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DEPRESSION AND QUALITY OF LIFE AMONG THE ELDERLY IN IDO/OSI LOCAL GOVERNMENT AREA OF EKITI STATE

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Supervisor: Prof F.O. Fatoye Dr M.A Lawal
Faculty: PSYCHIATRY
Institution of Training: OAUTH OSUN
Month: 10
Year: 2016

Abstract

BACKGROUND The quality of life (QoL) of the elderly is determined by various factors such as illness, financial status and social security among others. Depression in the elderly is associated with significant impairment in everyday functioning, negatively affects the quality of life and constitute huge burden on the family members and the society at large. There is dearth of research and community based studies especially in rural settings about the profiles and quality of life (QoL) of depressed elderly among Africans. OBJECTIVE The objectives of this study were to determine the prevalence of depression and its relationship with subjective quality of life (QoL) among the elderly in Ido/Osi Local Government Area of Ekiti state as well as to evaluate the associated factors. METHODS A total of 350 elderly subjects (male=210, female=140) were recruited from the constituent towns and villages of Ido/Osi Local Government Area. Each of the respondents completed a semi-structured socio-demographic questionnaire, the Geriatric Depression Scale (GDS) and the World Health Organization Quality of Life-short version (WHOQoL-BREF). They were also interviewed with modified Mini Mental State Examination (mMMSE) questionnaire and MINI (suicidality subscale). Furthermore, respondents that were found to be GDS positive as well as 10% of GDS negative respondents were further assessed with MINI (depression subscale) to diagnose depression. RESULTS Most of the respondents were within the age range 60 – 79 years (78.8%) and 70% (245) were currently married. Majority of the respondents were Christians and of Yoruba ethnicity. Using the GDS, forty-one respondents (11.7%) were considered depressed (GDS≥11). The severity of depression ranges from mild (10.6%) to severe (1.1%). Among the 72 respondents on which MINI (depression subscale) was administered, 27 (7.7%) met criteria for the diagnosis of major depressive episode (current) while 13 (3.7%) met criteria for recurrent depressive disorder. Thirteen respondents (3.7%) had varying degrees of suicide risk and 255 (72.9%) had normal cognition (MMSE≥23). Comparing depressed and non-depressed respondents on socio-demographic variables, statistically significant differences were observed between the groups on marital status, history of bereavement in the last 6 months, suicidality and cognitive status (p≤ 0.002). Also, the non-depressed respondents had statistically significant higher scores in the overall subjective QoL, health satisfaction and all the other four domains of WHOQoL-BREF (p<0.001). The association between QoL, socio-demographic and other variables shows that male sex and younger respondents (60 – 69years) had higher QoL scores. Also, respondents with history of mental illness and bereavement in the last 6months, suicidality and cognitive impairment had lower QoL scores. Multiple logistic regression analysis showed that bereavement in the last 6 months, psychological health (domain 2) of the WHOQoL- BREF and suicidality independently predicted depression among the respondents. CONCLUSION This study has shown that depression among the elderly in rural communities was significantly higher among those who were recently bereaved, with high suicidality and lower score on psychological domain of the WHOQoL-BREF. There is the need for physicians to routinely screen for depression among the elderly especially among those with the history of recent bereavement. Furthermore, research is required to explore the relationships between depression and bereavement using a longitudinal approach to allow causal inference.

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