% CI: 1.07–2.92), smokers (aOR: 1.49, 95% CI: 1.01–2.20) and having chronic multi-morbid conditions (aOR: 1.67, 95% CI: 1.09–2.55).

Conclusions

The prevalence of DS was high among community-dwelling older adults in eastern Nepal. Our findings suggest the need for mental health prevention and management programs targeting the older population in rural Nepal.
Literature
1.
go back to reference Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009;5:363–89.CrossRef Fiske A, Wetherell JL, Gatz M. Depression in older adults. Annu Rev Clin Psychol. 2009;5:363–89.CrossRef
2.
go back to reference Wilson AM, Browne P, Olive S, Clark A, Galey P, Dix E, et al. The effects of maintenance schedules following pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomised controlled trial. BMJ Open. 2015;5(3).CrossRef Wilson AM, Browne P, Olive S, Clark A, Galey P, Dix E, et al. The effects of maintenance schedules following pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomised controlled trial. BMJ Open. 2015;5(3).CrossRef
3.
go back to reference Patel V. Mental health in low- and middle-income countries. Br Med Bull. 2007;81–82(1):81–96.CrossRef Patel V. Mental health in low- and middle-income countries. Br Med Bull. 2007;81–82(1):81–96.CrossRef
4.
go back to reference Pilania M, Yadav V, Bairwa M, Behera P, Gupta SD, Khurana H, et al. Prevalence of depression among the elderly (60 years and above) population in India, 1997-2016: a systematic review and meta-analysis. BMC Public Health. 2019;19(1):832.CrossRef Pilania M, Yadav V, Bairwa M, Behera P, Gupta SD, Khurana H, et al. Prevalence of depression among the elderly (60 years and above) population in India, 1997-2016: a systematic review and meta-analysis. BMC Public Health. 2019;19(1):832.CrossRef
5.
go back to reference Bhamani MA, Karim MS, Khan MM. Depression in the elderly in Karachi, Pakistan: a cross sectional study. BMC Psychiatr. 2013;13:181.CrossRef Bhamani MA, Karim MS, Khan MM. Depression in the elderly in Karachi, Pakistan: a cross sectional study. BMC Psychiatr. 2013;13:181.CrossRef
6.
go back to reference Cherry N, Chowdhury M, Haque R, McDonald C, Chowdhury Z. Disability among elderly rural villagers: report of a survey from Gonoshasthaya Kendra, Bangladesh. BMC Public Health. 2012;12:379.CrossRef Cherry N, Chowdhury M, Haque R, McDonald C, Chowdhury Z. Disability among elderly rural villagers: report of a survey from Gonoshasthaya Kendra, Bangladesh. BMC Public Health. 2012;12:379.CrossRef
7.
go back to reference Simkhada R, Wasti SP, Gc VS, Lee ACK. Prevalence of depressive symptoms and its associated factors in older adults: a cross-sectional study in Kathmandu, Nepal. Aging Ment Health. 2018;22(6):802–7.CrossRef Simkhada R, Wasti SP, Gc VS, Lee ACK. Prevalence of depressive symptoms and its associated factors in older adults: a cross-sectional study in Kathmandu, Nepal. Aging Ment Health. 2018;22(6):802–7.CrossRef
8.
go back to reference Jonsdottir H, Amundadottir OR, Gudmundsson G, Halldorsdottir BS, Hrafnkelsson B, Ingadottir TS, et al. Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial. J Adv Nurs. 2015;71(11):2634–49.CrossRef Jonsdottir H, Amundadottir OR, Gudmundsson G, Halldorsdottir BS, Hrafnkelsson B, Ingadottir TS, et al. Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial. J Adv Nurs. 2015;71(11):2634–49.CrossRef
9.
go back to reference Unutzer J. Clinical practice. Late-life depression. N Engl J Med. 2007;357(22):2269–76.CrossRef Unutzer J. Clinical practice. Late-life depression. N Engl J Med. 2007;357(22):2269–76.CrossRef
10.
go back to reference Liu Q, Cai H, Yang LH, Xiang YB, Yang G, Li H, et al. Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci Rep. 2018;8(1):3841.CrossRef Liu Q, Cai H, Yang LH, Xiang YB, Yang G, Li H, et al. Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci Rep. 2018;8(1):3841.CrossRef
11.
go back to reference Lorant V, Croux C, Weich S, Deliege D, Mackenbach J, Ansseau M. Depression and socio-economic risk factors: 7-year longitudinal population study. Br J Psychiatr. 2007;190:293–8.CrossRef Lorant V, Croux C, Weich S, Deliege D, Mackenbach J, Ansseau M. Depression and socio-economic risk factors: 7-year longitudinal population study. Br J Psychiatr. 2007;190:293–8.CrossRef
12.
go back to reference Fisher BS, Regan SL. The extent and frequency of abuse in the lives of older women and their relationship with health outcomes. The Gerontologist. 2006;46(2):200–9.CrossRef Fisher BS, Regan SL. The extent and frequency of abuse in the lives of older women and their relationship with health outcomes. The Gerontologist. 2006;46(2):200–9.CrossRef
14.
go back to reference Shrestha R, Pant A, Shrestha SS, Shrestha B, Gurung R, Karmacharya B. A cross-sectional study of medication adherence pattern and factors affecting the adherence in chronic obstructive pulmonary disease. Kathmandu Univ Med J. 2015;49(1):64–70.CrossRef Shrestha R, Pant A, Shrestha SS, Shrestha B, Gurung R, Karmacharya B. A cross-sectional study of medication adherence pattern and factors affecting the adherence in chronic obstructive pulmonary disease. Kathmandu Univ Med J. 2015;49(1):64–70.CrossRef
15.
go back to reference Yadav UN, Tamang MK, Thapa TB, Hosseinzadeh H, Harris MF, Yadav KK. Prevalence and determinants of frailty in the absence of disability among older population: a cross sectional study from rural communities in Nepal. BMC Geriatr. 2019;19(1):283.CrossRef Yadav UN, Tamang MK, Thapa TB, Hosseinzadeh H, Harris MF, Yadav KK. Prevalence and determinants of frailty in the absence of disability among older population: a cross sectional study from rural communities in Nepal. BMC Geriatr. 2019;19(1):283.CrossRef
16.
go back to reference Yadav UN, Tamang MK, Paudel G, Kafle B, Mehta S, Chandra Sekaran V, et al. The time has come to eliminate the gaps in the under-recognized burden of elder mistreatment: a community-based, cross-sectional study from rural eastern Nepal. PLoS One. 2018;13(6):e0198410.CrossRef Yadav UN, Tamang MK, Paudel G, Kafle B, Mehta S, Chandra Sekaran V, et al. The time has come to eliminate the gaps in the under-recognized burden of elder mistreatment: a community-based, cross-sectional study from rural eastern Nepal. PLoS One. 2018;13(6):e0198410.CrossRef
17.
go back to reference Dias F, Teixeira AL, Guimaraes HC, Barbosa MT, Resende EPF, Beato RG, et al. Accuracy of the 15-item geriatric depression scale (GDS-15) in a community-dwelling oldest-old sample: the pieta study. Trends Psychiatr Psychother. 2017;39(4):276–9.CrossRef Dias F, Teixeira AL, Guimaraes HC, Barbosa MT, Resende EPF, Beato RG, et al. Accuracy of the 15-item geriatric depression scale (GDS-15) in a community-dwelling oldest-old sample: the pieta study. Trends Psychiatr Psychother. 2017;39(4):276–9.CrossRef
18.
go back to reference Khattri JB, Nepal MK. Study of depression among geriatric population in Nepal. Nepal Med Coll J. 2006;8(4):220–3.PubMed Khattri JB, Nepal MK. Study of depression among geriatric population in Nepal. Nepal Med Coll J. 2006;8(4):220–3.PubMed
19.
go back to reference Hanley JA, Negassa A, Edwardes MD, Forrester JE. Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol. 2003;157(4):364–75.CrossRef Hanley JA, Negassa A, Edwardes MD, Forrester JE. Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol. 2003;157(4):364–75.CrossRef
20.
go back to reference Wahlin A, Palmer K, Sternang O, Hamadani JD, Kabir ZN. Prevalence of depressive symptoms and suicidal thoughts among elderly persons in rural Bangladesh. Int Psychogeriatr. 2015;27(12):1999–2008.CrossRef Wahlin A, Palmer K, Sternang O, Hamadani JD, Kabir ZN. Prevalence of depressive symptoms and suicidal thoughts among elderly persons in rural Bangladesh. Int Psychogeriatr. 2015;27(12):1999–2008.CrossRef
21.
go back to reference Fernandez-Nino JA, Manrique-Espinoza BS, Bojorquez-Chapela I, Salinas-Rodriguez A. Income inequality, socioeconomic deprivation and depressive symptoms among older adults in Mexico. PLoS One. 2014;9(9):e108127.CrossRef Fernandez-Nino JA, Manrique-Espinoza BS, Bojorquez-Chapela I, Salinas-Rodriguez A. Income inequality, socioeconomic deprivation and depressive symptoms among older adults in Mexico. PLoS One. 2014;9(9):e108127.CrossRef
22.
go back to reference Steffens DC, Fisher GG, Langa KM, Potter GG, Plassman BL. Prevalence of depression among older Americans: the aging, Demographics and Memory Study. Int Psychogeriatr. 2009;21(5):879–88.CrossRef Steffens DC, Fisher GG, Langa KM, Potter GG, Plassman BL. Prevalence of depression among older Americans: the aging, Demographics and Memory Study. Int Psychogeriatr. 2009;21(5):879–88.CrossRef
23.
go back to reference Ostbye T, Kristjansson B, Hill G, Newman SC, Brouwer RN, McDowell I. Prevalence and predictors of depression in elderly Canadians: the Canadian study of health and aging. Chronic Dis Can. 2005;26(4):93–9.PubMed Ostbye T, Kristjansson B, Hill G, Newman SC, Brouwer RN, McDowell I. Prevalence and predictors of depression in elderly Canadians: the Canadian study of health and aging. Chronic Dis Can. 2005;26(4):93–9.PubMed
24.
go back to reference Pirkis J, Pfaff J, Williamson M, Tyson O, Stocks N, Goldney R, et al. The community prevalence of depression in older Australians. J Affect Disord. 2009;115(1–2):54–61.CrossRef Pirkis J, Pfaff J, Williamson M, Tyson O, Stocks N, Goldney R, et al. The community prevalence of depression in older Australians. J Affect Disord. 2009;115(1–2):54–61.CrossRef
25.
go back to reference Chalise HNLRS. Prevalence and Correlates of Depression among Nepalese Rai Older Adults. J Gerontol Geriat Res. 2013;2(130). Chalise HNLRS. Prevalence and Correlates of Depression among Nepalese Rai Older Adults. J Gerontol Geriat Res. 2013;2(130).
26.
go back to reference Wilhelm K, Parker G, Asghari A. Sex differences in the experience of depressed mood state over fifteen years. Soc Psychiatry Psychiatr Epidemiol. 1998;33(1):16–20.CrossRef Wilhelm K, Parker G, Asghari A. Sex differences in the experience of depressed mood state over fifteen years. Soc Psychiatry Psychiatr Epidemiol. 1998;33(1):16–20.CrossRef
27.
go back to reference Conceição P. Human Development Report 2019,Beyond income, beyond averages, beyond today: inequalities in human development in the 21st century. United Nations development Programme 1 UN plaza, New York, NY 10017 USA; 2019. Conceição P. Human Development Report 2019,Beyond income, beyond averages, beyond today: inequalities in human development in the 21st century. United Nations development Programme 1 UN plaza, New York, NY 10017 USA; 2019.
28.
go back to reference Tanaka H, Sasazawa Y, Suzuki S, Nakazawa M, Koyama H. Health status and lifestyle factors as predictors of depression in middle-aged and elderly Japanese adults: a seven-year follow-up of the Komo-Ise cohort study. BMC Psychiatr. 2011;11:20.CrossRef Tanaka H, Sasazawa Y, Suzuki S, Nakazawa M, Koyama H. Health status and lifestyle factors as predictors of depression in middle-aged and elderly Japanese adults: a seven-year follow-up of the Komo-Ise cohort study. BMC Psychiatr. 2011;11:20.CrossRef
29.
go back to reference Mendelsohn C. Smoking and depression--a review. Aust Fam Physician. 2012;41(5):304–7.PubMed Mendelsohn C. Smoking and depression--a review. Aust Fam Physician. 2012;41(5):304–7.PubMed
30.
go back to reference Markou A, Kenny PJ. Neuroadaptations to chronic exposure to drugs of abuse: relevance to depressive symptomatology seen across psychiatric diagnostic categories. Neurotox Res. 2002;4(4):297–313.CrossRef Markou A, Kenny PJ. Neuroadaptations to chronic exposure to drugs of abuse: relevance to depressive symptomatology seen across psychiatric diagnostic categories. Neurotox Res. 2002;4(4):297–313.CrossRef
31.
go back to reference González HM, Tarraf W, Whitfield K, Gallo JJ. Vascular depression prevalence and epidemiology in the United States. J Psychiatr Res. 2012;46(4):456–61.CrossRef González HM, Tarraf W, Whitfield K, Gallo JJ. Vascular depression prevalence and epidemiology in the United States. J Psychiatr Res. 2012;46(4):456–61.CrossRef
32.
go back to reference Bahall M. Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatr. 2019;19(1):4.CrossRef Bahall M. Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatr. 2019;19(1):4.CrossRef
33.
go back to reference Yadav UN, Paudel G. Prevalence and associated factors of elder mistreatment: a cross sectional study from urban Nepal. Age Ageing. 2016;45(5):609–13.CrossRef Yadav UN, Paudel G. Prevalence and associated factors of elder mistreatment: a cross sectional study from urban Nepal. Age Ageing. 2016;45(5):609–13.CrossRef
34.
go back to reference Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, et al. Nutritional assessment and factors associated with malnutrition among the elderly population of Nepal: a cross-sectional study. BMC Res Notes. 2019;12(1):246.CrossRef Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, et al. Nutritional assessment and factors associated with malnutrition among the elderly population of Nepal: a cross-sectional study. BMC Res Notes. 2019;12(1):246.CrossRef
36.
go back to reference Ghanmi L, Sghaier S, Toumi R, Zitoun K, Zouari L, Maalej M. Depression in the elderly with chronic medical illness. Eur Psychiatr. 2017;41:S651.CrossRef Ghanmi L, Sghaier S, Toumi R, Zitoun K, Zouari L, Maalej M. Depression in the elderly with chronic medical illness. Eur Psychiatr. 2017;41:S651.CrossRef
37.
go back to reference Han J. Chronic illnesses and depressive symptoms among older people: functional limitations as a mediator and self-perceptions of aging as a moderator. J Aging Health. 2018;30(8):1188–204.CrossRef Han J. Chronic illnesses and depressive symptoms among older people: functional limitations as a mediator and self-perceptions of aging as a moderator. J Aging Health. 2018;30(8):1188–204.CrossRef
38.
go back to reference Chang-Quan H, Zheng-Rong W, Yong-Hong L, Yi-Zhou X, Qing-Xiu L. Education and risk for late life depression: a meta-analysis of published literature. Int J Psychiatry Med. 2010;40(1):109–24.CrossRef Chang-Quan H, Zheng-Rong W, Yong-Hong L, Yi-Zhou X, Qing-Xiu L. Education and risk for late life depression: a meta-analysis of published literature. Int J Psychiatry Med. 2010;40(1):109–24.CrossRef
39.
go back to reference Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119–38.CrossRef Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119–38.CrossRef
Metadata
Title
Socio-demographic characteristics, lifestyle factors, multi-morbid conditions and depressive symptoms among Nepalese older adults
Authors
Uday Narayan Yadav
Tarka Bahadur Thapa
Sabuj Kanti Mistry
Roshan Pokhrel
Mark Fort Harris
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02680-3

Other articles of this Issue 1/2020

BMC Psychiatry 1/2020 Go to the issue