Prevalence and associated factors of depression among older adults in rural Tanzania

• Published in: International journal of geriatric psychiatry Vol. 36; no. 10; pp. 1559 - 1566
• Main Authors: Mlaki, Damas Andrea, Asmal, Laila, Paddick, Stella‐Maria, Gray, William K., Dotchin, Catherine, Walker, Richard
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.10.2021
• Subjects: Dementia; Dementia disorders; depression; epidemiology; Geriatric psychiatry; Mental depression; Mental disorders; Morbidity; older adults; Older people; prevalence; Regression analysis; Risk factors; Tanzania; Tanzania; epidemiology; Depression; Prevalence; Older adults; Risk Factors; Tanzania
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.5584

Objectives Depression is the commonest mental disorder in older adults worldwide, affecting 7% of the world’s older population and accounting for 5.7% of years lived with disability among adults aged over 60 years. We conducted a secondary data analysis to determine the point prevalence, associated risk factors and treatment gap for DSM‐IV depression among older adults in the Hai District, rural Tanzania. Methods The primary data source was a cross‐sectional two‐stage community‐based dementia study where older adults aged ≥70 years (n = 296) were fully‐assessed for dementia and depression in the second stage. Age‐adjusted prevalence of depression was determined based on the WHO standard population using the Direct Method. Univariate and multivariate logistic regression models were performed. Results Of the 296 older adults assessed for depression, 48 were diagnosed with depression based on Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. The median (Inter Quartile Range; QR) age was 80 (75–88) years. Age‐adjusted point prevalence of depression was 21.2% (95% CI: 16.6–21.9) and the treatment gap for depression was 100%. There was reduced odds of depression in older adults who rated their physical health as good or very good (adjusted odds ratio [AOR] = 0.22; 95%CI: 0.10–0.46; p < 0.001), or moderate (AOR 0.26; 95%CI: 0.10–0.66; p = 0.005). Conclusions Depression in older adults is associated with physical health status and there is an alarmingly high treatment gap. Future research on depression in older adults should focus on effective interventions to address physical morbidity, psychosocial factors and the treatment gap. Key Points Despite depression being the commonest mental disorder in older adults reported worldwide, in Sub‐Saharan Africa, the epidemiological data on depression in this population group are limited. We found point prevalence estimates of depression in older adults similar to those reported in community‐based studies in high income countries. Self‐rated overall physical health status was associated with depression in older adults. Future research on depression in older adults should focus on the physical morbidity, psychosocial factors and the treatment gap.