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ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 3  |  Page : 157-162

A Correlational Study on Depression and Quality of Life Among Older Persons


1 SRM College of Nursing, Kattankulathur, Tamil Nadu, India
2 Department of Psychiatry, SRM Medical College and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India

Date of Submission03-May-2022
Date of Acceptance17-May-2022
Date of Web Publication3-Oct-2022

Correspondence Address:
R Vijayalakshmi
Address for correspondence: R. Vijayalakshmi, Vice Principal, SRM College of Nursing, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnpnd.ijnpnd_21_22

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   Abstract 


Background: Globally, the population of older persons is increasing rapidly. Research evidences suggest that depression is a major mental health problem among older persons. Healthy ageing practices reduce the undesirable effects of ageing. It promotes good quality of life (QOL) among older persons and reduces the risk of depression among them. Objectives: To assess depression and QOL among older persons; and to correlate depression and QOL among older persons. Materials and Methods: A cross-sectional study design was used to assess the prevalence of depression and QOL among older persons aged ≥60 years. This study was conducted in NH 1, NH 2, and NH 3 villages covered under Community Medicine Department, SRM MCH at Chengalpattu district, Tamil Nadu. Yesavage Geriatric Depression Scale was used to assess depression and WHO Quality of Life-BREF scale was used to assess QOL among older persons. A structured face-to-face interview was carried out to collect the data after getting the consent from 600 older persons. Results: This study findings convey that 64.6% of the older persons are having various levels of depression ranging from mild and moderate to severe. Highly significant negative correlation (R = −0.424) between depression and QOL of respondents is observed in this study. This implies that the older persons with good QOL have low levels of depression and older persons with poor QOL have higher levels of depression. Conclusion: The prevalence of depression among older persons is considerably higher and the QOL is a major contributing factor. Creating public awareness on measures to overcome depression and improve QOL is a vital area to be strengthened by the health team members.

Keywords: Depression, older persons, quality of life


How to cite this article:
Vijayalakshmi R, Thirunavukarasu M. A Correlational Study on Depression and Quality of Life Among Older Persons. Int J Nutr Pharmacol Neurol Dis 2022;12:157-62

How to cite this URL:
Vijayalakshmi R, Thirunavukarasu M. A Correlational Study on Depression and Quality of Life Among Older Persons. Int J Nutr Pharmacol Neurol Dis [serial online] 2022 [cited 2022 Dec 5];12:157-62. Available from: https://www.ijnpnd.com/text.asp?2022/12/3/157/357453




   Introduction Top


Globally, the population of older persons is increasing rapidly. WHO fact sheet on ageing and health reports that by 2030 one in six individuals in the world will be ≥60 years. A report from the Ministry of Statistics and Programme Implementation titled “Elderly in India 2021” states that there are around 138 million older persons in India in 2021 and among them 67 million are men and 71 million are women. By the year 2031, this number is expected to increase by 56 million.

Ageing population poses a major challenge to the health care system. Reduction in the older person’s functional mobility, chronic health problems, loss of social status, and related stressors have a negative impact on their mental health. Geriatric populations with depression are at a higher risk for chronic diseases like coronary heart disease, cancer, diabetes mellitus, and hypertension.[1] Older persons wish to be physically active, treated with respect, and doing activities that enhance their self-worth. Such individuals report good quality of life (QOL).

Research evidences suggest that depression is a major mental health problem among older persons. Older persons >55 years with depression are at risk for dying due to heart ailments or stroke.[2] Healthy ageing reduces the undesirable effects of ageing. It promotes good QOL among older persons and reduces the risk of depression among them.

Studies on depression and its correlation on QOL among older persons will shed light on the current needs of the Mental Health Services for the older persons.

Objectives of the study:

  1. To assess depression and QOL among older persons;
  2. To correlate depression and QOL among older persons.



   Materials and Methods Top


A cross-sectional study design was used to assess the prevalence of depression and QOL among older persons aged ≥60 years. The study was approved by institutional ethics committee, SRM Medical College Hospital (SRM MCH), SRM Institute of Science and Technology (SRM IST). The study was conducted in NH 1, NH 2, and NH 3 villages covered under Community Medicine Department, SRM MCH at Chengalpattu district, Tamil Nadu. The general population of the selected villages was 15,227 and geriatric population is estimated as (13.6% Older Persons; TN Policy for Senior Citizens, 2022 draft)[3] 2069. Based on the sample size calculation (4pq/L2), the sample size was estimated as 600. Yesavage Geriatric Depression Scale was used to assess depression and WHO Quality of Life-BREF scale was used to assess QOL among older persons. The scales were translated to local language and back translated for maintaining content validity of the questions. Prevalence of depression and QOL were assessed among 600 older persons using simple random sampling method. A structured interview was carried out to collect the data after getting the consent from the older persons. Chi-square test was used to analyze the association of depression with the demographic variables of older persons. Analysis of association of QOL among older persons with their demographic variables was done using t test and one-way Analysis of Variance (ANOVA). Pearson correlation was used to analyze the correlation between depression and QOL among older persons. SPSS software (IBM Version 23 ,Chennai ,Tamil Nadu) is used for the statistical analysis.


   Results Top


Analysis revealed that 311 (51.8%) older persons have mild depression, 47 (7.8%) of them have moderate depression, and 30 (5.0%) older persons have severe depression [Table 1].
Table 1 Prevalence of depression among older persons

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As per [Table 2], the P values corresponding to the demographic variables “educational status, monthly income of the family, marital status, financial status, previous occupation, current employment, serious life events in the past 1 year, any verbal abuse by significant others, any physical abuse by significant others, are you treated in a dignified and respectful manner” are <0.01 and are highly significant at 1% level; hence, we can conclude that these demographic variables have highly significant association with the level of depression.
Table 2 Association of depression among older persons with their demographic variables

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It is evident from [Table 3] that 67 (11.2%) of the older persons have good QOL, 500 (83.3%) of the older persons have fair QOL, and 33 (5.5%) of the older persons have poor QOL.
Table 3 Assessment of quality of life among older persons

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As per [Table 4], the P values corresponding to the demographic variables “educational status, monthly income of the family, financial status, previous occupation, current employment, serious life events in the past 1 year, and any physical abuse by significant others” are <0.01 and are highly significant at 1% level; and hence, we understand that the above variables have highly significant association with QOL of older persons. Also the P values corresponding to the demographic variables “religion, type of family, marital status, and are you treated in a dignified and respectful manner” are <0.05 and are significant at 5% level. Hence, we can say that there is a significant association between the demographic variables “religion, type of family, marital status, and are you treated in a dignified and respectful manner” and the level of QOL.
Table 4 Association quality of life among older persons with their demographic variables

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The domain scores of QOL reveal that physical health, psychological health, social relationship, and environment more or less equally influence the QOL of the older persons [Table 5].
Table 5 Domain scores of quality of life

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As per [Table 6], the P value 0.000 is highly significant at 1% level since it is <0.01; and hence, we can say that there is a highly significant negative correlation (R = −0.424) between depression and QOL of respondents. This implies that the older persons with good QOL have low levels of depression and older persons with poor QOL have higher levels of depression.
Table 6 Correlation between depression among older persons and quality of life

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   Discussion Top


The study results revealed that 311 (51.8%) older persons have mild depression, 47 (7.8%) of them have moderate depression, and 30 (5.0%) older persons have severe depression. It is observed that 64.6% of the older persons are having various levels of depression ranging from mild and moderate to severe.

This study finding is supported by the community-based cross-sectional survey done by Bincy et al.[4] on depression and its associated factors among older persons. In Bincy et al.’s[4] study, the prevalence of depression was 67.5%.

The demographic variables “educational status, monthly income of the family, marital status, financial status, previous occupation, current employment, serious life events in the past 1 year, any verbal abuse by significant others, any physical abuse by significant others, and are you treated in a dignified and respectful manner” have highly significant association with the levels of depression among older persons.

About 67 (11.2%) of the older persons have good QOL, 500 (83.3%) of the older persons have fair QOL, and 33 (5.5%) of the older persons have poor QOL.

The study results reveals that “educational status, monthly income of the family, financial status, previous occupation, current employment, serious life events in the past 1 year, any physical abuse by significant others, religion, type of family, marital status, and are you treated in a dignified and respectful manner” have significant association with the QOL of the older persons.

The above findings are supported by a study done by Karmakar et al.[5] This study reports that QOL of older persons is influenced by education, marital status, and chronic diseases.

Highly significant negative correlation (R = −0.424) between depression and QOL of respondents is observed in this study. This implies that the older persons with good QOL have low levels of depression and older persons with poor QOL have higher levels of depression.

Shrestha et al.[6] in their study also stated that there was a negative correlation between the level of depression among elderly and their QOL.


   Conclusion Top


This study findings convey that 64.6% of the older persons are having various levels of depression ranging from mild and moderate to severe. The associated factors are: educational status, monthly income of the family, marital status, financial status, previous occupation, current employment, serious life events in the past 1 year, verbal abuse and physical abuse by significant others, and whether treated in a dignified and respectful manner.

As per the study results “gender, religion, educational status, monthly income of the family, financial status, previous occupation, current employment, gender of children, serious life events in the past 1 year, treated in a dignified and respectful manner, and being part of any old age association” have significant association with the QOL of the older persons.

This study results disclose that the QOL is influenced by the educational status, monthly income of the family, financial status, previous occupation, current employment, serious life events in the past 1 year, and physical abuse by significant others. The domain scores of QOL convey that physical health, psychological health, social relationship, and environment more or less equally influence the QOL of the older persons.

Manasatchakun et al.[7] discussed in their study that QOL of older persons cover the multidimensional aspects in terms of healthy ageing.

Spending time with friends and loved ones, engaging in activities they enjoy like: visiting new places, temples, new hobbies, and getting involved in social activities enhances the physical and mental health of older persons. Evidence suggests that positive attitude toward ageing plays a major role in healthy ageing.

Regular exercise and an active lifestyle reduces the risk of systemic diseases and heart ailments in older adults. It further lowers stress, and improves sleep and mood. High protein and low fat diet helps the older persons to keep themselves active and energetic.

All these multidimensional aspects promote healthy ageing and help the older persons to age gracefully and have a good QOL they deserve.

The current study findings reported negative correlation between depression and QOL of older persons. This implies that the older persons without depression have good QOL and older persons with depression have poor QOL. Similar finding is reported in the study done by Cao et al.,[8] which states that all World Health Organization Quality Of Life Instrument Short Form (WHOQOL-BREF) domains, with the exception of the social domain, were negatively correlated with depression.

Depression with aging, together with multidimensional factors increases the risk of mortality, and has a negative impact on the QOL in older persons.

Akyol et al.[9] stated that chronic disease and low educational status negatively impacts the QOL and increase the level of depression in the elderly. QOL is negatively influenced with the level of depression and the pain intensity.

There is a solution for older persons to control the depression, that is, by maintaining a healthy and regular routine of activities, boosting self-image with positive thoughts, seeking help and spending time with loved ones, building strong relationships through social network and having an active social life, practicing relaxation strategies like meditation and yoga, following a healthy sleep routine, exercising regularly, following healthy diet, maintaining healthy weight, and avoiding liquor.

Depression among the older persons is a major public health concern and the QOL definitely has great impact on the mental health and physical health of the older persons. Sensitizing the public and creating public awareness on measures to overcome depression and improve QOL is a vital area to be strengthened.The health team members play a vital role in the implementation of such initiatives.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
WHO Factsheet on Ageing and Health, 4 October 2021, accessed on 20.04.2022. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health  Back to cited text no. 1
    
2.
Jacob KS. Depression: a major public health problem in need of a multi-sectoral response. Indian J Med Res 2012;136:537–9.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
4.
Bincy K, Logaraj M, Ramraj B. Depression and its associated factors among the older adults in rural, Tamil Nadu, India. Clin Epidemiol Glob Health 2021;10:100677. doi.org/10.1016/j.cegh.2020.100677.  Back to cited text no. 4
    
5.
Karmakar N, Datta A, Nag K et al. Quality of life among geriatric population: a cross-sectional study in a rural area of Sepahijala District, Tripura. Indian J Public Health 2018;62:95–9.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Shrestha K, Ojha SP, Dhungana S et al. Depression and its association with quality of life among elderly: an elderly home-cross sectional study. Neurol Psychiatry Brain Res 2020;38:1–4.  Back to cited text no. 6
    
7.
Manasatchakun P, Chotiga P, Hochwälder J et al. Factors associated with healthy aging among older persons in Northeastern Thailand. J Cross Cult Gerontol 2016;31:369–84.  Back to cited text no. 7
    
8.
Cao W, Guo C, Ping W et al. A community-based study of quality of life and depression among older adults. Int J Environ Res Public Health 2016;13:693. doi: 10.3390/ijerph13070693.  Back to cited text no. 8
    
9.
Akyol Y, Durmuş D, Doğan C et al. Quality of life and level of depressive symptoms in the geriatric population. Arch Rheumatol 2010;25:165–73. doi: 10.5152/tjr.2010.23.  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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