Symptoms of depression in elderly : A comparative study on people aged 65 years and above living in an old age home and in their own home in Nepal.

Abstract

Objective: To compare the severity of the symptoms of depression among the people aged 65 years and above living in an old age home and in their own home.

Methods: The present study comprised of total 260 people aged 65 years and above (130 from Social Welfare center old age home Pashupatinath Kathmandu Nepal and 130 people aged 65 years and above from different VDCs of Rasuwa district Nepal). The interview through structured questionnaire was used to collect data of background (socio-demographic) variables and independent variables. Geriatric depression scale (long form) was used to collect the data on severity of the symptoms of depression. The severity of symptoms of depression as an outcome variable consisting three categories normal (0-9), mild (10-19) and severe depression (20-30) were assessed with geriatric depression scale. Cross tabulation and chi-square test were applied to measure the association of variables. Multivariate logistic regression analysis was used to calculate the crude and adjusted odd ratios (OR) with their 95% confidence intervals (CI).

Results:The severity of the symptoms of depression was higher in the residents of old age home (59.2 percent severe symptoms of depression) than in residents of their own home (20.8 percent severe symptoms of depression). The people living in old age home had higher likelihood of having symptoms of depression [OR 10.93, 95%CI (5.05-23.65)]. Gender and marital status were significantly associated with severity of symptoms of depression in both groups. Female gender had higher likelihood of having severe symptoms of depression than male. Widows/widowers had more likelihood of having severe symptoms than the people with other marital status. Literacy and caste were not associated with symptoms of depression for both groups. Age, occupation before age of 65 years and religion were associated only for those living in their own home. Self reported health, total disease present, level of satisfaction of life, perception of life and perception about old age showed significant association with mild and severe symptoms of depression in the people living in old age home even after adjusting for all socio-demographic variables. However among the people living in their own home only the perception of life, level of satisfaction of life and leisure time activities were significantly associated with mild and severe symptoms of depression.

Conclusion:Compared to old aged people residing in their own home, those residing in old age home had the higher likelihood of having symptoms of depression. The place of residence matters a lot to determine the symptoms of depression and there may be separate determinants of severity of symptoms of depression in case of old aged people living in an old age home and those living in their own home.Keywords: elderly, depression, symptoms, old age home, Nepal, mental health, GDS