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Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Research

Association between physical limitations and depressive symptoms among Indian elderly: marital status as a moderator

Authors: Babul Hossain, Pawan Kumar Yadav, Varsha P. Nagargoje, K. J. Vinod Joseph

Published in: BMC Psychiatry | Issue 1/2021

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Abstract

Background

Depression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions. Few studies have focused on older adults’ physical limitations and depressive symptoms. However, very little is known about marital status’ role in such associations, especially in India. The present study examines the association between physical limitations and self-reported depressive symptoms and moderating role of marital status in such association separately for men and women.

Methods

The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1, 2017–2018, a nationally and state representative longitudinal large-scale survey of ageing and health. For the present research, a total sample of 20,806 older adults aged 60+ years was selected after excluding missing values. Along with descriptive statistics, binary logistic regression analysis and interaction effect of marital status were applied to examine the association between physical limitations (functional limitations and mobility difficulty) with the depressive symptoms separately for men and women.

Results

About 58, 50, and 45% elderly reported having depressive symptoms and had difficulty in 2+ ADLs, 2+ IADLs, and 2+ mobility difficulties, respectively. By the marital status, the prevalence of depressive symptoms was higher among currently unmarried than currently married, irrespective of type and number of physical limitations. The unadjusted, marital and multivariate-adjusted association suggested that elderly with more than two ADLs, IADLs, and mobility difficulty had higher odds of depressive symptoms. The gender stratified interaction effect of marital status and physical limitations on depressive symptoms indicated that currently unmarried elderly, particularly unmarried older women with 2+ ADLs (OR = 2.85; CI 95% = 1.88–3.09), 2+ IADLs (OR = 2.01; CI 95% = 1.74–2.31) and 2+ mobility difficulty (OR = 2.20; CI 95% = 1.86–2.60) had higher odds of depressive symptoms. However, such association was only valid for unmarried men having mobility difficulty.

Conclusion

The study highlights that the elderly with physical limitations such as ADLs, IADLs, and mobility difficulty require attention and care. Although married elderly are less likely to have depressive symptoms even with all the mentioned physical limitations, unmarried women are more vulnerable to have depressive symptoms with physical limitations.
Literature
4.
go back to reference Katrona CL. Depression in old age. New York: Wiley; 1994. Katrona CL. Depression in old age. New York: Wiley; 1994.
5.
go back to reference Williamson GM, Schulz R. Symptoms of depression in elderly persons: beyond the effects of physical illness and disability. In: Vellas BJ, Albarede JL, editors. Facts and research in gerontology journal. New York: Springer; 1995. p. 9–19. Williamson GM, Schulz R. Symptoms of depression in elderly persons: beyond the effects of physical illness and disability. In: Vellas BJ, Albarede JL, editors. Facts and research in gerontology journal. New York: Springer; 1995. p. 9–19.
10.
go back to reference DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser [Internet]. 2013;13(16):1–33 Available at: https://pubmed.ncbi.nlm.nih.gov/24228079. DeJean D, Giacomini M, Vanstone M, Brundisini F. Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser [Internet]. 2013;13(16):1–33 Available at: https://​pubmed.​ncbi.​nlm.​nih.​gov/​24228079.
22.
go back to reference Dagfinrud H, Kjeken I, Mowinckel P, Hagen K, Kvien T. Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions. J Rheumatol. 2005;32(3):516–23.PubMed Dagfinrud H, Kjeken I, Mowinckel P, Hagen K, Kvien T. Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions. J Rheumatol. 2005;32(3):516–23.PubMed
26.
go back to reference Glass TA, Balfour JL. Neighborhoods, Aging, and Functional Limitations. In: Neighborhoods and Health. New York: Oxford University Press; 2003. p. 303–34.CrossRef Glass TA, Balfour JL. Neighborhoods, Aging, and Functional Limitations. In: Neighborhoods and Health. New York: Oxford University Press; 2003. p. 303–34.CrossRef
29.
go back to reference Wang Z, Yang H, Guo Z, Liu B, Geng S. Socio-demographic characteristics and co-occurrence of depressive symptoms with chronic diseases among older adults in China: the China longitudinal ageing social survey. BMC Psychiatr [Internet]. 2019;19(1):310 Available at: https://doi.org/10.1186/s12888-019-2305-2. Wang Z, Yang H, Guo Z, Liu B, Geng S. Socio-demographic characteristics and co-occurrence of depressive symptoms with chronic diseases among older adults in China: the China longitudinal ageing social survey. BMC Psychiatr [Internet]. 2019;19(1):310 Available at: https://​doi.​org/​10.​1186/​s12888-019-2305-2.
33.
37.
go back to reference Bulloch AGM, JVA W, Lavorato DH, Patten SB. The depression and marital status relationship is modified by both age and gender. J Affect Disord. 2017;223:65–8.CrossRef Bulloch AGM, JVA W, Lavorato DH, Patten SB. The depression and marital status relationship is modified by both age and gender. J Affect Disord. 2017;223:65–8.CrossRef
50.
go back to reference United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2015 (ST/ESA/SER.A/390). 2015. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2015 (ST/ESA/SER.A/390). 2015.
52.
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 [Internet]. 2019;19(1):832. Available at: https://doi.org/10.1186/s12889-019-7136-z. 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 [Internet]. 2019;19(1):832. Available at: https://​doi.​org/​10.​1186/​s12889-019-7136-z.
53.
go back to reference Perkins JM, Lee H, James KS, Oh J, Krishna A, Heo J, et al. Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India. BMC Public Health [Internet]. 2016;16(1):1032 Available at: https://doi.org/10.1186/s12889-016-3682-9. Perkins JM, Lee H, James KS, Oh J, Krishna A, Heo J, et al. Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India. BMC Public Health [Internet]. 2016;16(1):1032 Available at: https://​doi.​org/​10.​1186/​s12889-016-3682-9.
59.
go back to reference Chauhan S, Kumar S, Patel R. Does living arrangement predict urban–rural differential in Depressive Symptoms among older adults in India? A study based on longitudinal ageing study in India survey. J Popul Ageing [Internet]. 2021;(0123456789) Available at: https://doi.org/10.1007/s12062-021-09348-0. Chauhan S, Kumar S, Patel R. Does living arrangement predict urban–rural differential in Depressive Symptoms among older adults in India? A study based on longitudinal ageing study in India survey. J Popul Ageing [Internet]. 2021;(0123456789) Available at: https://​doi.​org/​10.​1007/​s12062-021-09348-0.
Metadata
Title
Association between physical limitations and depressive symptoms among Indian elderly: marital status as a moderator
Authors
Babul Hossain
Pawan Kumar Yadav
Varsha P. Nagargoje
K. J. Vinod Joseph
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03587-3

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