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Published: 2023-11-29

Factors Associated with Depressive Symptoms Among Community-Dwelling Older People in East-Coast Malaysia

Kulliyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
Kulliyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
Kulliyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
Kulliyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
School of Nursing, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
aging community-dwelling depression elderly factor mental health

Abstract

Older people are increasing in number globally, and they are likely to have mental health problems, including depression. In this population, the risk of having depressive symptoms is very high due to multidimensional factors, but these symptoms are often undertreated. This study aimed to determine the prevalence and associated factors of depressive symptoms among community-dwelling older people living on the East Coast of Malaysia. A cross-sectional study was conducted in several areas of the state of Terengganu based on multilayered stratified sampling. A total of 240 participants were randomly selected. Several instruments were employed, such as the Geriatric Depression Scale, University of California Los Angeles Loneliness Scale, Pittsburgh Sleep Quality Index, Elderly Cognitive Assessment Questionnaire, Multidimensional Scale of Perceived Social Support, Duke University Religion Index, Barthel Modified Index, and Instrumental Activities of Daily Living Scale. The prevalence of depressive symptoms was 24.6%. The results of the multivariate logistic regression model also revealed that being a single elderly (adjusted odd ratio [aOR] = 4.42; Confidence Interval [CI] = 1.22; 15.96), poor social support (aOR = 3.06; CI = 1.18; 7.93), loneliness (aOR = 21.11; CI = 9.87; 45.18), impaired functional status (aOR = 3.39; CI = 1.22; 9.39), impaired instrumental function (aOR = 6.09; CI = 1.95; 19.0), and having asthma (aOR = 14.14; CI = 2.83; 70.5) were associated with depressive symptoms. Thus, screening older people during primary care is needed for early detection of depression and initiation of community-based interventions to address the psychological aspects of this disorder.

Keywords: aging, community dwelling, depression, elderly, factor, mental health

Abstrak

Faktor-Faktor yang Berkaitan dengan Gejala Depresi pada Kalangan Lansia di Pantai Timur Malaysia. Jumlah penduduk lanjut usia di seluruh dunia semakin meningkat, dan mereka cenderung mempunyai masalah kesehatan mental, termasuk depresi. Pada populasi ini, risiko terjadinya gejala depresi sangat tinggi karena faktor multidimensi, namun gejala tersebut seringkali tidak tertangani. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor-faktor yang berhubungan dengan gejala depresi di kalangan lansia yang tinggal di Pantai Timur Malaysia. Sebuah studi cross-sectional dilakukan di beberapa wilayah negara bagian Terengganu berdasarkan multilayered stratified sampling. Sebanyak 240 peserta dipilih secara acak. Beberapa instrumen yang digunakan antara lain Geriatric Depression Scale, University of California Los Angeles Loneliness Scale, Pittsburgh Sleep Quality Index, Elderly Cognitive Assessment Questionnaire, Multidimensional Scale of Perceived Social Support, Duke University Religion Index, Barthel Modified Index, dan Instrumental Activities of Daily Living Scale. Prevalensi gejala depresi adalah 24,6%. Hasil multivariate logistic regression model juga mengungkapkan bahwa menjadi lansia tunggal (adjusted odds ratio [aOR] = 4,42; Confidence Interval [CI] = 1,22; 15,96), dukungan sosial yang buruk (aOR = 3,06; CI = 1,18; 7,93), kesepian (aOR = 21,11; CI = 9,87; 45,18), gangguan status fungsional (aOR = 3,39; CI = 1,22; 9,39), gangguan fungsi instrumental (aOR = 6,09; CI = 1,95; 19,0), dan menderita asma (aOR = 14,14; CI = 2,83; 70,5) berhubungan dengan gejala depresi. Oleh karena itu, memeriksa lansia selama perawatan utama diperlukan untuk deteksi awal depresi dan inisiasi intervensi berbasis komunitas yang dapat mengatasi aspek psikologis dari gangguan ini.

Kata Kunci: depresi, faktor, kesehatan mental, lansia, penuaan, tempat tinggal komunitas

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th ed.). American Psychiatric Publishing.
  2. Ashe, S., & Routray, D. (2019). Prevalence, associated risk factors of depression and mental health needs among geriatric population of an urban slum, Cuttack, Odisha. International Journal of Geriatric Psychiatry, 34(12), 1799–1807. doi: 10.1002/gps.5195.
  3. Aznan, M., CM, M., Suriati, N., & Zubir, M. (2019). Prevalence of depressive symptoms among elderly and its predictors: A cross sectional study in community Felda Bukit Goh, Kuantan Pahang. Journal of Family Medicine Forecast, 2(2), 1022.
  4. Bae, S.M. (2020). Factors associated with depressive symptoms among elderly Koreans: The role of health status, work ability, financial problems, living alone, and family relationships. Psychogeriatrics Society, 20(3), 304–309. doi: 10.1111/psyg.12499.
  5. Bhamani, M.A., Karim, M.S., & Khan, M.M. (2013). Depression in the elderly in Karachi, Pakistan: A cross sectional study. BMC Psychiatry, 13, 181. doi: 10.1186/1471-244X-13-181.
  6. Bincy, K., Logaraj, M., & Ramraj, B. (2021). Depression and its associated factors among the older adults in rural, Tamilnadu, India. Clinical Epidemiology and Global Health, 10, 100677. doi: 10.1016/j.cegh.2020.100677.
  7. Charoensakulchai, S., Usawachoke, S., Kongbangpor, W., Thanavirun, P., Mitsiriswat, A., Pinijnai, O., Kaensingh, S., Chaiyakham, N., Chamnanmont, C., Ninnakala, N., Hiri-O-Tappa, P., Ponginsee, V., Atichatpongsuk, V., Asawathepmetha, E.O., Thongprayoon, C., Mao, M.A., Cheungpasitporn, W., Varothai, N., & Kaewput, W. (2019). Prevalence and associated factors influencing depression in older adults living in rural Thailand: A cross-sectional study. Geriatrics and Gerontology International, 19(12), 1248–1253. doi: 10.1111/ggi.13804.
  8. Cherry, N., Chowdhury, M., Haque, R., McDonald, C., & Chowdhury, Z. (2012). Disability among elderly rural villagers: Report of a survey from Gonoshasthaya Kendra, Bangladesh. BMC Public Health, 12, 379. doi: 10.1186/1471-2458-12-379.
  9. Cong, L., Dou, P., Chen, D., & Cai, L. (2015). Depression and associated factors in the elderly cadres in Fuzhou, China: A Community-based Study. International Journal of Gerontology, 9(1), 29–33. doi: 10.1016/j.ijge.2015.02.001.
  10. Dai, H-lei., Yu, Z-bin., You, L-qing., Fan, M-hua., Zhu, H-wei., Jiang, D-jie., Wu, M-yin., Lin, S-juan., Zhang, X-cong., & Chen, K. (2019). Association between social health status and depressive symptoms among community-dwelling elderly adults in Zhejiang Province, China. Journal of Zhejiang University: Science B, 20(11), 910–919. doi: 10.1631/jzus.B1900207.
  11. Din, H.M., Adnan, R.N.E.R., & Minhat, H.S. (2018). Psychometric properties of Malay version of the multidimensional scale of perceived social support (MSPSS-M) among older persons living in community in Selangor. Putra Research Symposium, Selangor, Malaysia.
  12. Disu, T.R., Anne, N.J., Griffiths, M.D., & Mamun, M.A. (2019). Risk factors of geriatric depression among elderly Bangladeshi people: A pilot interview study. Asian Journal of Psychiatry, 44, 163–169. doi: 10.1016/j.ajp.2019.07.050.
  13. Economic Research Institute for ASEAN and East Asia (ERIA). (2019). Demand of long-term care: Older persons living alone. In Hayashi R. (Eds.), Demand and supply of long-term care for older persons in Asia (pp. 10-18). ERIA Research Project Report. Retrieved from: https://www.eria.org/uploads/media/8_RPR_FY2018_08_Chapter_3.pdf
  14. El-Gilany, A.H., Elkhawaga, G.O., & Sarraf, B.B. (2018). Depression and its associated factors among elderly: A community-based study in Egypt. Archives of Gerontology and Geriatrics, 77, 103–107. doi: 10.1016/j.archger.2018.04.011.
  15. Farah, N.M.F., Yee, T.S., & Rasdi, H.F.M. (2019). Self-reported sleep quality using the Malay version of the Pittsburgh sleep quality index (PSQI-M) in Malaysian adults. International Journal of Environmental Research and Public Health, 16(23), 4750. doi: 10.3390/ijerph16234750.
  16. Fatima, M., Sehar, A., Ali, M., Iqbal, A., & Shaukat, F. (2019). Incidence of depression among community dwelling healthy elderly and the predisposing socio-environmental factors. Cureus, 11(3), e4292. doi: 10.7759/cureus.4292.
  17. Güzel, A., & Kara, F. (2020). Determining the prevalence of depression among older adults living in Burdur, Turkey, and their associated factors. Psychogeriatrics, 20(4), 370-376. doi: 10.1111/psyg.12515.
  18. Hamzah, N.A.R., Adznam, S.N.A., Mohd Taib, M.N., Mun, C.Y., Ibrahim, Z., & Azam, S. (2018). Contributions of sociodemographic and psychosocial characteristics, functional status and physical activity level on prevalence of depressive symptoms among rural elderly in Johor state. Malaysian Journal of Nutrition, 24(2), 175–183.
  19. Harith, S., & Tan, S.L. (2020). Translation and validation of the Malay version of comprehensive geriatric assessment questionnaire for older adults in Malaysia. Annals of Geriatric Medicine and Research, 24(2), 115–124. doi: 10.4235/AGMR.20.0005.
  20. He, G., Xie, J.F., Zhou, J.D., Zhong, Z., Qin, C., & Ding, S. (2016). Depression in left-behind elderly in rural China: Prevalence and associated factors. Geriatrics and Gerontology International, 16(5), 638–643. doi: 10.1111/ggi.12518.
  21. Hussein, S.Z., Ismail, A.H., & Bakar, S.H.A. (2021). Loneliness and health outcomes among Malaysian older adults. Makara Journal of Health Research, 25(2), 3. doi: 10.7454/msk.v25i2.1277.
  22. Ismail, Z., Ibrahim, W., & Baharuddin, E. (2012). Religious participations among the older persons in Malaysia. Advances in Natural and Applied Sciences, 6(3), 388–391.
  23. Jha, R.M., Kumari, P., & Prakash, A. (2019). Psychology of depression in elderly: A review. EC Psychology and Psychiatry, 8(2019), 263-272.
  24. Kavithai, P., R., A., Bhuvaneswary, S., & Prakash, M. (2018). A cross sectional study on screening for depression among elderly in rural areas of Puducherry, India. International Journal of Research in Medical Sciences, 7(1), 46-51. doi: 10.18203/2320-6012.ijrms20185361.
  25. Khaltar, A., Priyadarshani, N.G.W., Delpitiya, N.Y., Jayasinghe, C., Jayasinghe, A., Arai, A., & Tamashiro, H. (2017). Depression among older people in Sri Lanka: With special reference to ethnicity. Geriatrics and Gerontology International, 17(12), 2414–2420. doi: 10.1111/ggi.13090.
  26. Kiyoshige, E., Kabayama, M., Gondo, Y., Masui, Y., Inagaki, H., Ogawa, M., Nakagawa, T., Yasumoto, S., Akasaka, H., Sugimoto, K., Ikebe, K., Arai, Y., Ishizaki, T., Rakugi, H., & Kamide, K. (2019). Age group differences in association between IADL decline and depressive symptoms in community-dwelling elderly. BMC Geriatrics, 19(1), 309. doi: 10.1186/s12877-019-1333-6.
  27. Konda, P.R., Sharma, P.K., Gandhi, A.R., & Ganguly, E. (2018). Geriatric depression and its correlates among South Indian urbans. Journal of Depression and Anxiety, 7(4), 314. doi: 10.4172/2167-1044.1000314.
  28. Kua, E.H., & Ko, S.M. (1992). A questionnaire to screen for cognitive impairment among elderly people in developing countries. Acta Psychiatrica Scandinavica, 85(2), 119–122. doi: 10.1111/j.1600-0447.1992.tb01454.x.
  29. Kugbey, N., Nortu, T.A., Akpalu, B., Ayanore, M.A., & Zotor, F.B. (2018). Prevalence of geriatric depression in a community sample in Ghana: Analysis of associated risk and protective factors. Archives of Gerontology and Geriatrics, 78, 171–176. doi: 10.1016/j.archger.2018.06.014.
  30. Li, J., Theng, Y.L., & Foo, S. (2015). Depression and psychosocial risk factors among community-dwelling older adults in Singapore. Journal of Cross-Cultural Gerontology, 30(4), 409–422. doi: 10.1007/s10823-015-9272-y.
  31. Manandhar, K., Risal, A., Shrestha, O., Manandhar, N., Kunwar, D., Koju, R., & Holen, A. (2019). Prevalence of geriatric depression in the Kavre district, Nepal: Findings from a cross sectional community survey. BMC Psychiatry, 19(1), 271. doi: 10.1186/s12888-019-2258-5.
  32. Md Nor, N.N.F., & Ghazali, S. (2016). Loneliness and it’s impacts to the health of elderly in rural Pahang. International Journal of Environment, Society and Space, 4(1), 29–37.
  33. Mirkena, Y., Reta, M.M., Haile, K., Nassir, Z., & Sisay, M.M. (2018). Prevalence of depression and associated factors among older adults at Ambo town, Oromia region, Ethiopia. BMC Psychiatry, 18(1), 338. doi: 10.1186/s12888-018-1911-8.
  34. Mohebbi, M., Agustini, B., Woods, R.L., McNeil, J.J., Nelson, M.R., Shah, R.C., Nguyen, V., Storey, E., Murray, A.M., Reid, C.M., Kirpach, B., Wolfe, R., Lockery, J.E., Berk, M., & ASPREE Investigator Group. (2019). Prevalence of depressive symptoms and its associated factors among healthy community-dwelling older adults living in Australia and the United States. International Journal of Geriatric Psychiatry, 34(8), 1208–1216. doi: 10.1002/gps.5119.
  35. Nurasikin, M.S., Aini, A., Syarinaz, A., & Ng, C. (2010). Validity and reliability of the Malay version of Duke University Religion Index (DUREL-M) among a group of nursing student. Malaysian Journal of Psychiatry, 19(2), 68–72.
  36. Park, J.I., Park, T.W., Yang, J.C., & Chung, S.K. (2016). Factors associated with depression among elderly Koreans: The role of chronic illness, subjective health status, and cognitive impairment. Psychogeriatrics Society, 16(1), 62–69. doi: 10.1111/psyg.12160.
  37. Pilania, M., Yadav, V., Bairwa, M., Behera, P., Gupta, S.D., Khurana, H., Mohan, V., Baniya, G., & Poongothai, S. (2019). Prevalence of depression among the elderly (60 years and above) population in India, 1997-2016: A systematic review and meta-analysis. BMC Public Health, 19(1), 832. doi: 10.1186/s12889-019-7136-z.
  38. Puspadewi, A.A.R., & Rekawati, E. (2017). Depresi berhubungan dengan kualitas hidup lansia di Panti Sosial Tresna Werdha di Jakarta. Jurnal Keperawatan Indonesia, 20(3), 133-138. doi: 10.7454/JKI.V20I3.636.
  39. Putri, S.I., & Fitriyani, P. (2016). Gambaran tingkat depresi lansia yang melakukan senam di Panti Sosial Tresna Werdha di Jakarta. Jurnal Keperawatan Indonesia, 19(2), 92-99. doi: 10.7454/jki.v19i2.464.
  40. Rajapakshe, O.B.W., Sivayogan, S., & Kulatunga, P.M. (2019). Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka. Psychogeriatrics, 19(3), 202–211. doi: 10.1111/psyg.12389.
  41. Rashid, A., & Tahir, I. (2015). The prevalence and predictors of severe depression among the elderly in Malaysia. Journal of Cross-Cultural Gerontology, 30(1), 69–85. doi: 10.1007/s10823-014-9248-3.
  42. Shao, P., Xu, Y., & Pan, C.W. (2017). Factors associated with and prevalence of depressive features amongst older adults in an urban city in eastern China. The South African Journal of Psychiatry, 23(1), a1064. doi: 10.4102/sajpsychiatry.v23i0.1064.
  43. Simkhada, R., Wasti, S.P., Gc, V.S., & Lee, A.C.K. (2018). Prevalence of depressive symptoms and its associated factors in older adults: A cross-sectional study in Kathmandu, Nepal. Aging and Mental Health, 22(6), 802–807. doi: 10.1080/13607863.2017.1310803.
  44. Song, D., Yu, D.S.F., Li, P.W.C., & Sun, Q. (2019). Identifying the factors related to depressive symptoms amongst community-dwelling older adults with mild cognitive impairment. International Journal of Environmental Research and Public Health, 16(18), 3449. doi: 10.3390/ijerph16183449.
  45. Swami, V. (2009). Psychometric analysis of the Malay version of the UCLA Loneliness Scale (ULS-8) and a comparison of loneliness among sojourning and non-sojourning Malaysian students. International Journal of Culture and Mental Health, 2(1), 38–50. doi: 10.1080/17542860802560397.
  46. Tanjanai, P.T., Moradinazar, M., & Najafi, F. (2017). Prevalence of depression and related social and physical factors amongst the Iranian elderly population in 2012. Geriatrics and Gerontology International, 17(1), 126–131. doi: 10.1111/ggi.12680.
  47. Teh, E.E., & Hasanah, C.I. (2004). Validation of Malay version of geriatric depression scale among older adult inpatients. Geriatric Depression, 1-11.
  48. Thilak, S.A., Sarada, A.K., & Neloopant, S.A. (2016). Prevalence and factors associated with depression among the elderly in rural areas of Kannur, North Kerala, India: A cross sectional study. International Journal of Community Medicine and Public Health, 3(8), 1986–1991. doi: 10.18203/2394-6040.ijcmph20162184.
  49. The Best Practice Advocacy Centre New Zealand (BPACnz). (2011). Best practice: Assessment and management of depression in older Adults. Best Practice Journal. Retrieved from: https://bpac.org.nz/BPJ/2011/July/docs/bpjse_elderly_depression_2011.pdf
  50. Vanoh, D., Shahar, S., Yahya, H.M., & Hamid, T.A. (2016). Prevalence and determinants of depressive disorders among community-dwelling older adults: Findings from the towards useful aging study. International Journal of Gerontology, 10(2), 81–85. doi: 10.1016/j.ijge.2016.02.001.
  51. Widiani, E., Hidayah, N., & Hanan, A. (2023). Anxiety, depression, loneliness, spirituality, and social support in older people during the COVID-19 pandemic. Jurnal Keperawatan Indonesia, 26(2), 79-88. doi: 10.7454/jki.v26i2.1093.
  52. Winahyu, K.M., & Sari, A.R. (2017). The relationship between religiosity and depression of older adults in Tangerang [Oral Presentation]. International Conference on Disaster Management and Infection Control (ICDMIC 2017), Bandung, Indonesia.
  53. World Health Organization (WHO). (2017, December 12). Mental health of older adults. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults#
  54. Yadav, U.N., Thapa, T.B., Mistry, S.K., Pokhrel, R., & Harris, M.F. (2020). Sociodemographic characteristics, lifestyle factors, multi-morbid conditions and depressive symptoms among Nepalese older adults. BMC Psychiatry, 20, 261. doi: 10.1186/s12888-020-02680-3.
  55. Yánez, Á.C., Apip, M.P.M., & Kellogg, G.L. (2019). The elderly and implications of their biopsychosocial needs for health care in Latin America. MOJ Gerontology & Geriatrics, 4(6), 223–227. doi: 10.15406/mojgg.2019.04.00210.

How to Cite

Zakaria, S. S., Jaafar, S. N. I., Che Hasan, M. K., Nik Mohd Hatta, N. N. K., & Wan Abdul Rahman, W. N. A. (2023). Factors Associated with Depressive Symptoms Among Community-Dwelling Older People in East-Coast Malaysia. Jurnal Keperawatan Indonesia, 26(3), 129–141. https://doi.org/10.7454/jki.v26i3.1073