Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T21:57:55.809Z Has data issue: false hasContentIssue false

Prevalence and correlates of clinically significant depressive symptoms among elderly people in Sri Lanka: findings from a national survey

Published online by Cambridge University Press:  14 September 2009

Rahul Malhotra*
Affiliation:
Health Services Research, Duke–NUS Graduate Medical School, Singapore
Angelique Chan
Affiliation:
Department of Sociology, National University of Singapore, Singapore and Health Services Research, Duke–NUS Graduate Medical School, Singapore
Truls Østbye
Affiliation:
Department of Community and Family Medicine, Duke University Medical Centre, Durham, North Carolina, U.S.A. and Health Services Research, Duke–NUS Graduate Medical School, Singapore
*
Correspondence should be addressed to: Dr. Rahul Malhotra, Health Services Research, Level 4, Duke–NUS Graduate Medical School, 8 College Road, Singapore169857. Phone: +65 6516 6721; Fax: +65 6534 8632. Email: rahul.malhotra@duke-nus.edu.sg; rmalhotra@post.harvard.edu.

Abstract

Background: Elderly Sri Lankans (11.2% of the nation's population) have witnessed many years of ethnic conflict, a destructive tsunami and increasing emigration of young adults. However, very little is known about the prevalence and correlates of depression among them. The present study utilizes data from a national aging survey to document the prevalence and correlates of clinically significant depressive symptoms among community-dwelling elderly Sri Lankans (aged ≥60 years).

Methods: The 15-item Geriatric Depression Scale (GDS-15) was administered to 1181 elderly Sri Lankans; the presence of clinically significant depressive symptoms was defined as a GDS-15 score of ≥6. Sociodemographic and health correlates of depressive symptoms were assessed using logistic regression analysis. Interactions between gender and other correlates were also assessed.

Results: The prevalence of depressive symptoms was observed to be 27.8% overall: 24.0% for men, and 30.8% for women. Certain subgroups of the elderly, i.e. those with disabilities, functional limitations, perceived income inadequacy, minorities, and elderly living alone, were significantly more likely to report depressive symptoms. There was a significant interaction between gender and ethnicity.

Conclusion: The prevalence of depressive symptoms among Sri Lankan elderly people is higher than that reported for most Asian countries. Clinicians and caregivers need to be aware of the potential presence of depressive symptoms among the elderly, especially among those with lower educational levels, functional limitations, hearing difficulty, physical disability, perceived income inadequacy, and among those who live alone, and ethnic minority males.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asian Development Bank (1999). Country Briefing Paper. Women in Sri Lanka. Manila: Asian Development Bank.Google Scholar
Blank, K., Gruman, C. and Robison, J. T. (2004). Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings. Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 59, 378384.Google ScholarPubMed
Catani, C., Jacob, N., Schauer, E., Kohila, M. and Neuner, F. (2008). Family violence, war, and natural disasters: a study of the effect of extreme stress on children's mental health in Sri Lanka. BMC Psychiatry, 8, 33.CrossRefGoogle ScholarPubMed
Chachamovich, E., Fleck, M., Laidlaw, K. and Power, M. (2008). Impact of major depression and subsyndromal symptoms on quality of life and attitudes toward aging in an international sample of older adults. Gerontologist, 48, 593602.CrossRefGoogle Scholar
Chiu, H. C., Chen, C. M., Huang, C. J. and Mau, L. W. (2005). Depressive symptoms, chronic medical conditions and functional status: a comparison of urban and rural elders in Taiwan. International Journal of Geriatric Psychiatry, 20, 635644.CrossRefGoogle Scholar
Chou, K. L., Ho, A. H. and Chi, I. (2006). Living alone and depression in Chinese older adults. Aging and Mental Health, 10, 583591.CrossRefGoogle ScholarPubMed
Dean, A., Kolody, B., Wood, P. and Matt, G. E. (1992). The influence of living alone on depression in elderly persons. Journal of Aging and Health, 4, 318.CrossRefGoogle Scholar
Department of Census and Statistics Sri Lanka (2001). Literacy rates by district, sex and sector. Census of Population and Housing 2001. Colombo: Department of Census and Statistics.Google Scholar
Department of Census and Statistics Sri Lanka (2007a). Average minimum wage rates and average earnings by sector, 1989–2006. Statistical Abstract 2007. Colombo: Department of Census and Statistics.Google Scholar
Department of Census and Statistics Sri Lanka (2007b). Percentage distribution of population by ethnic group and district, Census 1981–2001. Statistical Abstract 2007. Colombo: Department of Census and Statistics.Google Scholar
Djernes, J. K. (2006). Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatrica Scandinavica, 113, 372387.CrossRefGoogle ScholarPubMed
Gaminiratne, N. (2004). Population Ageing, Elderly Welfare, and Extending Retirement Cover: The Case Study of Sri Lanka. ESAU Working Paper 3. London: Economic and Statistics Analysis Unit, Overseas Development Institute.Google Scholar
Ghodse, H. and Galea, S. (2006). Tsunami: understanding mental health consequences and the unprecedented response. International Review of Psychiatry, 18, 289297.CrossRefGoogle ScholarPubMed
Glass, T. A., De Leon, C. F. M., Bassuk, S. S. and Berkman, L. F. (2006). Social engagement and depressive symptoms in late life: longitudinal findings. Journal of Aging and Health, 18, 604628.CrossRefGoogle ScholarPubMed
Gunaratnam, H. R., Gunaratnam, S. and Somasundaram, D. (2003). The psychosocial effects of landmines in Jaffna. Medicine, Conflict and Survival, 19, 223234.CrossRefGoogle ScholarPubMed
Hahn, C. Y., Yang, M. S., Yang, M. J., Shih, C. H. and Lo, H. Y. (2004). Religious attendance and depressive symptoms among community dwelling elderly in Taiwan. International Journal of Geriatric Psychiatry, 19, 11481154.CrossRefGoogle ScholarPubMed
Herrmann, N. et al. (1996). A validation study of the Geriatric Depression Scale short form. International Journal of Geriatric Psychiatry, 11, 457460.3.0.CO;2-2>CrossRefGoogle Scholar
Hollifield, M., Hewage, C., Gunawardena, C. N., Kodituwakku, P., Bopagoda, K. and Weerarathnege, K. (2008). Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. British Journal of Psychiatry, 192, 3944.CrossRefGoogle ScholarPubMed
Institute for Research and Development (2008). National Mental Health Survey. Colombo: Institute for Research and Development.Google Scholar
Ishine, M. et al. (2005). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: III. Phuto in Vietnam. Geriatrics and Gerontology International, 5, 115121.CrossRefGoogle Scholar
Ishine, M. et al. (2006). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: VII. Khon Khen in Thailand. Geriatrics and Gerontology International, 6, 4048.CrossRefGoogle Scholar
Jain, R. K. and Aras, R. Y. (2007). Depression in the geriatric population in urban slums of Mumbai. Indian Journal of Public Health, 51, 112113.Google ScholarPubMed
Jeon, G. S., Jang, S. N., Rhee, S. J., Kawachi, I. and Cho, S. I. (2007). Gender differences in correlates of mental health among elderly Koreans. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 62, S323329.CrossRefGoogle ScholarPubMed
Kaneko, Y., Motohashi, Y., Sasaki, H. and Yamaji, M. (2007). Prevalence of depressive symptoms and related risk factors for depressive symptoms among elderly persons living in a rural Japanese community: a cross-sectional study. Community Mental Health Journal, 43, 583590.CrossRefGoogle Scholar
Kawamura, T., Shioiri, T., Takahashi, K., Ozdemir, V. and Someya, T. (2007). Survival rate and causes of mortality in the elderly with depression: a 15-year prospective study of a Japanese community sample – the Matsunoyama-Niigata suicide prevention project. Journal of Investigative Medicine, 55, 106114.CrossRefGoogle ScholarPubMed
Lee, Y. and Shinkai, S. (2005). Correlates of cognitive impairment and depressive symptoms among older adults in Korea and Japan. International Journal of Geriatric Psychiatry, 20, 576586.CrossRefGoogle ScholarPubMed
Levkoff, S. E., MacArthur, I. W. and Bucknall, J. (1995). Elderly mental health in the developing world. Social Science and Medicine, 41, 9831003.CrossRefGoogle ScholarPubMed
MacMillan, H. L. et al. (2005). Screening for depression in primary care: recommendation statement from the Canadian Task Force on Preventive Health Care. Canadian Medical Association Journal, 172, 3335.CrossRefGoogle ScholarPubMed
Matsubayashi, K. et al. (2005). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: I. Singapore. Geriatrics and Gerontology International, 5, 99106.CrossRefGoogle Scholar
McConnell, D. (2008). The Tamil people's right to self-determination. Cambridge Review of International Affairs, 21, 5976.CrossRefGoogle Scholar
Mental Health Directorate (2005). The Mental Health Policy of Sri Lanka 2005–2015. Colombo: Ministry of Healthcare and Nutrition.Google Scholar
National Secretariat for Elders (2004). National Survey on Elders 2003–04. Colombo: National Secretariat for Elders, Ministry of Women's Empowerment and Social Welfare.Google Scholar
Okumiya, K. et al. (2005). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: IV. Savannakhet in Laos. Geriatrics and Gerontology International, 5, 159167.CrossRefGoogle Scholar
Østbye, T., Malhotra, R. and Chan, A. (2009). Thirteen dimensions of health among elderly Sri Lankans: results from a national Sri Lanka aging survey. Journal of the American Geriatrics Society, epublished ahead of print, doi: 10.1111/j.1532–5415.2009.02350.x.CrossRefGoogle Scholar
Patel, V. et al. (2007). Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet, 370, 9911005.CrossRefGoogle ScholarPubMed
Perera, B., Torabi, M. R., Jayawardana, G. and Pallethanna, N. (2006). Depressive symptoms among adolescents in Sri Lanka: prevalence and behavioral correlates. Journal of Adolescent Health, 39, 144146.CrossRefGoogle ScholarPubMed
Sakagami, T. et al. (2005). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: II. Hongchon in Korea. Geriatrics and Gerontology International, 5, 107114.CrossRefGoogle Scholar
Schreiner, A. S., Hayakawa, H., Morimoto, T. and Kakuma, T. (2003). Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects. International Journal of Geriatric Psychiatry, 18, 498505.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165173). New York: The Haworth Press.Google Scholar
Siddhisena, K. A. P. (2005). Socio-economic implications of ageing in Sri Lanka: an overview. In Leeson, G. W. (ed.), Oxford Institute of Ageing Working Papers. Oxford: Oxford Institute of Ageing.Google Scholar
Skapinakis, P., Weich, S., Lewis, G., Singleton, N. and Araya, R. (2006). Socio-economic position and common mental disorders. Longitudinal study in the general population in the UK. British Journal of Psychiatry, 189, 109117.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Yeh, S. H. and Tsai, H. H. (2005). Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan. International Journal of Geriatric Psychiatry, 20, 10971102.CrossRefGoogle ScholarPubMed
United Nations (2007). World Population Ageing, 2007. New York: Economic and Social Affairs, Population Division, United Nations.Google Scholar
Victor, C., Scambler, S., Bond, J. and Bowling, A. (2000). Being alone in later life: loneliness, social isolation and living alone. Reviews in Clinical Gerontology, 10, 407417.CrossRefGoogle Scholar
Wada, T. et al. (2005a). Depression, activities of daily living, and quality of life of community-dwelling elderly in three Asian countries: Indonesia, Vietnam, and Japan. Archives of Gerontology and Geriatrics, 41, 271280.CrossRefGoogle ScholarPubMed
Wada, T. et al. (2005b). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: VI. Maubin in Myanmar. Geriatrics and Gerontology International, 5, 276285.CrossRefGoogle Scholar
Wada, T. et al. (2005c). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: V. West Java in Indonesia. Geriatrics and Gerontology International, 5, 168175.CrossRefGoogle Scholar
Wancata, J., Alexandrowicz, R., Marquart, B., Weiss, M. and Friedrich, F. (2006). The criterion validity of the Geriatric Depression Scale: a systematic review. Acta Psychiatrica Scandinavica, 114, 398410.CrossRefGoogle ScholarPubMed
WHO Country Office for Sri Lanka (2008). Mental Health Update. Colombo: WHO Country Office for Sri Lanka.Google Scholar
Williamson, G. M. and Schulz, R. (1992). Physical illness and symptoms of depression among elderly outpatients. Psychology and Aging, 7, 343351.CrossRefGoogle ScholarPubMed
Wong, S. Y., Mercer, S. W., Woo, J. and Leung, J. (2008). The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population. BMC Public Health, 8, 119.CrossRefGoogle Scholar
World Bank (2008). Sri Lanka. Addressing the Needs of an Aging Population. Report No. 43396-LK. Human Development Unit South Asia Region, World Bank.Google Scholar
Yesavage, J. A. (2009). Geriatric Depression Scale. Available at: http:www.stanford.edu/~yesavage/GSD.html.Google Scholar
Zoysa, P. D. (2001). Conflict-related trauma in an Asian country: a report from Sri Lanka. International Review of Psychiatry, 13, 201208.CrossRefGoogle Scholar